Urinary Tract Infections in Children

Urinary tract infections (UTIs) are a common and potentially serious infection among children. This chapter reviews the epidemiology of UTIs among children, presentation and treatment of acute infection, risk factors and approaches to managing recurrent infection, the role of diagnostic imaging, and long-term outcomes. Most infections are caused by ascending coliform bacteria, with both host and pathogenic factors contributing to the development and sequalae of UTI. Young children and infants often have difficulty localizing symptoms. The diagnosis of UTI first requires the collection of an uncontaminated urine sample. Confirmation of UTI requires the growth of a potentially causative organism from an uncontaminated sample. Multiple, well-designed, randomized trials have been conducted comparing antibiotic prophylaxis to placebo for the prevention of recurrent UTI. Another important component of treatment is the management of lower urinary tract dysfunction, which is a strong predictor of recurrent infections and kidney damage.