Condition 101 About Urinary Tract Infection in Children

What is the definition of Urinary Tract Infection in Children?

A urinary tract infection is a bacterial infection of the urinary tract. This article discusses urinary tract infections in children.

The infection can affect different parts of the urinary tract, including the bladder (cystitis), kidneys (pyelonephritis), and urethra, the tube that empties urine from the bladder to the outside.

What are the alternative names for Urinary Tract Infection in Children?

UTI - children; Cystitis - children; Bladder infection - children; Kidney infection - children; Pyelonephritis - children

What are the causes for Urinary Tract Infection in Children?

Urinary tract infections (UTIs) can occur when bacteria get into the bladder or to the kidneys. These bacteria are common on the skin around the anus. They can also be present near the vagina.

Some factors make it easier for bacteria to enter or stay in the urinary tract, such as:

  • Vesicoureteral reflux in which urine flow backs up into the ureters and kidneys.
  • Brain or nervous system illnesses (such as myelomeningocele or spinal cord injury).
  • Bubble baths or tight-fitting clothes (girls).
  • Changes or birth defects in the structure of the urinary tract.
  • Not urinating often enough during the day.
  • Wiping from back (near the anus) to front after going to the bathroom. In girls, this can bring bacteria to the opening where the urine comes out.

UTIs are more common in girls. This may occur as children begin toilet training around 3 years of age. Boys who are not circumcised have a slightly higher risk of UTIs before age 1.

What are the symptoms for Urinary Tract Infection in Children?

Young children with UTIs may have a fever, poor appetite, vomiting, or no symptoms at all.

Most UTIs in children only involve the bladder. It may spread to the kidneys.

Symptoms of a bladder infection in children include:

  • Blood in the urine
  • Cloudy urine
  • Foul or strong urine odor
  • Frequent or urgent need to urinate
  • General ill feeling (malaise)
  • Pain or burning with urination
  • Pressure or pain in the lower pelvis or lower back
  • Wetting problems after the child has been toilet trained

Signs that the infection may have spread to the kidneys include:

  • Chills with shaking
  • Fever
  • Flushed, warm, or reddened skin
  • Nausea and vomiting
  • Pain in the side (flank) or back
  • Severe pain in the belly area

What are the current treatments for Urinary Tract Infection in Children?

In children, UTIs should be treated quickly with antibiotics to protect the kidneys. Any child under 6 months old or who has other complications should see a specialist right away.

Younger infants will most often need to stay in the hospital and be given antibiotics through a vein. Older infants and children are treated with antibiotics by mouth. If this is not possible, they may need to get treated in the hospital.

Your child should drink plenty of fluids when being treated for a UTI.

Some children may be treated with antibiotics for periods as long as 6 months to 2 years. This treatment is more likely when the child has had repeat infections or vesicoureteral reflux.

After antibiotics are finished, your child's provider may ask you to bring your child back to do another urine test. This may be needed to make sure that bacteria are no longer in the bladder.

What is the outlook (prognosis) for Urinary Tract Infection in Children?

Most children are cured with proper treatment. Most of the time, repeat infections can be prevented.

Repeated infections that involve the kidneys can lead to long-term damage to the kidneys.

When should I contact a medical professional for Urinary Tract Infection in Children?

Call your provider if your child's symptoms continue after treatment, or come back more than twice in 6 months or your child have:

  • Back pain or flank pain
  • Bad-smelling, bloody, or discolored urine
  • Fever of 102.2°F (39°C) in infants for longer than 24 hours
  • Low back pain or abdominal pain below the belly button
  • Fever that does not go away
  • Very frequent urination, or need to urinate many times during the night
  • Vomiting

How do I prevent Urinary Tract Infection in Children?

Things you can do to prevent UTIs include:

  • Avoid giving your child bubble baths.
  • Have your child wear loose-fitting underpants and clothing.
  • Increase your child's intake of fluids.
  • Keep your child's genital area clean to prevent bacteria from entering through the urethra.
  • Teach your child to go the bathroom several times every day.
  • Teach your child to wipe the genital area from front to back to reduce the spread of bacteria.

To prevent recurrent UTIs, the provider may recommend low-dose antibiotics after the first symptoms have gone away.

Female
Male
Voiding
Vesicoureteral

REFERENCES

American Academy of Pediatrics. Subcommittee on urinary tract infection. Reaffirmation of AAP clinical practice guideline: the diagnosis and management of the initial urinary tract infection in febrile infants and young children 2-24 months of age. Pediatrics. 2016;138(6):e20163026. PMID: 27940735 pubmed.ncbi.nlm.nih.gov/27940735/.

Jerardi KE and Jackson EC. Urinary tract infections. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM. eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 553.

Sobel JD, Brown P. Urinary tract infections. In: Bennett JE, Dolin R, Blaser MJ eds. Mandell, Douglas and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 72.

Wald ER. Urinary tract infections in infants and children. In: Kellerman RD, Rakel DP, eds. Conn's Current Therapy 2020. Philadelphia, PA: Elsevier; 2020:1252-1253.

Top Global Doctors For Urinary Tract Infection in Children

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Kjell Tullus
London, ENG, GB
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Francisca Mutapi
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Gabrielle J. Williams
AU
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Caleb P. Nelson
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Latest Advances On Urinary Tract Infection in Children

  • Condition: Pancreas and Kidney Failure
  • Journal: Zhonghua yi xue za zhi
  • Treatment Used: Ipsilateral Simultaneous Pancreas and Kidney Transplantation
  • Number of Patients: 146
  • Published —
This study investigated the clinical outcome of using ipsilateral simultaneous pancreas and kidney transplantation.
  • Condition: Schistosomiasis in Children
  • Journal: PLoS neglected tropical diseases
  • Treatment Used: Oral Praziquantel
  • Number of Patients: 2693
  • Published —
This study analyzed the effectiveness and safety of single-dose 40 mg/kg oral praziquantel for the treatment of schistosomiasis in preschool and school-age children.

Clinical Trials For Urinary Tract Infection in Children

Clinical Trial
  • Status: Not yet recruiting
  • Phase: Phase 3
  • Intervention Type: Drug
  • Participants: 120
  • Start Date: February 2021
Efficacy of Corticosteroids in Reducing the Renal Scarring in Acute Pyelonephritis in Children
Clinical Trial
  • Status: Recruiting
  • Phase: N/A
  • Intervention Type: Other
  • Participants: 230
  • Start Date: January 29, 2021
Quick-Wee Versus Bladder Stimulation to Collect Midstream Urine From Pre-continent Infants: a Randomized Controlled Trial