Infants health

Urinary Tract Infection in Infants

July 12 , 2018
Dr. Rasha Qaqish
My name is Rasha Munir Qaqish, I lived my childhood in Jordan where I studied at the Ahliyyah School for Girls....More

Urinary tract infection (UTI) is one of the most common pediatric infections. It distresses the child, concerns the parents, and may cause permanent kidney damage. Occurrences of a first-time symptomatic UTI are highest in boys and girls during the first year of life and markedly decrease after that.

Febrile infants younger than 2 months constitute an important subset of children who may present with fever without a localizing source. The workup of fever in these infants should always include evaluation for UTI.

 

How to Diagnose?

To diagnose you need both an abnormal urinalysis result, and a positive urine culture result are needed to confirm inflammation.

A positive culture result is defined as at least 50,000 colony-forming units per mL, rather than the previous criterion of at least 100,000 colony-forming units per ml.

Guidance is added for using clinical criteria to establish a threshold to decide whether to obtain a urine specimen

UTIs are much more common in girls because a girl's urethra is shorter and closer to the anus. Uncircumcised boys younger than 1 year also have a slightly higher risk for a UTI.

 

Causes include:

1. A problem in the urinary tract (for example, a malformed kidney or a blockage somewhere along the tract of normal urine flow)

an abnormal backward flow (reflux) of urine from the bladder up the ureters and toward the kidneys. This is known as vesicoureteral reflux (VUR), and many kids with a UTI are found to have it.

2. Poor toilet and hygiene habits (i.e. when changing for your child especially girls,  wipe from front to back after urinating or passing a bowel movement.

3. Family history of UTIs

 

What are the Symptoms?

  • Could be only fever, irritability,
  • Burning or pain when your child pees.
  • Foul-smelling or cloudy pee.
  • An urgent need to go, and then only peeing a few drops.
  • Nausea or vomiting.
  • Diarrhea.

 

How is it treated?

The recommended initial antibiotic for most children with UTI is trimethoprim/sulfamethoxazole. Alternative antibiotics include amoxicillin/clavulanate or cephalosporins.

A two- to four-day course of oral antibiotics is as effective as a seven- to 14-day course in children with a lower UTI. A single-dose or single-day course is not recommended.

Children with acute pyelonephritis can be treated effectively with oral antibiotics (e.g., amoxicillin/clavulanate, cefixime, ceftibuten) for 10 to 14 days or with short courses (two to four days) of intravenous therapy followed by oral therapy.

 

It is worth mentioning here that any medicine should not be taken before consulting the physician and starting any antibiotic course without a physician’s recommendation is something should not be tolerated.