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Urinary Tract Infections, Pediatric

Urinary Tract Infections, Pediatric is a topic covered in the 5-Minute Emergency Consult.

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Basics

Description

  • Bacteria colonize via retrograde contamination of rectal or perineal flora:
    • Infants—often hematogenous spread
    • Older children—vesicoureteral reflux (VUR) major risk
  • UTI is defined by culture of a single organism of >10,000/mL on a catheterized or suprapubic specimen. Other collection techniques are not routinely used in young children for definitive diagnosis.
  • In infants 0–3 mo old, UTI is associated with a 30% incidence of sepsis.
  • Predisposing factors:
    • Poor perineal hygiene
    • Short urethra of female
    • Female > male
    • Infrequent voiding
    • Constipation
    • Sexual activity
    • Male circumcision probably reduces risk

Etiology

  • UTI found in 4–7% of febrile infants
  • Bacterial agents:
    • Escherichia coli accounts for 80%
    • Klebsiella pneumoniae
    • Staphylococcus aureus
    • Enterobacter species
    • Proteus species
    • Pseudomonas aeruginosa
    • Enterococcus species

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Citation

Rosen, Peter, et al., editors. "Urinary Tract Infections, Pediatric." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307248/all/Urinary_Tract_Infections__Pediatric.
Urinary Tract Infections, Pediatric. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307248/all/Urinary_Tract_Infections__Pediatric. Accessed April 25, 2019.
Urinary Tract Infections, Pediatric. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307248/all/Urinary_Tract_Infections__Pediatric
Urinary Tract Infections, Pediatric [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 25]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307248/all/Urinary_Tract_Infections__Pediatric.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Urinary Tract Infections, Pediatric ID - 307248 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307248/all/Urinary_Tract_Infections__Pediatric PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -