Preventing Urinary Tract Infections in Children

Anadolu Health Centre Paediatric Nephrology Specialist Assoc. Prof. Dr. Neşe Bıyıklı shared prevention methods for urinary tract infections in children. In children, urinary tract infection symptoms resulting from bacteria settling in the kidneys and urinary tract include fever, vomiting, abdominal pain, urinary incontinence, burning during urination, crying during urination in infants, changes in urine colour and odour, fatigue and poor weight gain in infants. She noted that these are common indicators. Anadolu Health Centre Paediatric Nephrology Specialist Assoc. Prof. Dr. Neşe Bıyıklı stated, "If an infant or child experiences a febrile urinary tract infection, there is a possibility of underlying urinary tract system abnormality or functional disorder in one-third of these children."

Stopping treatment when the child starts feeling better can lead to disease recurrence

Assoc. Prof. Dr. Neşe Bıyıklı, who noted that urinary tract infection treatment requires antibiotic use, explained: "Antibiotic treatments in syrup or injection form can be selected depending on the microorganism cultured and the child's clinical condition. Similarly, treatment can be conducted either as an inpatient or outpatient depending on the child's clinical condition. Medications must be used for the duration determined by the physician. One of our main concerns is when parents stop treatment early after a few days when the child starts feeling better, because the infection can recur. Additionally, drinking plenty of water is important because increased urine flow helps us treat the infection," she explained.

Urine sample is essential for definitive diagnosis

Paediatric Nephrology Specialist Assoc. Prof. Dr. Neşe Bıyıklı emphasised that if clinical suspicion of urinary tract infection exists in a child, a urine sample collected under appropriate conditions is necessary for definitive diagnosis. "Both urinalysis and urine culture tests should be performed on this sample. There are several methods for collecting urine samples from children. In toilet-trained children, we can collect samples using containers, but collecting urine from infants is more challenging. Therefore, when collecting urine from infants, either sterile urine collection bags can be used, samples can be taken from where the infant urinates, or a urine sample can be obtained by inserting a needle through the abdomen into the urine collection bag," she explained. [caption id="attachment_157732" align="aligncenter"] Assoc. Prof. Dr. Neşe Bıyıklı[/caption]

Two important factors for protection from infection: hygiene and drinking plenty of water

Assoc. Prof. Dr. Neşe Bıyıklı emphasised that the two most important steps for preventing urinary tract infections are adequate water consumption and hygiene. "We particularly advise giving children plenty of water and developing water-drinking habits. If urine flow is abundant and the bladder is emptied completely and regularly, meaning urination is not delayed, the risk decreases. A child regularly emptying the bladder every 3-4 hours is an important factor. Preventing constipation is important because constipation both puts pressure on the bladder by filling the intestines, facilitating infection, and prevents the bladder from emptying comfortably. Attention to hygiene conditions is important. Toilet hygiene should be performed from front to back, especially in girls, wearing cotton and comfortable underwear, and not delaying urination are among the particularly important issues," she said.

Possible kidney problems should be investigated in patients with recurrent infections

Paediatric Nephrology Specialist Assoc. Prof. Dr. Neşe Bıyıklı stated that controlled urinalysis and urine cultures should be performed to determine whether the infection has fully resolved. "Additionally, if we have other clinical findings we suspect, we request urinalysis and cultures at regular intervals from our patients, even if they have no complaints. In children we suspect, we investigate whether there is a structural problem in the kidneys. If the infection recurs, we then request special kidney imaging," she said.

Urinary tract infection can recur in 50 to 70 per cent of cases

Paediatric Nephrology Specialist Assoc. Prof. Dr. Neşe Bıyıklı stated that they attach considerable importance to three issues in a child who has had a urinary tract infection. "One of these is the recurrence risk of urinary tract infection. A child who has had a urinary tract infection carries a 50 to 70 per cent risk of recurrence. This is important for us. The second important issue is that when children have a urinary tract infection, we may not initially understand whether it originates from the kidney or the bladder. If kidney-derived urinary tract infections have left damage or injury to the kidney, significant problems can occur in later life. Issues such as high blood pressure or hypertension or kidney function impairment can develop. Apart from this, there is a 30 to 50 per cent probability that a child with a urinary tract infection may have a problem such as urinary leakage. If these are not diagnosed in time, they can cause damage through recurrent infections," she explained.