Pediatric Urinary Tract Infection (UTI)
What Is a UTI?
A urinary tract infection (UTI) is a bacterial infection in the genitourinary system, which is made up of the kidneys, ureters, bladder, urethra and genital organs. It is a common condition in children that occurs when bacteria enter the urethra. While a UTI can affect any of the urinary or genital organs, the most common types of infections are cystitis (bladder infection) and pyelonephritis (kidney infection).
Common Types of UTIs and Symptoms
Cystitis (Bladder Infection)
This type of infection occurs when there is bacterial growth in the bladder urine, causing urinary symptoms without fever. Common symptoms include:
- Frequent urination or urinary incontinence (such as needing to go to the bathroom often or “accidents” in a potty trained child)
- Burning with urination (hurts to go to the bathroom)
- Needing to use the restroom more often and/or feeling an urgency to urinate
- Abdominal pain
Pyelonephritis (Kidney Infection)
A kidney infection occurs when a bacterial infection moves up the urinary tract. It can also result from an obstruction in the urinary tract. Common symptoms include:
- Decreased appetite
- Back pain
How Are UTIs Diagnosed?
A urine analysis is necessary in order to make an accurate diagnosis. Children with a UTI will have urine-culture results that show white blood cells and/or a significant amount of bacteria in their urine. In addition, a child with a UTI will experience changes in their urinary habits, such as needing to urinate more frequently or feeling an increased urge to urinate.
For children who are potty trained, a urine sample can be collected and sent for a urine culture. For a child who is not potty trained, we will need to use a catheter to ensure proper collection of the urine sample.
Urine culture results are generally available in 2 to 3 days. The urine culture will give information that is vital for treatment including identifying the type of bacteria that is growing, how much bacteria is growing, and which antibiotics will be most effective for your child’s infection. If the urine culture is negative, but the child shows symptoms, we will discuss the issues your child is having and target specific behavioral and toileting modifications for them.
How Are UTIs Treated?
Depending on urine culture results, antibiotics will be tailored to the type of bacteria found.
Also, optimizing bathroom hygiene habits can be very successful for children with recurrent non-febrile (without fever) UTI’s. Behavioral modification techniques, or re-learning bathroom habits such as re-teaching toileting practices like wiping from front to back, tailored to your child’s specific symptoms or complaints will be important. This may also include constipation management (difficulty having a bowel movement, hard or infrequent stools), which can be common in children with recurrent UTIs. Sometimes, the urologist may recommend starting with cranberry supplements and/or a course of daily, low-dose antibiotics to prevent future infections. These options can be discussed with your child’s urologist.
Typically, children with a single febrile (with fever) UTI and multiple non-febrile (without fever) UTIs will need additional testing to rule out any anatomical abnormalities that could be contributing to the UTIs. One such test is a renal ultrasound. Depending on the results of this ultrasound, your child’s urologist may recommend a voiding cystourethrogram (VCUG) to rule out vesicoureteral reflux (VUR). Again, these options will be discussed with your child’s urologist.