UTIs are common in children but often misapprehended. General infections occur mainly in the bladder and urethra (lower urinary tract), but sometimes may reach up to involve the kidneys and ureters, leading to the severe infections; these become caused by the entry of bacteria and multiplication in the urinary system. The patient can present nonspecific symptoms that may include abdominal pain, vomiting, and loss of appetite. The complications of the UTI can be avoided if and when early detection is made and proper treatment ensues. This will lead to their quick recovery. To ensure they treat the child as soon as possible, parents who know the risk factors can take action on the same.
What Causes UTIs in Children?
When we spoke to Dr Antony Robert C, Senior Consultant - Pediatric Surgery & Pediatric Urology, Marathahalli, Rainbow Children's Hospital, he said that it is formed when harmful bacteria travel up the urethra into the bladder and sometimes even to the kidneys.
These bacteria live in the intestine and are perfectly harmless unless they enter the urinary tract. The most common perpetrator is Escherichia coli (E. coli). Other microorganisms responsible for UTIs include Klebsiella, Proteus, Enterococcus, and Pseudomonas species. During usual conditions, urine is sterile and free of bacteria; however, there are some factors that put children at risk with infections. Some preventive practices include:
Hydration: Fluid intake promotes the flushing of bacteria from the urinary system by frequent urination.
Teach Proper Hygiene: Girls must be educated to wipe from front to back after urination and defecation to prevent anormal flora of anus from entering the urinary tract. Avoid Constipation: Constipation may predispose to infection, particularly in toddlers. Bowel movements must be encouraged.
Let the Child Empty the Bladder Completely: Ensure your child completely empties their bladder to avoid a bacterial reserve.
Diagnosing UTI in a Child To ascertain a diagnosis of UTI, the doctor will do a physical examination, review symptoms, and assess the medical history. To this, the doctor will perform a Urine Test, also known as Urinalysis, which is a laboratory test done to check for bacteria and infection indicators such as white blood cells and red blood cells in urine. The culture of urine will be conducted to establish the exact causative bacteria, thus facilitating the treatment.
From the surgical point of view, UTIs in children may indicate some underlying congenital urinary tract anomalies predisposing the child to infection.
However, most children's UTIs are not due to any structural anomaly and do not require surgical intervention. Surgical evaluation is generally reserved for a recurrent febrile UTI, male children who present with UTI, or an infection with an unusual presentation. Detection and treatment of such anomalies are very crucial to prevent recurrent UTI and the potential long-term damage to kidneys. Key Investigations that may be recommended by your pediatric surgeon:
- Kidney Ultrasound : It is often the first imaging test for checking for structural abnormalities, such as hydronephrosis or any other anatomical abnormality.
- Micturating Cystourethrogram (MCUG): Dye is used with X-ray to see if urine flows backward from the bladder into the kidneys, which enables a more definitive diagnosis of vesicoureteral reflux (VUR). Magnetic Resonance Urography: It offers detailed and precise views of the urinary tract and is diagnostic for complex anomalies. Nuclear Medicine Scan: Kidney function assessment. Detection of scarring from recurrent infections.
- Urodynamic Tests: For conditions like neurogenic bladder, urodynamic tests are helpful in estimating how much urine the bladder can hold and how it empties urine. This helps in devising an appropriate treatment plan for the patient.
- Treatment for UTI in Children The treatment depends on the age of the child, symptoms, and severity of infection. Some of the most common options are as follows:
- Antibiotics: This is the main form of therapy to eliminate infection. Antibiotic type and course depend on the urine culture. Pain Relief: Medications to manage their pain/discomfort and local methods to ensure they are comfortable.
Further follow-ups might be scheduled to ensure the efficacy of the drug. Do not hesitate to raise concerns or side effects that you may experience while under this treatment to your doctor.
This can be managed if your child finishes the dose of prescribed antibiotics according to the time limit, increases hygiene measures, and increases hydration. Scheduled doctor visits will allow an update on how well your child is progressing and discuss any concerns that may arise.
