Urinary Tract Infections  (UTI)

What is a UTI?

A urinary tract infection (UTI) is a common type of infection in children. UTI affects girls more commonly than boys.
The urinary tract includes the parts of the body involved in making urine: the kidneys and the bladder. A child gets a UTI when there is an abnormal growth of bacteria in the urine that leads to inflammation of the urinary tract. The infection can either be in the bladder (cystitis) or in the kidney (pyelonephritis). Understanding the difference between the two is important because how we will manage and treat your child is different.

What are the signs and symptoms of a UTI?

Cystitis is an infection in the bladder. Symptoms include:

• Burning feeling with urination
• Needing to use the bathroom more often
• Having urinary accidents
• Pain in the lower part of the abdomen
  
  

Pyelonephritis is an infection of the kidneys, usually caused by bacteria that have traveled up the urethra, bladder and ureters.

In infants and young children the symptoms include:

• High fever
• Decreased wet diapers

Older children will also have:

• High fever
• Possible back pain
• Nausea and vomiting

How do I know if my child has a UTI?

UTIs must be diagnosed with a urine sample. In infants or children who are not toilet trained, a catheter sample is best. Urine bag specimens lead to false results.

This can usually be done at your regular doctor’s office with a dip urinalysis test. This dip test can tell your doctor if it is possible that your child has a UTI. However, to confirm that this is a true

UTI, your child’s urine has to be sent to a laboratory to see if any bacteria are growing in the urine. This is called a urine culture. It will take one to two days to get these results back. The urine culture will let us know what kind of bacteria is growing in your child’s urine, how much of that bacteria is growing, and what antibiotics will best treat your child’s infection. When urine cultures are not obtained, children may be over treated with antibiotics or the wrong antibiotic may be chosen.

Both tests are necessary to be sure that your child has a urinary tract infection.

Can UTIs be prevented?

There is no definitive cure for recurrent UTIs. In order to improve and reduce symptoms, we utilize behavior modifications, bowel management strategies, and occasionally physical therapy.

Recommendations include:

• increasing hydration with water
• limiting of caffeine, citrus, and sugary beverages from the diet
• urinating every 2-3 hours
• treatment of underlying constipation or stool retention
• avoiding bubble baths or soap to genital area
• wide legged voiding posture for girls
• preference for showers over baths

At Arkansas Children’s Hospital Urology Clinic, we can discuss management approaches that are needed for your child depending on his or her symptoms, the urinalysis and urine culture results, and the age of your child. We can help determine if additional tests may be needed.