Urinary tract infection in newborns. Diagnosis of genitourinary infections

One of the most common causes of childhood illnesses is urinary tract infection in children. Most of all, this is observed in children under the age of one who need proper care. In patients with infection, the symptoms do not always appear, but often serious complications arise, which are difficult to cure. How to determine the presence of the disease?

General information about the disease

Infectious urinary tract inflammation in children is most often manifested without symptoms and is detected by a comprehensive examination of the patient. With diseases of the urinary system, the body quickly gives in to infectious effects, as a result of which the child's kidneys become inflamed. In order to examine the child for infection, a general urinalysis, ultrasound is prescribed. After the study, the baby is prescribed a treatment complex that includes antibiotics and uroantiseptics, which are reinforced with traditional medicine.

Reasons for the development of pathology

  Very often the cause of the development of pathology is E. coli.

Inflammation of the urinary tract in childhood occurs due to various harmful microorganisms. The infection that spreads in the body depends on what gender the child is, how old he is, and in what condition his immune system. Enterobacteria are among the most common microbes, among which Escherichia coli is more often found. Other factors in the occurrence of diseases of the urinary system can be:

• urodynamic disorders (ureteral reflux, malfunctioning of the bladder);
• decreased efficiency of the immune system (due to the production of a small number of antibodies, cell immunity decreases);
• disturbed metabolic processes;
• changes in blood vessels in the kidney tissue;
• irregular structure of the organs of the reproductive system, congenital anomalies;
• the spread of infection in the genitals or intestinal environment;
• the appearance of worms in a child;
• urinary tract surgery.

According to statistics, the disease is more common in patients up to a year, however, depending on gender and age, different incidence rates. Most often, the pathology is diagnosed in girls due to the fact that their urinary canal is close to the vagina, and the female urethra is much shorter than in men. Girls are most often ill at the age of 3-4 years. Infection of the genitourinary system in the baby is more characteristic of the boy. In this case, inflammation of the urinary tract in a child occurs due to abnormal development of the genitals. In addition, the cause of a urinary tract infection in the baby may be improper care.

Factors contributing to the development of infectious inflammation

  Infections can be dangerous with weakened immunity.

There are many predisposing factors that cause a bladder infection to spread in children. Among them, disturbed normal urinary outflow, obstructive uropathy, reflux of the bladder and urinary tract are distinguished. Pathology develops due to a deterioration in the functioning of the immune system, impaired metabolic processes, and also manifests itself in patients with diabetes mellitus, renal calcification. Also, infections can get into the urinary tract due to medical interventions, after which harmful microorganisms are able to multiply more actively.

Classification of harmful microorganisms

According to the prevalence of inflammation, there are microorganisms that affect the upper parts of the excretory system (kidneys, ureters) and the lower parts (bladder, urethra). Thus, with the defeat of the upper sections, pyelitis, pyelonephritis is diagnosed, and with infection of the lower sections - cystitis, urethritis. Depending on the period of occurrence, the disease is in the first episode or recurring. The disease is sometimes reinforced by secondary infection. Looking at the symptoms that appear in the patient, a mild and severe infection is secreted (complications appear, it is difficult to tolerate).

Symptoms of urinary tract infections in children

Symptoms occur depending on the age of the small patient. In children who are under 2 years old, there is a fever, vomiting, diarrhea, the shade of the urethra changes, and the skin turns pale. Newborns lack appetite, they are capricious, cry and become irritable. In patients of 2 years of age and above, pain begins during urination, the urine is dark in color, the lower abdomen hurts, and the body temperature rises to 38 degrees and above.

Features of manifestation in infants

  Inflammation of the genitourinary system of infants can be asymptomatic.

In infants, infectious inflammation of the genitourinary system manifests itself to a greater degree without signs: temperature indicators practically do not increase, intoxication, gray skin, apathetic state may occur, anorexia may occur. If the patient has acute bacterial cystitis, then his temperature rises above 38 degrees.

Diagnostic measures

Laboratory examination methods

Bacteriological method for the study of urine

The bacteriological method is the main when examining a patient for the presence of genitourinary infections. Such a study allows you to determine the type of harmful microorganism, as well as its level of sensitivity to antibiotics. To have accurate results, you must adhere to the rules of the survey, as well as have sterile instruments.

