Urinary tract infection in children – How dangerous is it?

Definition

Urinary tract infection is an infection of the urinary tract, which is usually caused by bacteria and only very rarely by viruses. In most cases, an inflammation of the urethra, the connection between the bladder and the outlet, occurs. In rare cases, the bladder itself may also be inflamed, as well as the ureter, which carries urine from the kidney to the bladder. Typically, girls are significantly more frequently affected by a urinary tract infection than boys.

Causes

There are several possible causes of urinary tract infections. Most often, the urinary tract infection is caused by bacteria from the intestine. Especially in children, the exit of the urethra in the diaper also comes into contact with the bowel movement.

Bacteria excreted from the intestine can enter the urethra and cause a urinary tract infection. Therefore, the most common pathogens of a urinary tract infection are the 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. Especially in children, viruses can also be responsible for urinary tract infections. In most cases, an infection with adenoviruses is the cause of the viral urinary tract infection.

Rarer 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 (so-called phimosis). This can complicate hygiene in the genital area.

Under the foreskin – i.e. directly at the entrance to the urethra – bacteria can thus 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 into the ureter. This is particularly common when there is reflux (the flow of urine from the bladder back up into the ureter). In most cases, this is also the result of a minor malposition of the ureteral structure.