Urinary Tract Infection (UTI)

What Causes a UTI?

A urinary tract infection occurs when bacteria, usually E. coli (Escherichia coli ) from the gastrointestinal tract, enters a child’s urinary tract through the urethra (the hollow tube that carries urine out of the body from the bladder).

A UTI can affect any portion of the urinary tract. They most commonly involve the urethra and bladder (lower tract), but can sometimes affect the ureters and kidneys (upper tract). Though rarer, infections of the upper urinary tract tend to be more severe. Left untreated, a UTI can progress to a kidney infection or sepsis, a life-threatening condition.

UTI Risk Factors

UTIs can develop in both boys and girls, but are far more common in girls because of their shorter urethra. UTIs that develop in boys are usually the result of a blockage in the urinary tract or vesicoureteral reflux (VUR). Risk factors for UTIs include:

• Wiping incorrectly (from back to front) when using the bathroom.
• Delaying going to the bathroom or constipation.
• Taking bubble baths, which can irritate the urethra and allow bacteria to grow, especially in girls.

UTI Symptoms

Symptoms of infection in infants and children may include:

• Bad-smelling urine
• Blood in the urine
• Chills
• Fatigue
• Fever
• Fussiness or crying
• Loss of bladder control (incontinence)
• Nausea, vomiting or diarrhea
• Pain above the pubic bone, in the back or the side below the ribs
• Pain or burning sensation while urinating
• Poor feeding in infants
• Sudden need to urinate or needing to urinate more often
• Trouble urinating

UTI Diagnosis in Children

After a physical exam and taking a medical history, your child’s healthcare provider may conduct the following tests:

• Urine test (urinalysis): A sample of your child’s urine will be examined in a lab looking for signs of infection. A culture can also determine the type of bacteria causing the UTI, which may inform the type of antibiotics prescribed to treat the infection.
• Kidney ultrasound: This imaging test uses sound waves and a computer to make images of blood vessels, tissues, and organs to see how they are functioning.
• Voiding cystourethrogram (VCUG): A catheter is placed through your child’s urethra into the bladder, slowly filling the bladder with a solution. A special machine called fluoroscopy takes pictures. The test can determine if any of the solution is going back up into the kidneys.
• Nuclear medicine scan: With this scan, a small amount of radioactive fluid is injected into a vein and is carried to the kidneys, where it gives off signals that can be captured with a special camera. This scan can help find out if there is scarring or a more severe infection.

UTI Treatment and Prevention

UTIs are treated with antibiotics, which typically clear up the infection in about a week. It’s important to take medication as directed and make sure to finish the full course prescribed, even if symptoms subside sooner. To address pain, you can give your child over-the-counter pain relievers or use a heating pad on a low setting.

The following strategies can help reduce the chance of your child getting a UTI in the future:

• Make sure your child stays hydrated.
• Make sure your child is emptying their bladder completely when urinating.
• Teach your child to wipe front to back when going to the bathroom.
• Try to prevent constipation with plenty of fluids and a fiber-rich diet.

Usually, UTIs are uncomplicated and are unlikely to recur. However, frequent UTIs can be a sign of another urinary condition in children, such as VUR, a ureterocele, megaureter or neurogenic bladder. If your child is diagnosed with one of these conditions, their healthcare provider may recommend other treatments, such as surgery.