Urinary Tract Infections in Children

The urinary system is also known as the excretory system. The urinary system is consisted of two kidneys, two ureters, the urinary bladder and the urethra. The function of the urinary system is to produce, store and excrete urine and waste products from the body. A Urinary Tract Infection is any infection along the urinary tract. Children of both genders, male and female are vulnerable of having infections due to a wide range of causes. Diagnosis of a urinary tract infection is made with a urinalysis to be able to know bacterial count. Gram Staining is done from the urine sample in order to identify the specific organism causing the infection. A culture and sensitivity test is also done in order to test what antibiotic is best for treatment. Typically a simple urinary tract infection can be treated even without the urine examination. Symptomatic treatment may be done to address the problem even without diagnosis by the use of routine antibiotics.

What Are the Causes of UTI in Children?

Urinary tract infections occur when bacteria enter and infect the urinary tract and multiply. A small amount of bacteria in the urine is alright but a large number of bacteria found in the urine are enough to cause signs and symptoms of infection.

Escherichia coli or E. coli is a normal flora in the child’s colon. A normal flora is any microorganism that is normally found in a specific body part without causing any symptom in a regular amount in a healthy individual. E. coli is one of the most common causes of urinary tract infections in any age group. In a child, it lives normally in the colon but may enter the urethral opening and may multiply along the tract through the bladder, ureters, and if severe infection occurs, may even go up to the kidneys. Urinary tract infections are more common in females than males because of their shorter urethra. Yes, size does matter. It is also the same for adults.

E. coli urinary tract infections commonly occur in those who are still being toilet trained. Children who are wearing diapers are at high risk because the bacteria can be inadvertently spread from their anus or fecal matter. When fecal matter spread towards the site of the urethra, bacteria can quickly culture then and multiply. Sometimes, mechanical washing from touching the anal part towards the urethral part causes bacteria to spread. This stroking poses more risk to females than males because of the anatomical proximities of the anus to the urethral opening. Strokes should be from the part of the urethra going to the anus to avoid contamination. The use of paper towels and baby wipes also pose a great risk for those who are unaware of this contamination process.

Escherichia coli also known as E. coli

Dysfunctional Voiding: Bad Habits

Alongside, there are also other common causes of urinary tract infections for kids. Dysfunctional voiding occurs when a child makes it a habit to hold their urine even though they have the urge to urinate. This happens when children are busy with school or play and tends to neglect the call of nature to urinate. The longer the bacteria stay at the bladder, the more the bacteria in the urine multiply and causes an infection. Dysfunctional voiding can be due to habit forming but can also be due to nerve damage. Bad habits should be outgrown by the child as early as toddler years. A good toilet training should be implemented at early years to avoid infections. Parents and caregivers should be aware of the bladder training of their child. They should be conscious about the frequency of voiding of the child. Never neglect the child’s need to urinate when outside the home. Some children make bad habits of neglecting the urge to void because of shame or being too pre-occupied with playing. Proper explanation of the importance of voiding when they feel the urge makes good outcomes as the child grows up.

In time, children should outgrow this bad habit, especially if they fully understand the importance of removing the waste products from their bodies. Even the child practices this; there are times wherein they still get urinary tract infections. Either their urinary tract is very sensitive or their body’s immune system is down, making them prone to have infections.

Constipation

This may not be a obvious cause because we are referring to the urinary tract, not the intestinal tract. Still, constipation plays a huge factor as well because constipation and fecal impaction may add pressure into the bladder. Constipation may be due to bad toilet habits, lack of fiber in the diet, or poor oral fluid intake of the child. Sometimes the child maybe neglecting also the urge to defecate which makes the feces more harder and more difficult to remove. Constipation cause the rectum to swell, which can put pressure on the bladder, preventing it from emptying normally. Residual urine may also be a good culture point for bacteria to grow.

Vesicoureteral Reflux

Reflux is the backflowing of urine in opposition to its normal flow. It is an uncommon condition but can cause urinary tract infections. What happens is that urine leaks back up from the bladder to the ureters and the kidneys. Primary vesicoureteral reflux is congenital. It is a reflux disorder of the ureteral valves that prevent urine from leaking from the bladder up to the kidneys. This happens when the valve does not function properly. Urine along with its bacterial content goes to the kidneys and infects it causing upper urinary tract infection, a more severe type than just the more common urinary tract infection of the lower section of the urinary system. Secondary vesicoureteral reflux is caused by a condition that arises after birth. This happens when urine is blocked from flowing out of the bladder, or when a lower urinary tract infection causes the ureters to become so inflamed and swollen that the one-way valves in the ureters fail, allowing urine to flow both ways. This can lead to upper urinary tract infections of the kidney and may cause bleeding, scarring or sepsis.

Signs and Symptoms of UTI in Children

The signs and symptoms of urinary tract infections in pediatric age group depend on the age. Symptoms also vary from one person to another. Consult a doctor if your child experiences these symptoms in order to get immediate care and treatment.

Infant

  • Fever
  • Irritability
  • Restlessness
  • Unable to be consoled
  • Vomiting and diarrhea
  • Loss of appetite
  • Failure to gain weight

Older Children

  • Burning or pain with urination
  • Frequent or urgent urination
  • Fever and chills
  • Lower abdominal pain
  • Foul Smelling urine
  • Discolored Urine (normal color of urine is from amber to yellow)
  • Bladder distention
  • Side or back pain
  • Blood in urine

 

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