General urinalysis

Another, no less reliable way to examine the patient is a general urine test. With it, you can determine the number of white blood cells, red blood cells, and protein levels in the urine. In the case of increased indicators, they speak of the occurrence of inflammatory processes in the organs of the urinary system, including in the kidneys and in the bladder.

General blood test method

  To determine the infection, you must take a blood test.

To determine the presence of inflammatory processes in the urinary system, a general blood test is performed. Using this method, you can detect elevated leukocyte level, high ESR and changes in the leukocyte formula. Often, inflammatory processes are characteristic of the development of pyelonephritis. For urethritis or cystitis, inflammation is less common.

Instrumental diagnostic methods

Ultrasound as a survey method

Ultrasound is allowed to be carried out regardless of age. Using the ultrasound examination method, it is possible to see the real size and condition of the kidneys, determine the stones in the urinary system, evaluate the volume of the bladder, as well as the presence of inflammatory processes in it. Ultrasound makes it possible to determine the abnormal development of organs in the early stages.

Young children suffer from urinary tract infections (kidneys, ureters, urinary bladder, urethra) - UTI is almost as common as SARS. Early age is one of the factors that increase the risk of developing diseases of this group.

Moreover, in the first 3 months of life, the infection often affects boys, and then the ratio changes. This article is addressed to parents of infants, it will help them recognize a urinary tract infection in their child. The publication also highlights the causes of these diseases, contains tips on their prevention and treatment.

Symptoms

It is difficult to recognize infectious diseases of the urinary system in an infant because:

• Their symptoms are not specific, characteristic of a number of other diseases;
• The child does not yet control urination;
• He is not able to describe his feelings.

As in adulthood, the main signs of UTI are pain and burning when urinating, usually accompanied by pain in the lower back and abdomen. Parents can guess that the baby is hurt, according to indirect signs:

• The child is anxious;
• Crying during urination;
• Negatively reacts to touching the tummy and lumbar region.

The following symptoms are also characteristic of UTI:

• A change in the daily volume of urine is a three-fold decrease in the volume of urine excreted, and a double or more increase;
• Frequent urination;
• The stream of urine is weak, intermittent;
• Unpleasant odor, atypical for the urine of the infant;
• Saturated yellow or pink, reddish color of urine, its turbidity;
• Swelling of the tissues;
• Lack of appetite, depressed mood, moods, crying;
• Fever, fever;
• Digestive disorders, diarrhea and vomiting.

More accurate diagnosis of UTI in infants allows laboratory analysis of urine or its rapid study using test strips, ultrasound of the kidneys and other laboratory and hardware methods. It is advisable to know for sure,.

Causes

The body of the infant is vulnerable to various infections, bacteria can enter the urinary tract in two ways:

• From other organs, if they have a focus of infection or pathogens;
• With the milk of a mother suffering from an infectious disease.

A predisposition to UTI is inherited, children whose parents suffered from such diseases are at risk. An important factor provoking urinary tract infection is congenital anomalies of their structure. The following reasons can be distinguished:

• Anomalies that cause vesicoureteral reflux, that is, outflow of urine into the kidneys through the ureters from the bladder - fluid congestion in the kidneys creates a favorable environment for the growth of bacteria;
• Violation of the outflow of urine due to narrowing of the ureter, usually caused by squeezing a nearby blood vessel;
• Abnormal location of the urinary organs;
• Pathology of the structure of the kidney (horseshoe-shaped kidney).

With congenital malformations, UTI are diagnosed at a very young age.

Most often, UTIs develop due to penetration into the urethra from the anus of Escherichia coli, the risk of infection increases if hygiene rules are not followed or improper washing technique. From the urethra, the infection can spread higher, capturing the excretory organs, up to the kidneys.

Less often, the kidneys are first infected: the infection enters them from the affected internal organs with a blood or lymph flow, then falls into the lower urinary tract. In addition to intestinal bacteria, the causative agent of infection can be streptococci and other bacteria, less often fungal and. The following factors contribute to the development of UTI, along with insufficient hygiene:

• Hypothermia;
• Improper nutrition;
• General weakness of the body (premature babies);
• Gastrointestinal diseases;
• Exchange disorders.

