Diagnosis and management of community-acquired urinary tract infection in infants and children

Abstract

Urinary tract infection (UTI) is the most common bacterial disease in childhood worldwide and may have significant adverse consequences, particularly for young children. In this guideline, we provide the most up-to-date information for the diagnosis and management of community-acquired UTI in infants and children aged over 90 days up to 14 years. The current recommendations given by the American Academy of Pediatrics Practice guidelines, Canadian Pediatric Society guideline, and other international guidelines are considered as well as regional variations in susceptibility patterns and resources. This guideline covers the diagnosis, therapeutic options, and prophylaxis for the management of community-acquired UTI in children guided by our local antimicrobial resistance pattern of the most frequent urinary pathogens. Neonates, infants younger than three months, immunocompromised patients, children recurrent UTIs, or renal abnormalities should be managed individually because these patients may require more extensive investigation and more aggressive therapy and follow up, so it is considered out of the scope of these guidelines. Establishment of children-specific guidelines for the diagnosis and management of community-acquired UTI can reduce morbidity and mortality. We present a clinical statement from the Saudi Pediatric Infectious Diseases Society (SPIDS), which concerns the diagnosis and management of community-acquired UTI in children.

Parental Knowledge and Awareness of Childhood Urinary Tract Infections: A Cross Sectional Survey

“… 2 As mentioned in the literature, uncircumcised boys and children with chronic constipation have a higher risk of recurrent UTIs, thus increasing the risk of complications and morbidity. 1 In our study, a considerable percentage of participants gave incorrect responses when asked about the relationship between chronic constipation, circumcision, and UTI occurrence (44.3% and 77.5%, respectively). Therefore, it is crucial to identify parental knowledge gaps regarding childhood UTI prevention and complications during clinical encounters at continuity and well-child clinics.…”

“…Potential short-term consequences of recurrent UTIs in children include an increased risk of developing sepsis and infections caused by multidrug-resistant organisms. 1 If such infections are not prevented, children can develop renal scarring, hypertension, and chronic kidney disease. 2 As mentioned in the literature, uncircumcised boys and children with chronic constipation have a higher risk of recurrent UTIs, thus increasing the risk of complications and morbidity.…”

“…Urinary tract infections (UTIs) are one of the most common bacterial infections pediatric patients. 1 Females, uncircumcised males, and infants are at a higher risk of developing UTIs. 2 Childhood UTIs prevalence varies considerably based on gender and age.…”

“… 2 , 11 , 12 Patients with symptoms and signs suggestive of a UTI should be evaluated with a comprehensive medical assessment, including a detailed medical history, a thorough physical examination and sending urine samples for microscopic and macroscopic urine sample evaluations and a urine culture. 1 , 13 …”

“…Uncomplicated UTIs are typically confined to the urinary bladder and occur in healthy individuals with no structural abnormalities. 1 , 14…”