Southern DHB Paediatrics - Southland
Public Service, Paediatrics
What is a urine infection?
A urine infection is the presence of bacteria in the urinary tract (bladder and kidneys). Urine should be sterile (free of bacteria).
Why did my child get a urine infection?
Approximately 1% of boys and 3% of girls get a urine infection in the first ten years of life. Bacteria can enter the urinary tract from the skin around the urethra (where the urine normally comes out), or occasionally from infection within the body. Constipation can contribute to a urine infection and children who hold on to their wees for long periods are also at risk of developing a urine infection. Some children will have a blockage in the urinary tract, or a back flow of urine from the bladder towards the kidneys (called vesico-ureteric reflux VUR) which has cause the infection.
How is the urine infection treated?
A course of antibiotics will treat a urine infection. If your child is vomiting or too unwell to take antibiotics by mouth, hospitalisation for intravenous (in the vein) antibiotics may be needed. Antibiotics should improve symptoms within 48 hours. If they have not, see your GP.
Why does my child need to have tests done?
All babies and very young children should have tests done to check their urinary tract. In up to 40% of young children with a urine infection, there is a back flow of urine towards the kidneys, and in a very small percentage there is a blockage in the urinary tract. These conditions stop the urine flowing normally and make children more likely to have repeated urine infections. Blockages and severe VUR may need to be repaired with surgery, and VUR may need long term treatment with antibiotics to help prevent kidney scarring and possible kidney failure. It is important therefore to take antibiotics until the tests are done, in case VUR is diagnosed.
What tests will be done?
The tests your GP has referred you for may include:
- kidney ultrasound: this is similar to the ultrasound to check the baby in the womb during pregnancy. It shows the size and shape of the kidneys and is usually done about one month after referral
- micturating cystourethrogram (MCUG): this test uses x-rays to see dye moving out of the bladder. It will detect back flow of urine (VUR) and blockages in the urinary tract. The dye is put into the bladder through the urethra using a thin tube called a catheter. Your child is then held still for several minutes while x-rays are taken. Inserting the catheter can be uncomfortable, and hands-on support by the accompanying adult may be needed. Arranging child care for any other children in your care is advisable for this test. In children older than about 18 months, sedation may be offered to make your child sleepy and less aware of the test. The MCUG is done approximately one month after the referral.
What if the tests show an abnormality?
You should see your GP after these tests have been done. Your GP may refer your child to a children’s doctor (paediatrician) at a hospital clinic. Antibiotics should be continued unless you are told otherwise.
Will my child get further urine infections?
Repeated urine infections can occur even when antibiotics are being taken. It is important to have your child’s urine checked if the following symptoms develop: fever; strong smelling or discoloured urine; pain on passing urine; your child is “not well” or has unsettled behaviour.
To prevent further infections, avoid constipation, avoid bubble baths (or other irritating soaps), take antibiotics when prescribed, change soiled nappies quickly, and wipe the bottom from the front to the back.