It is also possible infection during medical procedures.

Prevention

If the organs of the urinary system have a normal structure in a baby, infection can be prevented by strengthening the baby's immunity, protecting it from hypothermia and observing hygiene rules:

• Perineal washing should be carried out daily, infants must be washed and after each bowel movement;
• The correct washing technique - in the direction from the urinary organs to the anus, so as not to infect the infection;
• It is necessary to change wet and soiled diapers in a timely manner (in older children, change underwear daily).

If a nursing mother is sick with an infectious disease, it is necessary to take drugs that are allowed during lactation. In order to avoid infection of the baby, it is recommended to stop breastfeeding, express milk until the mother recovers, and temporarily transfer the baby to the mixture.

It is important rational nutrition of the mother, a minimum of sweets, foods that can cause intestinal upset.

An excellent measure for the prevention of UTI is the introduction of cranberry juice, blackcurrant juice into the diet, they can be given to children from six months old, better diluted with water or mixed with others.

Treatment

A timely untreated urinary tract infection is fraught with serious complications, damage to the kidney tissue. Therefore, in case of a febrile condition and other signs of UTI in an infant, it is necessary to consult a pediatrician throughout the day, who will prescribe general and more detailed urine tests, other examinations (primarily ultrasound), refer the child to narrow specialists - a pediatric nephrologist, gynecologist or urologist .

Paid analysis - the study of bacterial cultures in urine for sensitivity to antibiotics - allows you to prescribe the most effective antibiotic for a specific pathogen, and parents can take the initiative by asking the doctor for a referral to it.

But it should be borne in mind that the selection of material for analysis must be performed before antibiotic therapy begins.

Since UTI is most often bacterial in nature, antibiotic treatment is prescribed. First, a broad-spectrum drug is prescribed, if a study was conducted on the sensitivity of the pathogen to antibiotics, other drugs may be recommended according to its results.

Breasts can be given in suspensions, but if the child is vomiting, or for other reasons oral administration (through the mouth) is not possible, intravenous administration of the antibiotic through a catheter is most effective, requiring hospitalization of the baby. Intramuscular injections are painful and less effective.

Antibiotic therapy should lead to improvement on the second day, if within 48 hours the child does not feel better, additional diagnosis and correction of the treatment regimen are necessary. Antibiotic treatment of UTI should be long enough, at least 7 days, and you cannot stop taking the medicine, even if the symptoms have disappeared.

• Recipes of traditional medicine, all kinds of diuretic and anti-inflammatory teas in UTI are ineffective, but can be used as an adjunct treatment in parallel with antibiotic therapy;
• To relieve symptoms and strengthen the immune system, anti-inflammatory drugs with antipyretic and analgesic effects (Ibufen), antioxidants (vitamin E) are prescribed;
• When acute infection is eliminated, supportive physiotherapy is recommended - UHF, electrophoresis, paraffin and ozokerite applications, coniferous baths and other procedures.

If diseases are caused by abnormalities in the development of organs, antibiotic therapy helps in the fight against acute infection, but cannot prevent relapses. Therefore, after the elimination of the acute inflammatory process, it is recommended that the existing defects be corrected by surgical or endoscopic intervention.

Conclusion

Parents of infants should take care of their hygiene, the toilet of the genitals to prevent UTI, and if there are alarming symptoms, consult a doctor immediately. The only effective treatment for UTI is antibiotic therapy, and self-selection of drugs, as well as their cancellation, are strictly not allowed. If diseases of the urinary system are observed in a newborn child, it is necessary to examine him to identify possible malformations, which are corrected by surgical intervention.

Urinary tract infection in infants is a common occurrence, and by the time the child is 5 years old, up to 10 percent of the children have had this disease at least once.

In older children, the infection causes a number of obvious symptoms, accompanied by burning or pain when urinating. The disease is harder to detect because the symptoms are less specific. In fact, fever is sometimes referred to as the only symptom.

In most conditions of infection occurring penetration of bacteria into the urinary systemrepresented by the kidneys, ureters, bladder and urethra. Each of these organs is important for removing liquid waste from the body. The kidneys filter blood and produce urine, the ureters move urine from the kidneys to the bladder, the bladder stores urine until it is excreted through the urethra.

