What Is Urinary Tract Infection?

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 factorsChildren 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.Best of Express PremiumPremiumPremiumPremiumPremium
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 ScanThis 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.
DMSA ScanAny 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 Nephrolog, Rainbow Children’s Hospital, Hyderabad
Dr. V.V.R Satya Prasad  
MBBS, MD (Peds), Fellowship in Pediatric Nephrology (AIIMS), (NUH, Singapore)
Senior Consultant – Pediatric Nephrolog
Rainbow Children’s Hospital, Banjara Hills, Hyderabad