A urinary tract infection (UTI) is an infection of the bladder or kidneys.
- A bladder infection is called “cystitis”.
- A kidney infection is called “pyelonephritis”.
Signs and symptoms
Symptoms of a UTI can include the following:
- fever,
- irritability without apparent cause in a baby or toddler,
- need to urinate more often,
- pain or burning sensation when urinating,
- daytime urinary incontinence in a clean child,
- vomiting or abdominal pain,
- back pain,
- presence of blood in the urine.
Causes of urinary tract infection (UTIs)
UTIs occur when bacteria on the skin enter the bladder through the urethra (the channel that carries urine from the bladder out of the body).
How urinary tract infection is Diagnosed
The doctor will diagnose a UTI in your child by analyzing a urine sample. The diagnosis is carried out in three steps:
- test using a reactive strip,
- microscopic examination,
- culture (growth) in the laboratory of bacteria from the urine sample.
Urine sample
In clean children, the urine sample should be obtained “mid-stream” (in the middle of the stream). In children who are not toilet trained, urine can be collected during urination (passing urine), using a catheter (tube) or, sometimes, a urine bag.
Results of the analysis of the urine sample
The doctor will take into account the results of the test carried out by means of the test strip and the culture. If the urine sample was collected appropriately, a “positive” culture confirms the presence of a UTI. A “negative” culture confirms that the child does not have an infection.
The final urine culture results are usually ready after two or three days. They reveal which particular bacteria is causing the infection and will help determine the type of antibiotics needed for treatment.
In the case of a sample taken using a bag, if the dipstick test result is positive, the doctor should collect another sample during urination (passing urine) or by means of a catheter and send it to the laboratory for analysis.
How to care for a child with a UTI
Antibiotics
Depending on your child’s age, symptoms and medical history, the infection may require either oral (by mouth) antibiotics or hospitalization for intravenous administration.
Your child’s doctor will first prescribe a broad-spectrum antibiotic (which can treat most bacteria). Once he knows which bacteria caused UVI, he will prescribe a more specific antibiotic if needed. The infection will only be cleared when your child takes the correct antibiotic for their infection.
Your child’s symptoms should improve within 48 hours of starting the appropriate antibiotic. Even if your child is doing better, be sure to carry out the antibiotic treatment for the entire prescribed period. This will help prevent a relapse and reduce the risk of your child eventually getting an infection that is more difficult to treat with antibiotics.
Relief of pain and fever
Give your child acetaminophen or ibuprofen to relieve pain or fever. these drugs usually start working within an hour and do not interact with antibiotics. you may need to give them for the first few days of treatment until the antibiotics work.
Follow-up appointment
After starting antibiotic treatment, make an appointment with your child’s regular doctor. the latter will determine if the antibiotics give satisfactory enough results and will prescribe different ones if your child is still sick.
Other tests for children under two
If your child has their first UTI with a fever (known as a febrile ivu) before they are two years old, they will need to have an ultrasound of the kidneys.
He may also need to have a test called a voiding cysto-urethrogram (CUG) to check for urinary reflux. Urinary reflux is a disease characterized by a return of urine into the urethra and kidneys. This test will be carried out if the results of the ultrasound justify it and if your child is young and has had more than one febrile ivus.
How to Prevent Urinary Tract Infection
In young children, most UTIs are unavoidable. However, in older people, you can prevent these infections by taking the following steps:
- Teach your daughter to wipe back and forth after urinating. This is especially important when she has a bowel movement to prevent bacteria in the stool from entering the urinary tract.
- Prevent constipation in your child. Being constipated means that stools are harder and less frequent than usual, which can sometimes prevent the bladder from emptying completely and lead to UTIs.
- Encourage your child to drink plenty every day. His urine should be pale.
- Encourage your child to urinate at two to three hour intervals and not to hold urine for long periods of time.
- Some children with severe urinary reflux or other urinary tract abnormalities may need to take a low dose of an antibiotic daily to prevent new infections.
When to See a Doctor for a UTI
Contact the doctor during office hours if your child’s symptoms persist for more than 48 hours after starting antibiotic treatment.
Take your child to the nearest emergency department:
- if he becomes very ill or seems lethargic (very sleepy),
- if he complains of severe stomach or back pain,
- if he vomits repeatedly and cannot keep down any fluids or medication.
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