Infection of the urinary tract in the baby can occur anywhere along the tract, but the lower part - the urethra and the bladder - most often have to participate in the infection. This leads to cystitis. If a urinary tract infection in the baby affects the ureters, the kidneys, this leads to progressive pyelonephritis.

Prerequisites for the development of this disease

Although the presence of bacteria of this kind is mostly not detected in the urine, they are able to enter the urinary tract from the skin around the anus (intestinal bacteria such as E. coli are one of the causes of problems of this kind). Many other bacteria and viruses also provoke a similar disease. Rarely, bacteria can reach the bladder or kidney through the bloodstream. Researchers and doctors do not classify this bacterial infection as a contagious disease.

Urinary tract infection in infants is much more common in girls, because the girl’s urethra is shorter and is shorter than the anus. Uncut boys less than 1 year old are also at high risk of developing this problem.

Other risk factors for infection include:

• Anomalies in the structure or function of the urinary tract (detection of impaired renal function or blockage somewhere along the normal urine flow path).
• Incorrect reverse flow of urine from the bladder up to the ureters and kidneys.
• Wrong toilet and hygiene habits.
• Excessive use of cosmetics that irritate the structure of the urethra.

The infection is highly treatable, but important to start it early. An untreated or untreated situation may cause impaired renal function.

List of manifestations

  Signs change under the influence of which age group the child belongs to and which part of the urinary tract belongs to a number of infected people. In babies, symptoms may be common. The child can be convicted of irritability, poor nutrition, vomiting. Sometimes the only symptom is the state of fever, which, to parents, seems to manifest itself for no apparent reason and does not level out over time.

When infection is present:

1. Frequent urination (although only a small amount of urine is produced).
2. Regular nightly trips to the bathroom half asleep due to urination.
3. Manifestations of lumbar pain.
4. Pain surrounding the abdomen in the area of \u200b\u200bthe bladder (usually below the navel).
5. Urine may contain blood.

The need for preventive measures

In toddlers, not rare, but regular diaper changes can help prevent the bacterial spread that causes the disease. When children should already control the principles of self-care themselves, it is important to teach them how to maintain proper hygiene.

After each bowel movement, girls should remember that they should be wiped with paper from the front to the back, from the vagina to the anus, to prevent the spread of germs from the rectum into the urethra.

All children should learn that the urination process should be performed at the first urge and not be held back for some time (when of course circumstances do not interfere), because urine continues to remain in the bladder and forms favorable conditions for bacterial growth.

Parents of children who have been diagnosed with this will need to carefully follow the recovery plan prescribed by the doctor to prevent the risk of relapse.

In most situations, the infection in the baby can be eliminated after a week of proper treatment. The likelihood of relapse is common in children with abnormalities in the urinary system, in those whose bladder emptying is associated with a number of problems (for example, a child with a damaged spine).

Therapeutic technique

When a doctor suspects an abnormality, he will prefer to undergo certain tests, in addition to a urinalysis, which is characterized by ultrasound examinations of the kidneys and bladder, or an analysis accompanied by exposure to x-rays. These tests, as well as other types of imaging studies, will help identify and test structural or functional problems in the urinary tract.

The type of specific effective antibiotics that will be most effectively used to treat such a disease, and how long they should be taken, will depend on the type of bacteria that trigger the worsening of the infection, and the degree of duration and activation of the problems. After a few days, the doctor may repeat the urine test to confirm that the infection has been completely eliminated.

Urinary tract infection in young children is no less common than viral respiratory infections. Parents often attribute vomiting and nausea, pain in the abdomen to simple poisoning. However, with such symptoms, it is recommended to consult a doctor. If this is a urinary tract infection, then its untimely diagnosis and treatment will lead to unpleasant consequences for the baby.

Urinary tract infection occurs when bacteria begin to accumulate at high speeds in the body. This is caused by microbes such as:

• e. coli
• staphylococcus aureus,
• pseudomonas aeruginosa.

Bacteria enter the body through the intestinal tract, spread through the bloodstream and cause the baby to urinate frequently, as a result of which he constantly cries due to cutting pain.

