UTI in Children Flashcards
What is UTI in children?
It is a bacterial infection of the kidneys, ureter, bladder &/ urethra.
What is UTI in children?
It is a bacterial infection of the kidneys, ureter, bladder &/ urethra.
Classification?
Uncomplicated UTI and Complicated UTI
- It is an infection limited only to the lower urinary tract, without underlying abnormalities or impairment of urine flow. Common in girls >2 years.
Classification?
Uncomplicated UTI and Complicated UTI
- Uncomplicated UTI: It is an infection limited only to the lower urinary tract, without underlying abnormalities or impairment of urine flow. Common in girls >2 years.
- Complicated UTI: It is an infection that affects the urinary tract, involving renal parenchyma (Acute Pyelonephritis) or is associated with congenital anomalies of the kideny’s and urinary tract.
What are the causes of UTI?
- E.Coli
2. Staphylococcus saprophyticus
Risk factors?
- ↑Bacterial inoculation: Sexual activity, wiping back-to-front, urinary incontinence, fecal incontinence, constipation.
- Anatomical abnormality:
- ↓ Urine flow: dehydration, obstructed urinary tract
- ↑Bacterial growth: DM, immunocompromised, catheter.
Clinical Presentation
- Uncomplicated:
Dysuria, frequency, urgency, cloudy urine, and lower abdominal discomfort. - Complicated:
Neonates:
Fever, vomiting, hypothermia, prolonged jaundice, poor feeding ], failure to thrive, sepsis (Septicemia), renal failure, lethargy
Infants and Children:
Failure to thrive, frequency, persisting fever, dysuria, abdominal pain, enuresis or urgency, febrile convulsion (>6 months).
DDx?
- PID
- Vaginitis
- DM
- Interstitial cystitis
Diagnostic criteria:
- Clinical
- Special investigations:
↪Urine dipstick: ↑Leucocytes or nitrates
↪Urine MC&S: E.Coli/ Stap s
↪ Ultrasound: Vesicouretic reflux, ureteric dilatation
↪MCUG (Micturating cystourethrogram):
in children with abnormalities of the kidneys, ureter, or bladder demonstrated by ultrasound.
PERFORM Urine dipstick: - If there are no Leukocytes/ nitrates→ UTI is unlikely
- Leukocytes only → Repeat dipstick on a second specimen. If leukocytes on a 2nd specimen, suspect UTI and treat empirically. Collect urine aseptically if possible for urine MC&S.
- Leukocytes or nitrates with symptoms of UTI→ Treat empirically for UTI. Collect urine aseptically if possible for urine MC&S
- Leukocytes AND nitrates: Collect urine aseptically if possible, for urine MC&S, treat empirically for UTI
General measures
•Ensure adequate nutrition and hydration. Maintain hydration with Oral &/ IV fluids if necessary.
•For recurring infections: ↪Avoid irritant soaps and bubble baths ↪Treat constipation, if present ↪Treat pinworm ↪Perineal hygiene. ↪Regular complete emptying of the bladder &/ di[double voiding, ie, making an additional attempt at voiding after the initial flow of urine has ceased.
Medicine Treatment
- Uncomplicated: children >3months
↪Augmentin, oral, 25mg/kh/dose 8 hourly
Treat for 3 days only
2. Complicated: ↪Augmentin, IV, 25mg/kg/dose 8 hourly OR ↪Ceftriaxone, IV, 80mg/kg/dose daily teat for 7 days
Treat PAIN:
↪ Paracetamol, oral, 15mg/kg/dose
Pharmacology
Augmentin: ↪Bind to penicillin receptors ↪Bactericidal ↪Inhibit cell wall biosynthesis ↪Results in cell wall lysis & death
Indications:
↪Infections caused by amoxicillin-resistant organisms producing β-lactamases sensitive to v=calvulanic acid
↪Gastro-urinary tract infections, such as cystitis, urethritis, pyelonephritis.↪↪
Side effects
Dizziness, Headache, diarrhea, interstitial nephritis
Augmentin Mechanism of Action
Augmentin: ↪Bind to penicillin receptors ↪Bactericidal ↪Inhibit cell wall biosynthesis ↪Results in cell wall lysis & death
Augmentin indications
Indications:
↪Infections caused by amoxicillin-resistant organisms producing β-lactamases sensitive to v=calvulanic acid
↪Gastro-urinary tract infections, such as cystitis, urethritis, pyelonephritis.
Augmentin side effects
Side effects
Dizziness, Headache, diarrhea, interstitial nephritis
