Urinary tract infection in children

The urinary system is formed by the kidneys, which filter urine, the ureters, which drain urine from the kidneys into the bladder, the bladder, which is a reservoir of urine, and the urethra, which is the urethra.

In healthy children, urine is sterile. MVS infection begins when microbial agents (bacteria, viruses, yeast fungi) enter the bladder or kidneys.

There are several factors contributing to the development of UTIS:

• age - for boys under 1 year old, for girls under 4 years old;

• phimosis (timely circumcision of the glans penis reduces the risk of UTIS by 4 times in boys with this pathology);

• the presence of a permanent urinary catheter;

• congenital anomalies of the urinary system;

• neurogenic bladder dysfunctions;

• previous and repeated images;

• diabetes mellitus.

UTI symptoms depend on the age of the child and the level of urinary tract damage.

Acute pyelonephritis (inflammation of the urinary system of the kidneys themselves) is characterized by symptoms of intoxication, fever above 38 ° C, chills, vomiting, diarrhea, agitation or unusual lethargy, drowsiness, decreased appetite.

In children under 2 years of age, fever is sometimes the only symptom of the disease. Children over the age of 2 complain of soreness and increased frequency of urination, pain in the lower abdomen and/or in the lower back. The presence of catarrhal symptoms, otitis media, and gastroenteritis does not always guarantee the absence of UTIS, since in 8% of cases a combined course of diseases is possible.

If a urinary tract infection is suspected, consult a doctor within 24 hours!

Untimely treatment of pyelonephritis can lead to damage to the renal parenchyma (nephrosclerosis), hypertension, and renal failure.

To confirm UTIS, urine tests are required: clinical, as well as urine culture to identify pathogenic flora. Imaging methods such as ultrasound, X–rays, and radioisotope studies will help identify congenital malformations of MVS, bladder dysfunction, and initial signs of damage to the renal parenchyma.

Treatment of UTIS is most often performed on an outpatient basis with timely diagnosis. If the patient's condition does not improve or worsens, a second visit to the doctor is necessary to change therapy or make a decision about hospitalization. Indications for hospitalization may include:

• age up to 2 months;

• vomiting or inability to take medications inside;

• inefficiency of home treatment.

Antibiotics are prescribed until the result of urine culture is obtained, since UTIS is a condition where treatment must be started immediately. The result of the bacteriological examination will be extremely necessary later for the correction of therapy. The child should feel better after 24-48 hours. To assess the effectiveness of the treatment, it is recommended to conduct a control urinalysis on the 2nd-3rd day of treatment.

Unfortunately, from 8 to 30% of children have recurrent UTIs. Usually – during the first 6 months, and most often – in girls. After repeated UTIs, the doctor may recommend long-term use of an antibacterial drug in a small dosage in the evening for a period of 6 to 12 months. Measures to prevent recurrent urinary tract infections also include the treatment of concomitant diseases (for example, constipation and neurogenic bladder dysfunctions).