Urinary tract infections in children

Specialty of Nephrology

What is a UTI?

A UTI, or urinary tract infection, is the one of the most common infections in children. It is not difficult to diagnose due to characteristic symptoms and non-invasive investigations, however it does need to be treated timely and effectively to avoid any long-term damage to the kidneys, especially in young children.

What are the symptoms?

Symptoms and signs can often be non-specific in infancy including vomiting, diarrhoea, loss of appetite and weight, and being irritable. At this age, it is very important for parents to get their baby checked if they feel their baby is not well for an unknown reason.

In older children (after infancy), a UTI usually displays symptoms of pain when passing urine, fever (usually above 38 degrees), and/or feeling generally unwell. A UTI can be associated with other symptoms including pain in the abdomen/flanks, vomiting, loss of appetite etc.

In adolescence and older age groups a UTI can present with localised symptoms such as cystitis, an inflammation of only the bladder when the patient is otherwise feeling well, but experiences pain when passing urine

How is it diagnosed?

The symptoms of a UTI are usually specific enough for the paediatrician or doctor to make a diagnosis. The diagnosis can further be supported with other simple investigations such as checking the urine sample for pus cells, and nitrite, an enzyme present due to bacteria. The gold standard of investigation is still to culture the urine in a laboratory to see which bacteria is causing the infection, if any.

Sometimes, further investigations may be needed including an ultrasound of the kidneys/bladder, and other special types of X-rays, more so in younger children.

How is it treated?

UTIs are often easy to treat with 1st line antibiotics, and the duration of antibiotic prescription is often less than a week. It is important for the doctor to prescribe the right kind of antibiotic, based on the culture sent to the laboratory.

Can a UTI be prevented?

UTIs are often caused through poor bladder habits, lack of correct hygiene, constipation, and poor liquid intake.

Parents should encourage their children to drink at least 6-8 glasses of clear liquid every day, empty their bladder regularly during the daytime, have a regular bowel habit with soft stool, and maintain good hygiene. Daily showers/baths are recommended, if possible.

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