Pediatric Urinary Tract Infections

Introduction

Urinary tract infection is one of the most common infections in children and a significant cause of childhood morbidity. Children between three to twelve months are more commonly affected. The urinary tract consists of the body part involved in urine formation. It consists of two kidneys, two ureters, a bladder, and a urethra.

The kidney helps in the filtration of blood and extra water, resulting in the formation of urine. The kidneys take urine to the bladder with the help of the ureter. The urine is stored in the bladder until it is removed from the body. Then, the urine is removed from the bladder with the help of a tube known as the urethra. If the bacterial infection occurs in the urinary tract and urethra, it results in a urinary tract infection.

What Are the Types of Urinary Tract Infections?

There are two types of urinary tract infections found in toddlers.

• Lower Urinary Tract infection - It is also known as cystitis. Infection is found in the urinary bladder.

• Upper Urinary Tract infection - It is also known as pyelonephritis. Infection is found in the kidney.

• Urethritis - Infection is found in the urethra.

What Are the Causes of Urinary Tract Infections?

Urinary tract infection is caused by bacteria that enter the skin into the urinary tract. Then, bacteria begin to multiply in the bladder. Colonic bacterias mainly cause infection. Next, bacteria colonize the periurethral area and ascend to the bladder. Finally, it spreads through the urinary tract to the kidney, causing bacteremia.

Following are the species of bacteria which cause urinary tract infections.

• Escherichia coli.

• Klebsiella.

• Proteus.

• Enterococcus species.

• Staphylococcus saprophyticus.

• Streptococcus group B.

• Pseudomonas aeruginosa.

What Are the Clinical Features of Urinary Tract Infections?

The sign and symptoms of infection depend upon the severity of the disease. Infants and young children are unable to describe the symptoms. Therefore, parents should observe the child rule out the infection.

Following are the signs and symptoms of urinary tract infection.

Cystitis: The infection is seen in the urinary bladder.

• Presence of fever.
• Babies appear to be fussy.
• Vomiting.
• Children use the bathroom often, but they pass tiny amounts of urine.
• Children wet themselves more often.
• Pain and burning sensation during urination.
• Presence of abdominal pain and back pain.
• Presence of blood in the urine.
• Irritability.
• Nausea.
• Chills with shaking.
• Severe Fatigue.
• Skin appears to be flushed and warm.
• Diarrhea.

Pyelonephritis: The infection occurs in the kidney.

• High fever.
• Chills are shaking, along with nausea and vomiting.
• Pain and pressure are present in the lower back, lower pelvis, and the region below the navel.
• The urine appears to be cloudy.
• The urine smells foul.
• There is a burning and stinging sensation during urination.
• The child wakes up frequently from sleep for urination.
• The child feels the need for frequent urination with minimal urine output.
• Even after proper toilet training, children wet themselves.

What Are the Risk Factors for Urinary Tract Infections?

Following are the risk factors for urinary tract infections.

• Girls are more susceptible to infection because the urethra is closer to the anus. Bacteria can reach to urethra easily.

• Boys below the age of one year are at higher risk of urinary tract infection.

• Presence of any structural deformity.

• Vesicoureteral reflux is a congenital disability that causes the abnormal backward flow of urine.

• Abnormal functioning of the urinary tract.

• Tight-fitting clothes for girls.

• Improper wiping after a bowel movement.

• Poor hygiene.

• Poor Toilet

• Infrequent urination.

• Delaying urination for a more extended period.

• Lack of circumcision in boys.

• Improper toilet training.

• Bubble bath.

• Constipation.

• Family history of urinary tract infections.

What Are the Complications Caused by Urinary Tract Infection?

Proper diagnosis and treatment of urinary tract infections are essential as it causes various complications.

Following are the complications of urinary tract infections.

• Reduced kidney function.

• Kidney failure.

• Kidney abscess.

• Hydronephrosis.

• Septicemia.

How Is Pediatric Urinary Infection Treated?

Children suffering from urinary tract infections are treated by antibiotic therapy. The treatment plan depends upon the severity of the infection. Painkillers are given to relieve pain in the abdomen and back. If the infection is less severe, it can be treated with oral medication; however, intravenous fluids and hospitalization are required if the infection is severe. The commonly used antibiotics to treat urinary tract infections are.

• Amoxicillin

• Clavulanic acid.

• Cephalosporin.

• Doxycycline.

• Nitrofurantoin.

• Sulfamethoxazole trimethoprim.

How Is Pediatric Urinary Tract Infection Prevented?

Parents can take the following measures to prevent urinary tract infections.

• Fluid Intake - Parents should ensure that their child drinks plenty of water.

• Emptying the Bladder - Parents should ensure that a child's bladder is empty while urinating. Children sometimes do not open their bladders after peeing. Holding on to the urine for more extended time tightens the bladder muscles. Parents should practice double peeing when their child goes for urination. Double peeing is going to urinate a second time immediately for urine discharge.

• Potty Session - Parents should train their children for the potty session. It is essential to maintain a schedule, and the bladder should be empty often.

• Wiping - Parents should wipe their children properly. It should be done from front to back motion. Parents should avoid using toilet tissue to wipe their bottom and urethral area.

• Clothing - Parents should avoid wearing tight clothes. Undergarments made up of cotton fabric are recommended. Tight clothes affect circulation resulting in the perfect environment for bacterial growth. The child's undergarments should not be wet as moisture promotes bacterial growth.

• Avoid Bubble Baths - Parents should avoid bubble baths for their children. A bubble bath should contain frothy particles, leading to skin irritation on and around the genitalia.

Conclusion

Urinary tract infection is one of the most common infections that is painful and uncomfortable for children. Children are too young to voice their symptoms if they suffer from the infection. Parents should observe and take care of their children. It needs to be treated immediately to prevent damage to the kidneys. With proper treatment, all the symptoms of urinary tract infections clear up. Parents should be able to recognize the signs and symptoms of urinary tract infection and visit a pediatrician as early as possible.