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Urinary Tract Infections in Children

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Urinary tract infections (UTIs) are common in children and are usually caused by bacteria entering the urinary tract. Girls are at higher risk than boys due to anatomical differences. Common…

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Urinary Tract Infection in Children

Introduction:
♦ One of the most common conditions of the childhood
♦ UTI is characterized by inflammation usually of bacterial origin, may involve
the urethra, bladder (Lower urinary tract) and /or the ureters or kidney (Upper
urinary tract).
♦ Because it is often impossible to locate the infection, the broad designation
UTI is applied to the presence of significant numbers of micro-organisms
anywhere in the urinary tract.
♦ Peak incidences occur between 2-6 years, and adolescence who are sexually
active.
♦ Girls have a 10-20 times greater risk of developing UTI than boys because of
their shorter urethral structure, which provide a quick pathway for organism.

Etiology
Infection
♦ Gram negative bacteria- E. coli (Accounts for 80% of all UTI), Proteus,
Pseudomonas, Klbsiella, Enterococcus.
♦ Gram positive bacteria- Staphylococcus aureus
♦ Via blood stream in Neonates

Predisposing factors
♦ Urinary stasis- Caused by obstructive Uropathy, Vesico-uretric reflux,
Neurogenic Bladder
♦ Inadequate water intake
♦ Poor perineal hygiene
♦ Indwelling urinary catheter
♦ Antimicrobial agent
♦ Tight cloths of diapers
♦ Sexual intercourse
♦ Bubble bath

Pathology
 Confined to bladder (Cystitis), or renal parenchyma (Pyelonephritis)
 In cystitis bladder is inflamed and edematous, its wall is thicken and fibrosed
 Distortion of Utrthrovesical junction
 Ureter and pelvis may be dilated
 Renal parenchyma is inflamed
Clinical Manifestations:
 Depends of age and severity of disease
 Neonate: Neonate may have features of sepsis with fever, vomiting,
diarrhea, jaundice, poor weight gain and lethargy.
 Infants: Unexplained fever, frequent micturation, abnormal urinary
stream, occasionally convulsion
 Older children: Foul selling urine, dysurea, abdominal pain,
frequency and urgency of micturation and incontinence
 Fever, chills and rigor, flank pain, hematuria, in pyelonephritis.

Investigations:
 Urine: routine and microscopic examination
 Urine culture
 Renal: Ultrasonography, Intravenous Pyelography
 (IVP), Renal Scan.

Treatment:
• Antibiotic therapy:
Infant: Ampicillin, Gentamycin, Aminoglyosides, Ceftriaxone, Cefotaxim
Children: Cotrimoxazole, Amoxicillin, Nalidixic Acid, Ampicillin, Gentamycin,
Amikacin, Ceftriaxone, Cefotaxim
• General Measures
• Increase fluid intake
• Analgesic and antipyretics as needed

Nursing Measures
 Assessment: Urinary pattern, frequency, dysurea, Hydration and body
temperature
 Review Laboratory reports:
 Administer prescribed antibiotics and analgesic antipyretics.
 Provide comfort measures- Promote rest, Perineal rinses, Sitz bath
 Encourage fluid intake, fruits and Juice
 Patient and family teaching

Urinary Tract Infection in Children Introduction: ♦One of the most common conditions of the childhood ♦UTI is characterized b
Clinical Manifestations:  Depends of age and severity of disease  Neonate: Neonate may have features of sepsis with fever,

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