Pediatric Infectious Diseases - Urinary Tract Infection Flashcards
UTI risk factors for girls
-White race
-Age less than 12 months
-Temperature over 39C for 2 or more days
-Absence of another source of infection
UTI risk factors for boys
-Nonblack race
-Temperature over 39C for more than a day
-Uncircumcised
-Absence of another source of infection
Common pathogens in UTI
-E. Coli
-Klebsiella
-Proteus
-Enterobacter
-Citrobacter
-Staphylococcus saprophyticus
-Enterococcus
Signs and symptoms of UTI in newborns
-Jaundice
-Sepsis
-Failure to thrive
-Vomiting
-Fever
Signs and symptoms of UTI in infants/young children
-Fever
-Strong-smelling urine
-Hematuria
-Abdominal/flank pain
-New-onset urinary incontinence
Signs and symptoms of UTI in school-aged children
-Dysuria
-Increased frequency
-Increased urgency
What are the methods of urine collection?
-Clean catch
-Catheterization
-Supra-pubic aspiration
When is clean catch used for urine collection?
Older patients
When is catheterization used for urine collection?
Less than 24 months old
When is supra-pubic aspirations used for urine collection?
-Gold-standard but invasive
-Reserved for children who fail catheterization
When should a urinalysis be tested?
-Less than one hour after voiding if room temperature
-Less than 4 hours after voiding if refrigerated
What does a urine dip stick test for?
-Nitrite
-Leukocyte esterase
What number is indicative of a UTI in a urine culture obtained through SPA?
Over 10,000
What number is indicative of a UTI in a urine culture obtained through catheterization?
Over 10,000
What number is indicative of a UTI in a urine culture obtained through clean catch?
Over 100,000
When would you use IV therapy over oral therapy for UTI?
-Oral and IV equally efficacious
-Most patients can have oral therapy
-Choose IV for patients who are toxic or unable to retain oral intake
What is the duration of therapy for UTI in patients ages 2-24 months?
7-14 days
What is the duration of therapy for UTI in patients with pyelonephritis?
10-14 days
What is the duration of therapy for UTI in patients with cystitis in older female patients?
3-7 days
What are the empiric therapy options for pediatric patients with UTI?
-Cephalexin
-Amoxicillin (traditionally first-line)
-Augmentin
-Bactrim
-Nitrofurantoin (ONLY cystitis) (usually avoid)
In what circumstances are FQs viable for UTIs in children?
-Multi-drug resistant pathogens with no safe alternative
-IV therapy is not feasible
-No other effective oral agent
What is important to not about cipro?
Do not give through feeding tube because it can clog it
