Definition
A urinary tract infection is an infection (usually by bacteria, rarely by viruses) of the urinary tract. This can lead to an inflammation of the urethra. The bladder can also be inflamed, and the ureter, which carries urine from the kidney to the bladder, can also be affected by the infection. In most cases, however, it is an uncomplicated urinary tract infection of the urethra (from the bladder to the exit). Typically, girls are more often affected by the urinary tract infection than boys.
Causes
There are several possible causes for the development of urinary tract infections. Most often, the urinary tract infection is caused by bacteria from the intestine. Especially in children, the discharge of the urethra in the diaper also comes into contact with the bowel movement.
Bacteria that are excreted from the intestine can enter the urethra and cause a urinary tract infection. Therefore, the most common pathogens causing a urinary tract infection are enterobacteria from the intestine. These include bacterial species such as E. coli, Proteus mirabilis and Klebsiellen.
Enterococci and staphylococci can also cause urinary tract infections. Particularly in children, viruses can also be responsible for urinary tract infections. In most cases, an infection with adenoviruses is at the root of the viral urinary tract infection.
Less common causes of urinary tract infection in children are abnormalities in the anatomy of the urinary tract. For example, boys occasionally have to struggle with a narrowing of the foreskin (phimosis). This can complicate hygiene in the genital area.
Under the foreskin – i.e. directly at the entrance to the urethra – bacteria can quickly accumulate, which then cause a urinary tract infection. Some children are also particularly susceptible to more complicated urinary tract infections. The bacteria rise through the urethra into the bladder and from there further up the ureter. This is especially common when there is reflux (the flow of urine from the bladder up into the ureter). In most cases this is also the result of a minor malposition of the ureteral structure.
Diagnosis
The diagnosis of the urinary tract infection is made in a urine sample. It is important that the urine sample is taken cleanly so that it is not contaminated by normal (naturally occurring) skin germs, which are then mistakenly mistaken for pathogens. In the urine sample, various substances such as bacteria, inflammatory cells and degradation products of the bacteria can be detected by means of a U-Stix (a small paper strip).
You can also look at the urine under a microscope and find bacteria there. A urine culture should be carried out to detect the germ that caused the infection. This involves placing a few drops of urine on a culture medium and then observing whether bacteria grow there.
