UTI in Children Flashcards
Non-bacterial causes of UTI
Adenovirus
Candida
T or F Group B strep is the most common org encountered in pediatric UTI
F: seldom encountered
Form of UTI that involves the renal parenchyma
Acute pyelonephritis
UTI that involves the bladder
Acute cystitis
T or F: Gold standard for the treatment of ASB in children is empiric antibiotics
False It’s better NOT to treat with antibiotics in ASB
Amount of WBC in urinalysis to be classified as pyuria
> 10 WBC/mm3 in unspun
>5 in spun
False positive pyuria may be a result of
Contamination by antiseptics
Contamination with ammounium containing detergent
Dipstick left for too long
False negative pyuria may ba a result of
Dilute urine
Acidic urine
LMW or non-albumin protein
Outdated strip
GOLD STANDARD in diagnosing UTI in children
Urine Culture
Principle behind Nitrite test
Bacterial conversion of nitrate to nitrite in urine, negative result cannot rule out UTI
Bag Urine is the mthod of choice in collection of urine for culture
False, not suitable for urine culture, but negative growth may rule out UTI
What can cause negative urine culture
Prior antibiotics
Increased H20 intake
Intake of high doses of Vit C
Some bacteria take several yrs to grow
Refers to structural and functional causes of abnormalities of bladder storage and emptying
Voiding dysfunction
Why does holding urine more likely to develop UTI?
It allows bacteria to grow
When is circumcision considered in newborn infants?
Those with significant perinatal hydronephrosis or reflux; those with recurrent UTI
This is used to loosen the phimotic band
Corticosteroid
Diagnostic method used to describe bladder volume, bladder wall thickness, presence of renal and bladder calculi
Renal and Bladder UTZ
Disadvantage of Renal and Bladder UTZ
Poor detection rate of parenchymal defects and VUR
Diagnostic method used to define permanent loss of renal parenchyma
DMSA renal scan
Timing of VCUG
When the child is dead, de joke lng.. once the child is afebrile and has a negative urine culture
T or F: Childhood UTI progressing to CKD will never happen
False. It does, but It’s rare
Long term complications of UTI includes
HPN
CKD
T or F: Children with non-febrile UTI needs imaging that focuses on bladder function
False. Kids with non febrile – no need imaging while those who have had several attacks need imaging that focuses on bladder fxn
Features of high risk children
Recurrent inf Poor urinary stream/ palpable kidneys Bacteremia/septicemia Older boy Known dilatation or abnormality on antenatal US screening of UT
Common bacterial drugs used as empiric therapy in childhood UTI include
Ampicillin derivatives
Cephalosporin
Aminoglycosides
Length of treatment for childhood UTI
7-14 days
Antibiotics commonly used for prophylaxis
Nitrofurantoin
Cephalexin
Cotrimoxazole
Antibiotic prophylaxis is recommended for children under 5 with ______
Vee You Are, also for those kids with gr 4 or 5 VUR, or kids with recurrent febrile UTI
T or F: Routine dipstick is a good screening test, but NOT ALL pyuria is considered UTI
True
