Urine Infection in Children

If you would like to learn about urine infection in children the following information will be of help to you.

 

Urine infections in children can cause various symptoms. Antibiotics usually clear the infection. Tests may be advised, especially for children under five years, as some children with a urine infection have a problem with their bladder or kidneys.

 

 

There are two kidneys, one on each side of the abdomen. They make urine which drains down the ureters into the bladder. Urine is stored in the bladder and is passed out through the urethra from time to time when we go to the toilet.

 

 

A urine infection is caused by bacteria (germs) that get into the urine. Most urine infections are due to bacteria that normally live in your own bowel. They cause no harm in the bowel but can cause infection if they get into other parts of your body. Some bacteria lie around the anus (back passage) after passing a stool (faeces). These bacteria can sometimes travel to the urethra and into the bladder. Some bacteria thrive in urine and multiply quickly to cause infection. The infection is commonly just in the bladder ('cystitis'), but may travel higher up to also affect one or both kidneys. A urine infection is often called a 'urinary tract infection' (UTI) by doctors.

 

Nearly 1 in 20 boys, and more than 1 in 10 girls, have at least one urine infection by the time they are 16 years old. Children under five years are the most commonly affected.

 

Young children and babies can have various symptoms which may include one or more of:

 

 

 

A sample of urine is needed to confirm the diagnosis. Urine is normally sterile (no bacteria present). A urine infection is confirmed if bacteria are found in the sample.

 

Ideally, the sample of urine should not come into contact with skin or other materials that may contaminate it with other bacteria. Adults and older children can do this by a 'mid stream' collection of urine. This is not easy to do in young children and babies. The following are ways to get a sample of urine that is not contaminated.

 

 

The usual way is to catch some urine in the specimen bottle whilst in 'full flow'. Just be ready with the open bottle as the child passes urine. (Be careful not to touch the open rim of the bottle with your fingers as this may contaminate the specimen with bacteria from your fingers.)

 

 

One method is to place a special absorbent pad in a nappy. Urine is sucked into a syringe from the wet pad. Another method is to use a plastic bag that sticks onto the skin and collects urine. If no pad or plastic bag is available, the following might work. Take the nappy off about one hour after a feed. Tap gently with a finger (about once a second) just above the pubic bone. (This is the bone at the bottom of the abdomen above the genitals.) Have ready the open bottle. Quite often, within about five minutes, the baby will pass urine. Try and catch some in the bottle.

 

 

A course of an antibiotic will usually clear the infection. Give lots to drink to prevent dehydration. Also, give paracetamol or ibuprofen to ease any pains and fever (high temperature).

 

 

Tests are advised in some cases to check on the kidneys and/or bladder. As a general rule, children under the age of five years who have a first urine infection will usually be referred to a kidney specialist with a view to having some tests. Children over the age of five who have two infections within the space of 12 months will usually be referred to a kidney specialist with a view to having some tests.

 

The tests that are advised may vary depending on local policies and the child's age. They usually include a kidney scan. There are various other tests that can check on the structure and function of the urinary tract (the kidneys, ureters, bladder and urethra). If a child is referred to a specialist for tests, your doctor may prescribe a daily low dose of antibiotic whilst waiting to be seen. The aim of this is to prevent a further urine infection until the results of any tests are known.

 

 

In some cases, a problem is found. The most common condition is called 'vesico-ureteric reflux'. This is a problem at the junction where the ureter enters the bladder. In this condition, urine is passed back (refluxes) up the ureter from the bladder from time to time. This should not happen, as once urine gets to the bladder it should only pass out of the urethra when going to the toilet. This condition makes urine infections more likely. Also, infected urine that refluxes from the bladder back up to the kidneys can cause kidney infection, scarring, and damage. In some cases this leads to severe kidney damage if urine infections recur frequently. Other rare problems that may be found include kidney stones, or congenital abnormalities of parts of the urinary tract.

 

Diagnosing urinary tract problems in children can make a big difference. Treatment may prevent kidney damage which might have caused high blood pressure or kidney failure later in life.

 

 

Children with severe constipation are more prone to urine infections. This is because large hard faeces sometimes collect in the rectum (back passage) and press on the bladder. The bladder may then not empty fully when the child passes urine which can make the urine more prone to become infected. Treating severe constipation sometimes prevents recurring urine infections.

 

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