Urinary tract infections are considered the most common in our country, both in children and adults. Famous pediatrician Yevgeny Komarovsky tells about how to suspect and recognize such infections in a baby, what they are, how to treat a child.
General information
Urinary tract infections (UTIs) are a large group of diseases that are mostly caused by microbes that affect one or another part of the genitourinary system. If the lesion of pathogenic bacteria affects the urinary tract, they speak of urethritis. If the bladder located above is inflamed, then this is cystitis. Both of these ailments are inferior UTIs.
The defeat of the upper tract - pyelonephritis. It affects the tissues of the kidneys, pelvis and calyx. Simple forms of UTI are usually not accompanied by disturbances in the outflow of urine, while complicated ones often occur against the background of abnormalities and disorders in the very structure of the organs of the urinary system.
Also, infections can be both hospital (appeared after some medical procedures) and community-acquired, which develop without preliminary manipulations (for example, the introduction of a catheter).
Childhood infections are very insidious. According to Dr. Komarovsky, their identification is significantly complicated by the fact that they often occur with less severe symptoms than in adults. In addition, the widespread use of diapers makes it rather difficult to initially diagnose the sometimes only child symptom in infants and older babies - frequent urination, because mothers simply do not notice this in a diaper.
All types of UTIs can be acute and in children they are most often just like that, but there is a risk of chronicity of the disease if the disease is not noticed in time, the diagnosis is not carried out, the treatment is incorrect or treatment is interrupted.
In general, urinary tract infections in childhood, according to Evgeny Komarovsky, respond well and quickly to therapy.
Symptoms
In newborns and infants, such infections can be quite difficult for unprepared parents who do not have a medical education diploma. The symptoms are not clear-cut. Children become more irritable, whiny, their appetite worsens, and sometimes the temperature rises. The first sign is frequent urination, which is very difficult to notice in a baby.
Older children, preschoolers and schoolchildren can already inform their parents about cramps, pain, frequent urge to urinate, and therefore the diagnosis is easier. Also, the child becomes irritable, may complain of chills, be apathetic. The older the children become, the more often the symptoms of urinary disorders come out on top.
With infectious lesions of the urinary tract, the color and amount of urine change, it becomes cloudy or completely cloudy, and an unpleasant odor appears.
Causes
The development of UTIs is facilitated by various congenital anomalies in the structure of the departments and organs of the genitourinary system, as well as their functional disorders. Many parents believe that a child can get sick with acute pyelonephritis or cystitis from hypothermia. It is more correct to say that hypothermia provokes a decrease in immunity, and bacteria are still the trigger mechanism of the inflammatory process.
Dr. Komarovsky emphasizes that, stomping barefoot on the floor, a child cannot get cystitis, since the vessels of the lower extremities can narrow and thereby "save" internal heat. But sitting on a cold one is a dangerous prerequisite for the development of inflammatory processes in the urinary system.
Another common premise, according to Komarovsky, is incomplete emptying of the bladder. This happens when the baby leans forward while urinating. This is mainly done by girls, since they are sitting on the pot. It should be noted that girls are 30 times more likely to suffer from UTI diseases also for the reason that the anatomical structure of their urethra differs from that of boys. It is shorter, located closer to the anus, and therefore the likelihood of infection with bacterial flora is higher.
Cystitis or pyelonephritis can be provoked by any ailment that undermines the state of an already weak children's immune system - ARVI, flu, etc. Separately, there is the so-called neurogenic bladder - a condition in which, due to dysfunction of the central nervous system, collection and diversion of urine.
How can germs get into a child's urinary tract? There are several such methods. Most often, inflammation is caused by E. coli, it can get in with improper washing, insufficient level of hygiene of the child. Pseudomonas aeruginosa, Klebsiella, Proteus, enterococci, streptococci and candida fungi can also cause inflammation of any part of the urinary tract.
Most often, the infection develops along the ascending path, from the bottom up - from the urethra to the kidneys. But infection from neighboring foci of infection is also possible, as well as through the bloodstream with blood and lymph.
