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Management of Urinary Tract Infections: Children Are Different

Urinary tract infection (UTI) is a common problem in infants and children and may have serious consequences leading to chronic renal failure. In spite of its frequency and potential severity, UTI often is felt to be a simple problem. Nothing could be further from the truth; there are many dynamic issues related to its proper diagnosis and appropriate treatment. Especially important are the differences in UTI between adults and children that emphasize that children are not "little adults."

Epidemiology

The prevalence of UTI varies by age and sex. In the newborn period, approximately 1% to 2% of both girls and boys (usually uncircumcised) have UTIs. In infancy and childhood, UTI is more common in girls than in boys; approximately 1% of school-age girls develop symptomatic infection each year. This incidence increases even further when adolescent girls become sexually active. Risk factors for UTI in females include sexual intercourse, sexual abuse, use of bubble bath, constipation, pinworms, and infrequent or incomplete voiding. In either sex, risk factors include ureteric reflux in a sibling, urologic abnormalities, indwelling urethral catheterization, and neurogenic bladder.

Pathogenesis

Although cystitis may be caused by adenovirus, UTI usually is caused by bacteria that commonly are found on the perineum and ascend up the urethra into the bladder.

This article has been cited by other articles:

				V. Loening-Baucke Urinary Incontinence and Urinary Tract Infection and Their Resolution With Treatment of Chronic Constipation of Childhood Pediatrics, August 1, 1997; 100(2): 228 - 232. [Abstract] [Full Text] [PDF]