URINARY-TRACT INFECTIONS IN CHILDREN - WHY THEY OCCUR AND HOW TO PREVENT THEM

Urinary tract infections (UTIs) usually occur as a consequence of colo nization of the periurethral area by a virulent organism that subseque ntly gains access to the bladder During the first few months of life, uncircumcised male infants are at increased risk for UTIs, but thereaf ter UTIs predominate in females. An important risk factor for UTIs in girls is antibiotic therapy, which disrupts the normal periurethral fl ora and fosters the growth of uropathogenic bacteria. Another risk fac tor is voiding dysfunction. currently the most effective intervention for preventing recurrent UTIs in children is the identification and tr eatment of voiding dysfunction. Imaging evaluation of the urinary trac t following a UTI should be individualized, based on the child's clini cal presentation and on clinical judgment. Both bladder and upper urin ary tract imaging with ultrasonography and a voiding cystourethrogram should be obtained in an infant or child with acute pyelonephritis. Im aging studies may not be required, however, in older children with cys titis who respond promptly to treatment.