Urinary tract infection (UTI) is common in infants and children
UTI is difficult to recognise
Collecting urine and interpreting laboratory results is not easy
Diagnosis is not always confirmed
UTI in infants and children may have long-term sequelae

Clinical features of UTI
Evaluation of any sick child must include examination of urine
Every young child with unexplained fever should have urine examined
Clinical features often non-specific
Boys seldom get recurrent UTI in absence of urinary tract abnormalities

UTI Diagnosis – Collect urine
Specimen collection
Suprapubic Aspiration
Catheter specimen collection
Clean catch collection
Bag specimen collection
Pad specimen collection

Urine culture
In all children <3 years if clinical suspicion
  105 CFU/ml of single organism
 On SPA alone any growth of single organism
PS < 105/ml of one organism or a mixed growth = contamination
Urine obtained before start of antibiotics

UTI Treatment
At least 5 days of parenteral therapy
Antibiotic prophylaxis: Trimethoprim
  Infant and older child
“Upper tract “ - 7 days oral
“Lower tract” –3 days oral
Antibiotic prophylaxis for <3 year olds until imaging: Trimethoprim, Nitrofurantoin (not in <3 mo)

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