Understanding UTIs in Children: Diagnosis and Treatment

How Do We Test For a UTI?

There are 2 ways we test for a UTI, which are a lab test of your child’s urine and an ultrasound of your child’s kidneys and bladder.

Lab Testing

For the lab test, we will do a urinalysis and a urine culture. The urinalysis will tell us if there are bacteria in your child’s urine. The urine culture will tell us which types of bacteria are in your child’s urine. We will receive the culture results 24-48 hours after the test.

The way we collect a sample of your child’s urine depends on their age. If your child is not yet toilet trained, a doctor or nurse might insert a catheter (a small tube) into your child’s urethra so urine can flow out into a sterile container. We use a catheter so we can avoid picking up bacteria from your child’s skin or rectal area (bottom).

If your child is toilet trained, we will have them do a clean-catch urine collection. For this, we will give your child special wipes to remove bacteria from their genital area. Then, your child will urinate normally into the toilet. Your child will stop urinating midstream and finish urinating in a sterile container.

Which Imaging Tests Do We Use to Learn More About a UTI?

We might need to use imaging tests to figure out where the UTI is in your child’s urinary tract. The imaging tests we might do include:

• Ultrasound
  Your child’s nephrologist (kidney doctor) might send your child for an ultrasound of the kidneys and bladder. This will help us figure out where the infection is in your child’s urinary tract.
• Voiding Cystourethrogram (VCUG)
  Your child’s nephrologist (kidney doctor) might send your child for a voiding cystourethrogram (VCUG). This test helps us see if urine is going back up into the kidney and causing infections.

How Do We Treat a UTI?

We will give your child antibiotics to treat the UTI. Even though the results of your child’s urine tests take 24-48 hours to come back, we can give your child antibiotics right away.

How Can I Prevent a UTI in the Future?

There are many ways that you can help prevent your child from getting a UTI in the future. Here are some ways you can help:

• Tell your child not to hold in their urine. If they have the urge to go, then go. Children should urinate every 2-3 hours.
• Have your child drink plenty of liquids, like water or cranberry juice, to flush bacteria out of the urinary tract.
• Wear cotton underwear to prevent moisture from becoming trapped near your child’s body. Bacteria like to grow in warm, moist places. Cotton will help prevent moisture from becoming trapped near your child’s body.
• Avoid wearing a wet bathing suit for long periods of time. This can also create a place for bacteria to grow. Have your child change into dry clothes shortly after wearing a wet bathing suit so moisture doesn’t become trapped near their body.

If you have a daughter...

• Teach her to wipe front to back after using the bathroom. Wiping front to back will help prevent bacteria from the rectum getting into the urinary tract. Girls’ urethras are closer to where they wipe, so bacteria from the rectum can more easily get into the urethra.
• Have her avoid bubble baths until the UTI is gone. Bubble baths can irritate her urethra and make her uncomfortable.

If your child has recurring or frequent UTIs, we might have them get additional imaging tests. We will talk with you about whether your child needs additional imaging tests.

Rev. 5/2015. Mass General for Children and Massachusetts General Hospital do not endorse any of the brands listed on this handout. This handout is intended to provide health information so that you can be better informed. It is not a substitute for medical advice and should not be used to treatment of any medical conditions.