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Thursday, June 30, 2022

What Is Urinary Tract Infection?

Urinary tract infection occurs when germs from outside the body enter the bladder, multiply and cause an infection.

Updated: June 2, 2022 5:05:16 pm
Urinary tract infection (UTI)

Urinary tract infection (UTI) is an infection in the body’s urinary tract. The urinary tract includes kidneys (which makes urine), ureters (that takes urine from the kidney to the bladder), the bladder (which stores urine) and urethra (the tube which carries urine from the bladder to outside of the body).

What causes a urinary tract infection?

Urinary tract infection occurs when germs from outside the body enter the bladder, multiply and cause an infection. In some cases the germs will move up, out of the bladder and towards, or into, one or both of the kidneys.

Predisposing factors
Children with abnormality of kidneys (for example, obstruction, vesico ureteric reflux), stones in the urinary tract, incomplete emptying of bladder with residual urine and constipation are more prone to urine infections.

Is a urinary tract infection serious?

Urinary tract infections can make children feel very ill. The symptoms include vomiting, abdominal pain and high temperatures. If infections enter the kidney, the infection can lead to a renal scar. This scarring is permanent. It is therefore very important that urinary tract infections are treated without delay to prevent scar formation

What is the role of imaging in Urinary tract infection?

Ultrasound Scan
This is a very simple, painless investigation to know the size, shape and position of the kidneys. Abnormalities like hydronephrosis (swelling of kidneys), ectopic kidneys (kidneys present in different location), absent kidney, stones in the kidney or abnormalities in urinary bladder can be easily diagnosed.

MCUG (Micturating Cystourethrogram)
Any child with recurrent UTI or anatomical abnormalities in kidneys requires MCUG. This test is carried out to rule out vesico uretic reflux (VUR).  Reflux means backflow of urine towards the kidney from the bladder instead of going out through the urethra, due to weak valves at the entrance of ureter into the bladder or high pressure in the bladder. This can take infection into the kidneys from the bladder and sometimes can lead to scar formation in kidneys.

Any child with UTI and reflux will require the DMSA scan as it shows the areas of the kidney which are working well and if there are any areas of scarring. The DMSA scan is a radio nuclear scan used to check the structure of kidneys, their size and shape. We can compare the function of the two kidneys to see if one kidney functions differently from the other.

How should UTI be treated?

Antibiotics (oral or IV) are required to treat UTI. It may be necessary to change the antibiotic after 48-72 hours if the child is showing no improvement or if the laboratory results show that a different antibiotic would be better.

It is important to repeat the urine test after completing the antibiotics to make sure that the urine infection has been treated completely.

How to prevent UTI

  • Encourage plenty of liquids including water
  • Child once toilet trained should go to the toilet to empty their bladder regularly once in 2 to 3 hours
  • Ensure your child has a healthy diet 
  • Constipation should be prevented. Encourage  plenty of fruits and vegetables as it contain fibre which prevents constipation 

Dangers of Recurrent UTI

  • High Blood pressure
  • Kidney damage
  • Growth retardation
Dr VVR Satya Prasad, Senior Consultant Pediatric Nephrologist, Department of Pediatric Nephrology, Rainbow Children’s Hospital, Hyderabad

Dr. V.V.R Satya Prasad  

MBBS, MD (Peds), Fellowship in Pediatric Nephrology (AIIMS), (NUH, Singapore)

Consultant – Pediatric Nephrologist

Rainbow Children’s Hospital, Banjara Hills, Hyderabad

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