UTI in children


Published on

Urinary ract infection in children, renal system, urinary system, pediatrics

Published in: Education, Health & Medicine
  • Be the first to comment

No Downloads
Total views
On SlideShare
From Embeds
Number of Embeds
Embeds 0
No embeds

No notes for slide

UTI in children

  2. 2. It is the most common conditions of childhood. It may involve urethra, bladder, calyces and renal parenchyma. It mainly includes:  Upper: it involves the ureters and kidneys(Pyelonephritis)  Lower: it involves the urethra(Urethritis) and
  3. 3. INCIDENCE  3-8% of girls and 1-2% of boys develop a UTI during childhood.  Peak incidence is between 2 – 6 years of age.
  4. 4. CLASSIFICATION  Bacteriuria  Asymptomatic bacteriuria  Symptomatic bacteriuria  Recurrent UTI  Persistent UTI  Febrile UTI  Urethritis  Cystitis  Pyelonephritis  Urosepsis
  5. 5. ETIOLOGY  Escherichia coli – 80% of cases  Gram negative enteric organisms  Other organisms include Proteus, pseudomonas, klebsiella, staphylococcus aureus, haemophilus etc.  Anatomic and physical factors  Structure of lower urinary tract accounts to bacteriuria in females - Short urethra in young girls (2cm) & in mature women (4cm) provides pathway for organism to invade
  6. 6.  Closure of urethra in the end of micturition may lead to return of bacteria to bladder - Longer male urethra and prostatic secretions inhibit entry of pathogens in males  Urinary stasis  Incomplete emptying result from reflux , anatomic abnormalities, dysfunction of voiding mechanism, extrinsic ureteral compression caused by constipation etc leads to UTI.  Altered urine and bladder chemistry  An alkaline medium is favored by the pathogens. A urine pH of about 5 hampers the bacterial multiplication.
  7. 7. RISK CATEGORY  Throughout childhood, the risk of having a UTI is 2 percent for boys and 8 percent for girls.  Having an anomaly of the urinary tract increases the risk of a UTI.  Vesicoureteral reflux  Urinary obstruction  Dysfunctional voiding  Boys who are younger than 6 months sold who are not circumcised are at greater risk for a UTI than circumcised boys the same age.
  8. 8. PATHOPHYSIOLOGY Cause : UVR, catheterization , postponement of voiding, DM, low fliud intake etc bacteria ascends the urethra Lining of urinary tract becomes inflammed Micturition reflex triggered Urgency, frequency, burning hematuria, irritability, failure to thrive, pyuria
  9. 9. DIAGNOSTIC EVALUATION  Urine culture  First morning urine specimen  Clean catch mid stream  specimen  Collection bag  Supra pubic aspiration  Bladder catheterization  Urinalysis  Increased number of RBC  Nitrate test positive  Significant bacteriuria  Renal ultrasound  GU tract anatomy  Pelvi calceal dilatation  Hydronephrosis  Renal scarring  Dipstick tests  USG  VCUG  GU anatomy  IVP
  10. 10. THERAPEUTIC MANAGEMENT  Goals -eliminate current infection -Identify contributing factors and reduce risk of occurrence -prevent systemic spread of infection -preserve renal function  Antibiotic therapy based on:  identification of pathogen  history of antibiotic use  location of infection  Antimicrobial drugs (sometimes it will not be effective due to resistance of organism)  Anti-infective agents  penicillin, sulfonamide, cephalosporin, nitrofurantoin
  11. 11.  SURGICAL MANAGEMENT For primary reflux or bladder neck obstruction, surgical correction is needed to avoid recurrence.  NURSING MANAGEMENT  Careful history taking regarding voiding habits, stooling pattern  Caution the parents in suspected cases  Collect appropriate specimen  Checking diaper half hourly for straining, dripping of small amounts of urine.  Explanation of procedure according to their age  Administer proper dosage of medications  Increase the fluid intake
  12. 12. COMPLICATIONS Most UTIs are not serious, but some infections can lead to serious problems, such as kidney infections. Chronic kidney infections Infections that recur or last a long time can cause permanent damage, including kidney scars, poor kidney growth, poor kidney function, high blood pressure, and other problems. Some acute kidney infections infections that develop suddenly can be life threatening, especially if the bacteria enter the bloodstream, a condition called septicemia.
  13. 13. PREVENTION  Simple hygienic habits should be followed  Practice habit of voiding soon as they feel the urge  Adolescent girls are advised to urinate soon after an intercourse  Reinforce parents and older children the importance of compliance  Circumcision in males  Plenty of oral fluids  Treatment of constipation, pinworms