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JAMA PEDIATRICS PATIENT PAGE
Urinary Tract Infections in Children and Adolescents
The urinary tract includes several parts of the body, including the kidneys,
the bladder, ureters, and the urethra.
The kidneys are 2 bean-shape organs located in the abdominal area
that filter blood to clean it and make urine as a byproduct. The urine
travels down the ureters to the bladder for storage. The urethra connects the bladder to the outside of the body where urine leaves the
body. Any of these parts of the urinary tract can get an infection called
a urinary tract infection (UTI).
Urinary tract infections are common in infants and young children. About 3% of girls and 1% of boys will have a UTI by 11 years of
age. Urinary tract infections are also common in female adolescents
and young women; young women develop UTIs at more than 3 times
the rate of young men. Symptoms of UTIs may include the following:
• Urine-related symptoms may include burning or pain during urination, needing to urinate more often, difficulty getting urine out,
urgently needing to urinate, or having an “accident” such as wetting underwear or the bed by a child who knows how to use the
toilet, foul-smelling urine, or cloudy or bloody urine.
• Vomiting, nausea, not wanting to eat.
• Fever and chills.
• Abdominal pain, side pain, or back pain.
Sometimes the symptoms are not obvious to the child or to the
parents, such as irritability in an infant or unexplained fever in a small
child. A young child with a high fever and no other symptoms has a
1 in 20 chance of having a UTI.
Evaluation for a UTI includes testing a urine sample, called a urinalysis. The urine can also be checked for bacteria, called a urine culture. Urinary tract infections are caused by bacteria that get into
the urinary tract by the skin around the genitals and rectum, or by
the bloodstream from other parts of the body. In young children and
children with repeated UTIs, an ultrasonography examination of the
urinary system may be done.
Treatment of a UTI is with antibiotics to eliminate the bacteria.
The way your child receives the antibiotics depends on the severity
of the infection and which parts of the urinary tract are involved in
the infection. An infection that involves the kidneys is more serious
because of the concern that the infection could damage the kidneys. It is important to treat the urinary infection quickly to prevent the spread of the infection and reduce the chances of damage
to the kidney. This month’s issue of JAMA Pediatrics includes a research study showing that early antibiotic treatment of UTIs helped
prevent the risk of damage to the kidneys. This research study shows
the importance of quick diagnosis and treatment.
Girls as well as young women are particularly susceptible to UTIs
because their urethras are shorter so germs from the bowel can pass
Author: Megan A Moreno, MD, MSEd, MPH
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Kidney
Ureter
Bladder
Urethra
alongthisroutetothebladder.TopreventUTIs,girlsshouldalwayswipe
from front to back with toilet paper after bowel movements. Adolescent females who are menstruating should change tampons and sanitary napkins frequently. Since bubble baths and perfumed soaps can
irritate the genitals and urethra, girls should avoid contact with these
substances.Somefoodsandbeveragescancausebladderirritationsuch
ascolas,caffeinateddrinks,chocolate,andsomespices.Ifyourchildhas
any of the symptoms of a UTI listed above, contact your pediatrician.
FOR MORE INFORMATION
https://www.healthychildren.org/english/health-issues/conditions
/genitourinary-tract/pages/prevent-urinary-tract-infections-in
-children.aspx
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JAMA Pediatrics September 2016 Volume 170, Number 9 (Reprinted)
Copyright 2016 American Medical Association. All rights reserved.
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