Diagnostics
In order for the child to be diagnosed accordingly, according to Komarovsky, laboratory diagnostics are required. Usually, a general clinical analysis of urine for urinary tract infections shows a huge number of leukocytes. Further laboratory research (bacterial sowing) makes it possible to establish the name of the exact causative agent of the inflammatory process. If necessary, other techniques are also used to establish the exact location of the inflammation, such as X-ray of the bladder with contrast, ultrasound of the bladder and kidneys.
Much of the accuracy of the diagnosis depends on how the parents collect the urine correctly.
The child needs to be washed and only the average portion of liquid should be collected in the container in the morning after waking up.
For bacterial culture, urine is collected in a sterile container, which is given in a medical institution. It is necessary to deliver a jar of baby urine to the laboratory of a polyclinic or children's hospital as soon as possible, because during each subsequent hour the colonies of pathogenic bacteria in it increase and grow.
If necessary, in difficult cases, the child can be recommended MRI and CT. But the need for this arises only in case of suspicion after ultrasound of structural congenital anomalies of the urinary system, which may require surgical intervention.
To sound the alarm, according to Komarovsky, the mother should immediately, as soon as she suspects something was wrong, much in the prognosis of UTI treatment depends on the timeliness of treatment. To do this, Evgeny Olegovich recommends looking into diapers as often as possible, assessing the color, smell and amount of urine. If something seems suspicious, there is no need to be shy, you should immediately show the child to the pediatrician, who will first of all prescribe a general urine test.
Treatment
Dr. Komarovsky urges parents to be attentive to the treatment of such ailments in children.
In no case should you not treat the disease and wait until everything goes away on its own. Unconventional treatment with traditional medicine - herbs, broths - can also be dangerous.
Treatment can be outpatient and inpatient, it depends on the severity of the disease and the degree of damage. It is very important that a qualified doctor is involved in the treatment. Komarovsky argues that bacterial infections, which, in fact, are UTIs, should be treated exclusively with antibiotic therapy.
The treatment is carried out by a pediatrician, urologist, nephrologist. Treatment always begins with a change in regimen. It is necessary to limit physical activity, increase the amount of fluid consumed by the child - a warm and plentiful drink will contribute to more abundant urination.
Mom needs to make sure that the child empties the bladder every two hours, stagnant urine can increase the growth of bacteria.
If the infection is severe, the child may be given bed rest. During treatment, you should not give the baby pickled foods, smoked meats, but foods with a high content of vitamin C should be added to the diet to increase the acidic component of urine. Antibiotics must be taken strictly according to the scheme prescribed by the doctor. Even if it gets better on the second day, you cannot refuse further course of antibacterial drugs, since the surviving bacteria will acquire resistance to the drug, and the disease can become chronic.
Komarovsky claims that UTIs are treated quickly enough, and therefore, in the absence of relief on the second day after starting antibiotics, it is necessary to consult a doctor and choose a new drug.
It is best to prescribe a specific medicine to the child after urine culture, taking into account the type of pathogen. Antipyretic drugs can be used at high temperatures, antihistamines for severe general intoxication. Physiotherapy may be recommended at the end of the treatment course.
Prevention
Urinary tract infections in a child are always easier to prevent than to cure, says Evgeny Komarovsky, and therefore all parents need to know the rules for the prevention of inflammatory processes of the urinary tract.
- First of all, it is important to strengthen the immune system so that even the presence of bacteria and hypothermia do not cause an inflammatory process. For this child, you need to temper, do cool baths, gymnastics, and walk with him more often.
- Parents should promptly identify and eliminate risk factors that can contribute to the development of infection - visit a doctor, undergo all necessary examinations with the child on time, participate in medical examination, and take urine tests. This will help to find out in time about the beginning pathological processes and prevent the development of severe UTI.
- A child needs to be taught from an early age to observe the rules of personal hygiene: to teach how to wash properly, wipe the bottom after a bowel movement.
- It is important to ensure that your baby does not sit on cold surfaces.
You will learn more about urinary tract infections in the transmission of Dr. Komarovsky.
