Urinary tract infections are infections of the urinary tract caused by bacteria, the most frequent being Escherichia coli, which comes from the large intestine. If the infection affects only the lower urinary tract (urinary bladder) is called acute bacterial cystitis, on the other hand if it reaches the kidneys is called acute pyelonephritis. There are other bacteria that can cause urinary tract infections: Enterococcus, Pseudomonas, Klebsiella, Staphylococcus epidermidis (rare) and proteus (associated with urinary lithiasis).
Urinary tract infections (UTIs) in the pediatric age are common. Urinary tract infections can be extremely painful and completely ruin a few days. In order to minimize the suffering, it is important you act fast. Here is some key information summarised from uti.co.nz.
UTIs constitute the second most frequent bacterial infection in children, only surpassed by the upper respiratory infections. Its importance is important in newborns and infants, since they have an increased risk of involvement of the kidneys, which can form abnormal scars and their deterioration, negatively affecting renal function. During the first years of life, the diagnosis of urinary tract infections is difficult, since they do not present with specific symptoms.
WHAT FACTORS CAN INFLUENCE IN THE DEVELOPMENT OF UTIs?
These factors can be poor hygiene, or bad habit of enduring the urge to urinate for many hours, which facilitates the growth of bacteria. This is often seen in schoolchildren.
In some cases this disease is caused by alterations in the functioning of the urinary tract, such as obstructive problems, or vesicourethral reflux; Which would increase the likelihood of developing chronic kidney damage. That is why it is so important that children with urinary tract infection be evaluated by specialists such as the pediatrician, urologist and / or nephrologist, who will determine the studies necessary to rule out such situations.
HOW ARE UTIs MANIFESTED?
UTIs may occur with fever, irritability, decreased appetite, vomiting, diarrhea, changes in the smell of urine, and developmental problems that can affect growth. Children over four years of age, as they already have the ability to communicate, may show burning and frequent urination, abnormal color and strong urine odor, incontinence, low belly discomfort and abdominal pain. On the contrary, in younger children it is more difficult to detect the problem since they can not express the symptoms; Which is why mothers often do not realize that their child has a urinary tract infection.
HOW ARE ITUs DIAGNOSED?
When the urologist or pediatrician suspects the existence of a UTI, he / she should initially perform a simple urinalysis and a urine culture. In newborns and children under three years of age it is recommended to insert a catheter (thin hollow tube) into the urethra to obtain the urine sample. With this, urine is obtained directly from the urinary bladder, avoiding the possibility of contamination with the outside. In children who urinate alone, the urine sample is taken from the middle of the stream, after hygiene of the genitals; Retracting the foreskin in the case of children, or separating the lips from the vulva in the case of the girls.
It is recommended that all children be studied after presenting the first UTI, in order to reduce the incidence of renal scars and the sequelae they may lead to (renal failure, hypertension), when diagnosing and treating congenital anomalies Eg vesicoureteral reflux) that may be causing and perpetuating the disease.
All children who have had febrile UTIs need to be screened for imaging:
- Abdominal and pelvic ultrasound: to look for abnormalities at the level of the kidney and / or urinary bladder.
- Micturition Cystography: to rule out vesicoureteral reflux, posterior urethral valves, ureterocele and other urinary abnormalities. This study should be performed with sterile urine after treatment for UTI, ie without infection, verified by a urine culture.
3.- Renal Gammagram: This study shows if there are scars or kidney damage resulting
from previous urinary tract infections. It is also used to demonstrate the actual function of
WHAT IS A TYPICAL TREATMENT?
The primary goal of timely treatment is to prevent or reduce complications of UTI, such as kidney damage. Depending on the diagnosis, the specialist will prescribe antibiotics and analgesics, and will establish its therapeutic plan directed towards the cause of UTI; Some needing some surgical procedure. For UTIs limited to the bladder, you should consume about 5-10g of D-mannose per day.
WHAT COMPLICATIONS CAN BE PRESENT IF THE ITU IS NOT DIAGNOSED AND TREATED ON TIME?
If it is not diagnosed and treated properly it could recur one or several times, and end up seriously damaging the kidneys, causing chronic kidney failure and hypertension.
In the case of newborns, immunological immaturity also facilitates the expansion of bacteria into the blood causing sepsis, a situation that could be very dangerous.
It is essential that hardly any suggestive manifestations of urinary infection are detected, especially in children under four years old, in whom the risks of complications are greater, consult the pediatrician who can request the support of the urologist for the joint management of the problem.