Child health- UTI

Question 1

define UTI

Answer 1

growth of bacteria within urinary tract (10^5 organisms/ml grown on culture of appropriate sample)

Acute pyelonephritis ie upper tract UTI

Acute cystitis ie lower tract UTI

Question 2

importance of UTI in children

Answer 2

affects 3-5% of girls and 1-2% of boys

Question 3

how is UTI diagnosed in <3 months old

Answer 3

urine microscopy

dipstick is not valid

Question 4

how would a <3 month old with fever be treated

Answer 4

admit for IV abx

vigilant for sepsismos

Question 5

most common infectious cause of UTI (typical cause of UTI in children)

Answer 5

E.coli

Question 6

what do atypical causes of UTI in children indicate?

Answer 6

anatomical issues with urinary tract

Question 7

what is the treatment for UTI in children

Answer 7

IV cefuroxime to start, empirical broad spectrum

more specific tx to follow

renal tract ultrasound <6 month old, any age if recurrent

Question 8

when is a lumbar puncture indicated in children?

Answer 8

when presenting with fever and systemic infection as the blood brain barrier is more susceptible to infection

Question 9

what is the relevance of the renal tract ultrasound?

Answer 9

assesses for structural abnormalities eg, agenesis of the kidneys, vesicouteric reflux

Question 10

what is the commonest cause of chronic renal failure in children <16

Answer 10

recurrent pyelonephritis

Question 11

what does E.coli produce which degrades Abx

Answer 11

extended spectrum beta lactamase (ESBL)

Question 12

E.coli which is an ESBL producer is treated with which broad spectrum abx?

Answer 12

meropenem

carbapenem antibiotic