Article in Japanese
Urinary Tract Infection in Children: Up-to-Date
In this article, up-to-date knowledge of urinary tract infection (UTI) in children will be reviewed.
While UTI is relatively common in children, especially in infants, it is often overlooked because of the lack of specific findings in clinical symptoms and laboratory findings. For the diagnosis of UTI, urine culture is essential. In order to avoid the contamination, urine samples for culture should be collected using a urinary catheter before antibiotic administration from all infants with fever of unknown origin as they may suffer from upper UTI. Regarding treatment for UTI, intravenous cephem antibiotics administration is effective in most cases. However, the possibility of multidrug-resistant bacteria including extended spectrum β-lactamases-producing bacteria as a pathogen in intractable cases should be considered as it is recently increasing.
Upper UTI during infancy is associated with renal scar formation leading to permanent renal damage. In addition, majority of children with upper UTI have underlying conditions such as vesicoureteral reflux (VUR) and/or bladder and bowel dysfunction (BBD). Therefore, it is imperative to perform renal ultrasound examinations and voiding cystourethrography to detect VUR and to take history regarding BBD symptoms. If high-grade VUR or BBD is found, preventive measures for recurrent UTI should be taken, such as continuous antibiotic prophylaxis for VUR and behavioral therapy for BBD.
Finally, research topics on UTI such as the role of innate immunity within the urinary tract and the association of urinary microbiome with urinary tract diseases will be introduced.
1) Department of Pediatrics, Kansai Medical University
|Received||January 1, 1970|
|Accepted||January 1, 1970|