The causes of the disease

Sometimes parents notice that their baby's urine smells strongly of rotten fish, and the smell sometimes resembles acetone. In such situations, the first thing that comes to mind is cystitis. However, the diagnosis may not always be true. Before starting treatment, study the reasons why urine smells like acetone or rotten fish.

If the child has passed all the tests and the results indicated a urinary tract infection, the question arises for parents - why and when did this happen? The causes of the ailment can have a different origin.

Main reasons:

• chronic neuralgia;
• contact with another patient in the pool (E. coli);
• frequent hypothermia;
• non-compliance with basic hygiene rules;
• misuse of diapers;
• lack of a special diet for a small child (protein in urine is higher than the required level);
• the presence in the diet of a large number of smoked and spicy foods.

All these factors can trigger the development of the disease. You need to carefully monitor the condition of the baby and, when he cries for no reason, immediately go to the doctor. If stones form, urination will be accompanied by severe pain.

Symptoms of ailment

The baby's body is very weak, and sometimes immunity to fight pathogenic bacteria is not enough. It is for this reason that parents should carefully monitor how their baby behaves, whether something bothers the child. If you have the symptoms listed below, you should seek medical attention as soon as possible.

What symptoms should I look for:

• frequent urination
• enuresis (urine is released involuntarily in a dream);
• blood in the morning feces of the baby;
• swelling of the legs and under the eyes does not go away for several days;
• signs of E. coli (fever, frequent vomiting and nausea);
• cutting pains in the abdomen (the baby cries when he goes to the toilet);
• urine smells of fish (unpleasant rotten smell);
• the smell resembles acetone.

Diagnosis of ailment

As soon as the parents notice symptoms of a urinary tract infection in their child, they should immediately consult a doctor to prescribe treatment. If urine smells like rotten fish or the smell resembles acetone, then this is a bad sign. The first action in this situation is to take tests.

What the analysis shows if there is an infection (E. coli or others):

• protein;
• in some cases, red blood cells:
• are there any oxalates;
• high white blood cell count.

What blood shows if there is an infection:

• acute phase protein;
• the leukocyte formula shifts to the left.

Sometimes just passing a urine test is not enough to detect infections such as E. coli and the like.

In such a situation, an additional blood donation is required. The doctor studies the results and only after that makes a diagnosis, on the basis of which treatment is prescribed.

Bakposev

In order to determine the main pathogen and whether the body is resistant to antibiotics, it is necessary to additionally pass urine to bacteriosis before starting treatment. The analysis is done no longer than 5-6 days.

The smell of urine, like acetone, is not a definitive diagnosis. Bakseeding allows you to clearly determine whether there is a threat of kidney damage, whether there are oxalates in the urine.

How is the material collected for analysis:

• the genitals of the child are well washed;
• the container for collecting analysis is sterilized;
• a morning portion of urine is collected, which is then poured into a prepared container, after which the last is tightly closed.

What are oxalates and what are they talking about

Oxalates are those salts whose presence in the urine is indicated by analysis. If their number deviates from the norm in a smaller or larger direction, you should consult a doctor.

Salts of oxalates deviate from the norm in the following situations:

• urolithiasis disease;
• bacteria in the child's body;
• inflammatory processes in the intestines.

If oxalate salts and protein were detected in the urine sediment, this means that the child's diet was incorrect.

It is necessary to start treatment of urinary tract infection in time so that the child does not have complications. The first thing to do is to ensure that the oxalate salts and protein reach a normal level.

The diet needs to be changed based on simple recommendations:

1. More fluid for the baby - at least 2 liters per day. Moreover, it should be not only tea or juice, but also ordinary water. Only in this way the blood from the urine will go away, and the protein and the necessary amount of salt (oxalates) will be restored.
2. To kill bacteria, more magnesium must be ingested. It is found in foods such as millet, oats and fish.
3. All B vitamins do an excellent job of removing bacteria from the baby’s body.

If parents continue to notice blood in urine and an odor similar to acetone does not pass, then nutrition did not help restore protein and oxalates (salts) to the desired level. Symptoms indicate that a urinary tract infection still worries the baby.

Treatment of ailment

When a child cries, any parents suffer. They are trying to do everything possible to improve the condition of the baby. However, if the smell of urine resembles acetone, self-medication will not help.

