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Urinary tract infection - children
A urinary tract infection (UTI) is an infection of the urinary tract. This article discusses UTIs in children.
The urinary tract includes the:
UTI - children; Cystitis - children; Bladder infection - children; Kidney infection - children; Pyelonephritis - children
Causes, incidence, and risk factors
Urinary tract infections (UTIs) can occur when bacteria find their way into the bladder or the kidneys. These bacteria are normally found on the skin around the anus or sometimes around the vagina.
Normally, there are no bacteria in the urinary tract itself. However, certain things can make it easier for bacteria to enter or stay in the urinary tract. These include:
UTIs are more common in girls, especially around age 3 when they first begin toilet training. In boys who are not circumcised, the risk for UTIs is slightly higher before the first birthday.
Young children with UTIs may only have a fever, poor appetite, vomiting, or no symptoms at all.
Most urinary tract infections in children only involve the bladder. If the infection spreads to the kidneys, it is called pyelonephritis and may be more serious.
Symptoms of a bladder infection in children include:
Symptoms that the infection may have spread to the kidneys include:
Signs and tests
A urine sample is needed to diagnose a UTI in children. The sample is examined under a microscope and sent to a lab for a urine culture.
In children who are not toilet trained, getting a urine sample can be difficult. The test cannot be done using a wet diaper. Possible ways to collect a urine sample in very young children include:
If this is your child's first UTI, special imaging tests may be done to find out why the infection happened, or to see if there is any kidney damage. Tests may include:
These studies may be done while the child has an infection. Most often they are done weeks to several months afterward.
Your doctor will consider many things when deciding if and when a special study is needed, including:
In children, UTIs should be treated quickly with antibiotics to protect the kidneys. Any child under 6 months old or who has other complications should see a specialist right away.
Younger infants will usually stay in the hospital and be given antibiotics through a vein. Older infants and children are treated with antibiotics by mouth. If this is not possible, they are admitted to the hospital where they are given antibiotics through a vein.
It is important that your child drink plenty of fluids while they have a urinary tract infection.
Some children may be treated with antibiotics for long periods of time (as long as 6 months - 2 years). This treatment is more likely when the child has had repeat infections or a condition called vesicoureteral reflux, which causes urine to flow back up into the ureters and kidneys.
The health care provider may also recommend low-dose antibiotics after the first symptoms have gone away. This type of treatment is less common now than it once was.
Antibiotics commonly used in children include:
Follow-up urine cultures may be needed to make sure that bacteria are no longer in the bladder.
Most children are cured with proper treatment. The treatment may continue over a long period of time.
Long-term problems from repeated UTIs in children can be serious. However, these infections can usually be prevented.
Calling your health care provider
Call for an appointment with your health care provider if your child's UTI symptoms continue after treatment or come back more than twice in 6 months.
Call your health care provider if the child's symptoms get worse, or new symptoms develop, especially:
Long-term use of preventive (prophylactic) antibiotics may be recommended for some children who get repeated UTIs.
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Williams G, Craig JC. Long-term antibiotics for preventing recurrent urinary tract infection in children. Cochrane Database Syst Rev. 2011;(3):CD001534.
Craig JC, Simpson JM, Williams GJ, et al. Antibiotic prophylaxis and recurrent urinary tract infection in children. N Engl J Med. 2009;361:1748-1759.
Skoog SJ, Peters CA, Arant BS Jr, et al. Pediatric Vesicoureteral Reflux Guidelines Panel summary report: clinical practice guidelines for screening siblings of children with vesicoureteral reflux and neonates/infants with prenatal hydronephrosis. J Urol. 2010;184:1145-1151.
Shaikh N, Morone NE, Lopez J, Chianese J, Sangvai S, D'Amico F, Hoberman A, Wald ER. Does this child have a urinary tract infection? JAMA. 2007;298:2895-2904.
Reviewed by:Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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