Urinary Tract Infections in Children

Demographics Context and Definition

Clinical Presentation

Urine testing – who needs it?

Urinary Collection Techniques

When to send urine for culture

Further Imaging

Prevention and Prophylaxis

2 Topics

Urinary Tract Infections in Children

Urinary Tract Infections in Children

Urinary Tract Infections in Children Urinary Tract Infections in Children

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Question 1 of 8

1. Question
Which of the following symptoms or signs are NOT suggestive of a UTI?
- Failure to thrive
- Offensive urine
- Jaundice
- Incontinence
- Vulval itching
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Question 2 of 8

2. Question
Which of the following is not an acceptable urine collection method in children?
- Ultrasound guided suprapubic aspirate
- Clean catch urine sample
- Cotton wool balls in nappy
- Catheter sample
- Urine collection pad
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Question 3 of 8

3. Question
A 4-year-old girl has her first confirmed E. coli UTI. She is systemically well. Which of the following investigations is appropriate?
- Nothing
- An ultrasound of her renal tract
- An ultrasound and DMSA scan
- A micturating cystourethrogram (MCUG)
- A dimercaptosuccinic acid (DMSA) scintography scan
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Question 4 of 8

4. Question
A 9-month-old boy is successfully treated with antibiotics after his first UTI. Which of the following drugs is recommended as prophylaxis?
- No antibiotic
- Nitrofurantoin
- Trimethoprim
- Cephalexin
- Amoxicillin
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Question 5 of 8

5. Question
Which of the following organisms is NOT a commonly recognised cause of UTI?
- Proteus mirabilis
- Escherichia coli
- Klebsiella
- Mycoplasma hominis
- Pseudomonas aeruginosa
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Question 6 of 8

6. Question
Which of the following statements regarding urine dipstick testing are true?
- Dipsticks should not be used in infants under 3 months
- A 2-year-old child who has nitrites but no leukocytes on urine dipstick should be treated for UTI
- A 2-year-old child who has leukocytes but no nitrites on urine dipstick should be treated for UTI
- Leukocytes found on urine dipstick can only be caused by a UTI
- A 5-year-old child with leukocytes but no nitrites on dipstick should only have antibiotics started if there is good clinical evidence of a UTI
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Question 7 of 8

7. Question
Which of the following is not an indication for urine microscopy and culture?
- A febrile 4 year old with positive result for nitrites on urine dipstick
- A febrile 2-month-old
- A febrile 4-year-old with bulging red tympanic membranes, green on NICE Traffic Light criteria
- 7-year-old with lower urinary tract symptoms and several previous UTIs
- A 8-year-old who is febrile and shocked despite 40ml/kg fluid bolus
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Question 8 of 8

8. Question
Which of the following is correct?
- CRP should be used to differentiate between upper and lower UTI
- Hydronephrosis may represent renal tract obstruction or vesicoureteric reflux
- All children who diagnosed with UTI with need a DMSA or MCUG scan as an outpatient
- Never administer antibiotics for UTI until a urine sample has been obtained
- All febrile children require a urine dipstick +/- culture
Correct

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