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Urinary tract infection in children

Disclaimer: This fact sheet is for education purposes only. Please consult with your doctor or other health professional to make sure this information is right for your child.

Urinary tract infections (UTI) are common in children. UTIs are caused by a growth of germs in the bladder and sometimes in the kidneys. An infection may make a child only mildly ill or very sick. All children who have UTI must be investigated for any underlying problems in the kidneys or bladder.

Symptoms in children over three years of age

The symptoms of a urinary infection in children over three years old are similar to adults. They may:

• complain of pain while passing urine
• go to the toilet more often
• accidentally wet their pants
• wet the bed at night
• feel unwell
• lose their appetite
• have a high temperature.

Symptoms in children under three and babies

Younger children and infants are different. They are unable to communicate their discomfort on passing urine and you may not notice them going more frequently. They are often sick with fevers and are very irritable. Young babies can be extremely unwell, because the infection can spread into the bloodstream (septicaemia).

Collecting a specimen

If your doctor suspects an infection, you will be asked to collect a urine specimen. The urine specimen is usually collected by catching some of the urine when it comes out (although this can be pretty tricky, particularly in infants!). If this can't be done, it may be necessary for the doctor to collect the urine sample by passing a fine tube into your child's bladder or by putting a needle into your child's bladder through the wall of the abdomen - just like having a blood test. The method of collecting a sample of urine using a stick-on collecting bag is NOT a reliable method, as urine samples collected in this way are often contaminated.

After the urine has been collected, your child may be started on antibiotics. If antibiotics are started these may need to be changed once the urine results are known. If the urine test confirms that your child has an infection, your doctor will plan further tests. Meanwhile, you should continue giving your child the antibiotics. If your child is sick, they may be admitted to hospital where the antibiotics will be given intravenously through a "drip". Otherwise, five to seven days of antibiotics by mouth will usually kill the infection.

All children who have a urinary tract infection must be investigated for any underlying problems of the kidney and bladder.

Tests may include a kidney ultrasound, a "DMSA" scan to look at kidney function and defects, and a bladder x-ray called an 'MCUG'. Your doctor will discuss which tests are needed for your child. During the MCUG, a fine tube is passed into the bladder (see Cystogram fact sheet). The bladder is filled with fluid which shows up on the x-ray. This can be done by children's x-ray specialists or by paediatric urologists (kidney surgeons). The most common abnormal finding is called vesico- ureteric reflux. This means that urine travels back up the wrong way through the tube connecting the kidney to the bladder. Usually reflux will disappear by itself as the child gets older. The child may need protective antibiotics to prevent further infections.

• Urinary tract infections are common in children
• All children who have a urinary tract infection must be investigated for any underlying problems of the kidney and bladder.

The Children's Hospital at Westmead Tel: (02) 9845 3585 Fax: (02) 9845 3562 www.chw.edu.au	Sydney Children's Hospital, Randwick Tel: (02) 9382 1688 Fax: (02) 9382 1451 www.sch.edu.au	Kaleidoscope, Hunter Children's Health Network Tel: (02) 4921 3670 Fax: (02) 4921 3599 www.kaleidoscope.org.au