It is important to correctly diagnose the ailment, pass the necessary tests and only then draw conclusions.

1. If a child cries heavily before going to the toilet, and the smell of urine resembles acetone, these are symptoms similar to cystitis. A timely visit to a doctor will help diagnose the ailment at the stage when home treatment is still possible. Parents should know that bacteria cannot be killed without antibiotics, there are no other ways. When blood appears in urine, getting rid of cystitis will be much harder. Therefore, the main advice in this case is to consult a doctor as soon as possible and strictly follow his recommendations.
2. Pyelonephritis. If the bacteria were not eliminated in time, pyelonephritis develops. This disease can not be cured on its own, and the child will have to be placed in a hospital under the supervision of a doctor.

Regardless of the diagnosis, the first thing that doctors do is restore protein and oxalates (salts) in the children's body.

Blood is constantly being donated for analysis and urine to monitor if the disease is progressing or the bacteria are dying.

Attention is also drawn to whether an odor similar to acetone has disappeared. If this happens, then the condition of the child is improving.

Preventative measures

No parents want to see their beloved baby cry. To prevent urinary tract infections and other bacteria, follow simple preventative measures.

1. Regularly bathe your baby in a daisy and a string. These herbs kill any bacteria, help strengthen the immune system.
2. In order to maintain the right amounts of salts and oxalates in the baby’s body, feed the baby correctly and do not abuse harmful products (smoked, fried).
3. Of course, for a small child it is important to observe the rules of hygiene. Change your diapers regularly, wash your baby every day, and make sure your clothes are always clean.

Symptoms such as blood in urine and poor analysis (high protein, oxalate salts are present) are harbingers of trouble. The faster you see a doctor, the sooner you will save your baby from unpleasant pain.

In a child, they are a very common cause of hospitalization and only ARVI are second in this dubious championship.

What exactly causes infections? How are they diagnosed in newborns? Is it possible to prevent their appearance? This will be the subject of today's article.

What is the urinary system

Before talking about diseases, let's remember which organs belong to a person.

• Let's start with the kidneys - the paired organ responsible for filtering urine.
• The ureters, the tubes through which the filtered urine moves into the bladder (the organ for the accumulation of this fluid), depart from it.
• The urethra is a tube through which urine comes out.

Normally, all of these structures cannot be a medium for the propagation of microorganisms, since they are sterile. But when bacteria get there from the outside amid weakening of the immune system, a person can develop diseases - urinary tract infections.

In a child, as in an adult, cystitis, pyelonephritis, urethritis, etc. are attributed to such pathologies. But in children, the risk that the inflammatory process goes into a chronic form is much higher. This is even more dangerous due to the frequent absence of obvious clinical manifestations of the disease.

Infection of the cause of its occurrence in a child

As the main reason for the large number of these diseases, the structural and functioning of the genitourinary system in children are highlighted.

For example, in infants up to three years old, due to the immaturity of the renal tissue and weak immunity compared with adults, there are almost no isolated infectious manifestations of the same urethritis or cystitis. Urinary tract infections in a child spread to the entire system, affecting both the urethra and the bladder.

The pathology itself is most often caused by being natural in the flora of the large intestine, becoming a source of inflammation, getting into the kidneys, but it can also be excited by staphylococci, streptococci or other types of bacteria.

Helminthic invasions, which reduce the child’s immune background, frequent constipation, dysbiosis, as well as the presence of chronic inflammation on the skin or other foci of infection, are also a serious danger.

Urinary tract infection in the baby: how it manifests

As you already understood, in order to prevent UTI, it is important to first observe the rules of hygiene. So, in newborn girls, the wide urinary canal that is close to the anus is easily infected, therefore, proper (without soap) and regular washing will play an important role in maintaining the health of the future woman.

But if infection nevertheless happened, then the following signs may indicate this:

•   when trying to pee;
• baby's urine smells bad;
• streaks of blood appear in it or it becomes cloudy;
• baby loses appetite;
• temperature rises;
• vomiting occurs.

Each of these symptoms requires a pediatrician and a thorough examination of the newborn. Untreated urinary tract infections in a child often lead to serious pathologies of the kidneys and other organs at an older age.