Skip to main navigation menu Skip to main content Skip to site footer

An Approach To:

Vol. 19 No. 2 (2021)

Approach to: Pediatric urinary tract infection (UTI)

DOI
https://doi.org/10.26443/mjm.v19i1.312
Submitted
September 27, 2020
Published
2021-07-12

Abstract

Urinary tract infections (UTIs) are prevalent in the children. Presentation of UTI vary in children of different ages. In infants, who cannot localize symptoms, UTI can present with a fever whereas in older children a UTI can present with urinary symptoms (dysuria, urinary frequency, incontinence). It is important to establish a clear diagnosis in order to treat and resolve the infection with antibiotics therapy to prevent bacteremia, pyelonephritis, and long-tern renal disease. Urine is collected through a mid-stream urine sample, in toilet trained children, via urethral catheterization, suprapubic aspiration and pediatric urine collection bags. Urine analysis and culture are the first-line investigations in children with suspected UTI. Goals of treatment include elimination of infection, relief of acute symptoms, and prevention of recurrent and long-term complications. The Canadian Pediatric Society recommends initial treatment with oral antibiotics for nontoxic children with febrile UTIs. Imaging, such as a renal/bladder ultrasound, may be used.

References

  1. Schlager TA. Urinary tract infections in children younger than 5 years of age: epidemiology, diagnosis, treatment, outcomes and prevention. Paediatr Drugs. 2001;3(3):219-27.
  2. Simões e Silva AC, Oliveira EA. Update on the approach of urinary tract infection in childhood. J Pediatr (Rio J). 2015;91(6 Suppl 1):S2-10.
  3. Balighian E, Burke M. Urinary Tract Infections in Children. Pediatr Rev. 2018;39(1):3-12.
  4. Robinson JL, Finlay JC, Lang ME, Bortolussi R. Urinary tract infections in infants and children: Diagnosis and management. Paediatr Child Health. 2014;19(6):315-25.
  5. Shaikh N, Morone NE, Bost JE, Farrell MH. Prevalence of urinary tract infection in childhood: a meta-analysis. Pediatr Infect Dis J. 2008;27(4):302-8.
  6. Leung AKC, Wong AHC, Leung AAM, Hon KL. Urinary Tract Infection in Children. Recent Pat Inflamm Allergy Drug Discov. 2019;13(1):2-18.
  7. Morello W, La Scola C, Alberici I, Montini G. Acute pyelonephritis in children. Pediatr Nephrol. 2016;31(8):1253-65.
  8. Shaikh N, Morone NE, Lopez J, Chianese J, Sangvai S, D'Amico F, et al. Does this child have a urinary tract infection? Jama. 2007;298(24):2895-904.
  9. May OW. Urine Collection Methods in Children: Which is the Best? Nurs Clin North Am. 2018;53(2):137-43.
  10. Al-Orifi F, McGillivray D, Tange S, Kramer MS. Urine culture from bag specimens in young children: are the risks too high? J Pediatr. 2000;137(2):221-6.
  11. Roberts KB. Urinary tract infection: clinical practice guideline for the diagnosis and management of the initial UTI in febrile infants and children 2 to 24 months. Pediatrics. 2011;128(3):595-610.
  12. Hoberman A, Charron M, Hickey RW, Baskin M, Kearney DH, Wald ER. Imaging studies after a first febrile urinary tract infection in young children. N Engl J Med. 2003;348(3):195-202.
  13. Zhang X, Xu H, Zhou L, Cao Q, Shen Q, Sun L, et al. Accuracy of early DMSA scan for VUR in young children with febrile UTI. Pediatrics. 2014;133(1):e30-8.
  14. Leroy S, Fernandez-Lopez A, Nikfar R, Romanello C, Bouissou F, Gervaix A, et al. Association of procalcitonin with acute pyelonephritis and renal scars in pediatric UTI. Pediatrics. 2013;131(5):870-9.

Downloads

Download data is not yet available.