Urinary tract infection UTI

A urinary tract infection (UTI) is an infection anywhere in the urinary tract. The urinary tract includes any organs that collect, store or pass urine inluding the bladder, urethra (the tube from which urine passes out of the bladder), and kidneys.
UTI is quite common, especially in young children who are still in nappies. It can also occur in older children. 

What causes a urinary tract infection?

A UTI is usually caused when germs (bacteria) get into the bladder or urethra. The germs most often come from the bowels (gut), or from poo which is on the skin and then gets into the urethra. This can happen to any baby and is not due to poor washing or changing.

Signs and symptoms

• Pain when doing wee
  
• Needing to go to the toilet a lot to do a wee
  
• Passing urine before getting to the toilet (incontinence or wetting)
  
• Pain in the lower part of the stomach
  
• Experiencing a burning pain when passing urine
  
• Smelly urine
  
• Fever
  
• In young children UTI may cause a fever or general unwellness without any of the above symptoms.
  

Tests

Testing your child's urine is the only way to know for sure if they have a UTI. Tests are usually done to look for a problem with the bladder or kidneys. Most children will have an ultrasound scan. This is a simple and painless test much like the scans that some women have during pregnancy.
In some children, a Micturating Cysto-Urethrogram (MCU) is done. This test involves putting a catheter into the bladder through the urethra. Dye is injected through the catheter and X-Ray pictures are taken. The test is done mainly to look for a condition known as urinary reflux (sometimes called VUR). Discuss the test with your doctor.
There are other tests that are needed in a small number of patients. Your doctor will discuss these with you.
Urine specimens are first usually tested with a dipstick. This can help show if there is any sign of infection, but a final diagnosis can only be made by sending the urine to a laboratory for further tests using a culture. Culture results may take 24 to 48 hours.
If the dipstick test shows there is a UTI, then treatment may be started. The diagnosis and treatment may be changed once the culture results are back from the laboratory. You may be asked to call your doctor to discuss the results and treatment when the laboratory results are back. See the factsheet: Urine tests.

Treatment

Antibiotics are the main treatment. They can be taken by mouth. Young infants, or children who are very unwell with a UTI, should be admitted to hospital for antibiotics directly into a vein by intravenous therapy (IVT).

Care at home

• Children with a UTI often need to stay home and get extra rest.
  
• Your child may need to have extra drinks to help wash out the infection.
  
• Your doctor may recommend that your child stays on a low dose of antibiotic to try and prevent another UTI. This is often suggested for children who are still in nappies or who have had frequent UTIs. It is possible that your child might get another UTI even if your child is on a low dose of antibiotics.
  

You should take your child to a doctor immediately for a urine test if your child:

• Develops any symptoms that might suggest another UTI (see above).
  
• Is unwell with a fever without another obvious cause.
  

Follow up

Most children with UTI make a good recovery and have no future problems. In a very small number of children, there may be kidney problems or high blood pressure. Your doctor will discuss the necessary tests and how to monitor for this.
It is sensible for anyone who has had a UTI in the past to check their blood pressure and do a urine test every year once they reach adolescence.
It is important that any pregnant woman who has had a UTI in the past to tell her obstetrician.

http://www.rch.org.au/kidsinfo/fact_sheets/Urinary_tract_infection_UTI/