Demographics Context and Definition

UTI is defined as the presence of pathogenic micro-organisms in the genitourinary tract with accompanying symptoms. It is a common bacterial infection causing illness in infants and children. It is difficult to recognise because the symptoms and signs are non-specific, particularly in children under 3 [1]. Collecting urine and interpreting results is not easy in this age group, so it is not always possible to confirm the diagnosis.

Up to 7% of girls and 2% of boys will have a symptomatic, culture confirmed urinary tract infection (UTI) by the age of six. The prevalence of UTI in febrile infants is approximately 7% [2].

A systematic review in 2010 [3] found that 15% of children had evidence of renal scarring on a follow up DMSA scan after initial episode of UTI.

Historically, management after the acute infection has involved imaging, prophylaxis and prolonged follow up. This was costly, unpleasant for children, and had a limited evidence base. The current NICE guidelines [1] aim to achieve a more consistent clinical practice, based on accurate diagnosis and effective management.

Learning bite

Routine imaging of all children with a first time UTI is no longer carried out