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What Is The Cause And Treatment For Urinary Tract Infection In An Infant?

Posted on Wed, 24 Dec 2014

Question: My 8 months baby boy was admitted in hospital with high grade fever for growth of E coli in urine.Initially treated with ceftrioxone and amikacin.In absence on clinical improvement,antibiotic upgraded to meropenem and after 11 days of treatment was discharged.
Again after 3 days of discharge UTI relapsed with urine RE pus cell count 15-20/H.P.F,epithelial cells-4-5,RBC-occasional.
My pediatrician gave Taxim O dry syrup course for 10 days for Recurrent UTI and advised for USG(KUB),MCU,DMSA after 1 month.USG report done is normal and there is no fever as of now but last 2 Urine RE reports PUS CELL count has again gone up from 10-15 to Many now after Taximo course completion.
Pls suggest.Iam worried.

Answered by Dr. Sumanth Amperayani (44 minutes later)

Brief Answer:
Suggestions on recurrent and complicated UTI

Detailed Answer:
Hi...this seems to be a complicated urinary tract infection (UTI) as it has occurred for the 2nd time in a short span of time.

I completely agree with your doctor. In USG (KUB), MCU we will find out if there is any backward flow of urine and in DMSA we will come to know if there is any scarring of the kidneys. Based on this we need to decide if the kid needs any continuous preventive or prophylactic antibiotics till the age of 1 year or not.

Only caution is that - we need to prove by urine culture that the urine is sterile before going ahead with MCU.

Till then if there is no high grade fever/ burning urination/ rigors incessant vomiting - no need to worry.

Regards - Dr. Sumanth

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Sumanth Amperayani (3 hours later)

Is it common for UTI to relapse so early in babies?

Kindly Suggest any special care to be taken at home for the baby.We already stopped using baby diapers since doctor said UTI might have happened from using diapers for long periods

Answered by Dr. Sumanth Amperayani (7 hours later)

Brief Answer:
Suggestions on UTI prevention

Detailed Answer:
Hi S.K XXXXXXX ...Yes UTI can occur and recur also so early. Not only that it is especially true in the case of younger kids and early infancies and it is more common in girl babies than boys. In this perspective you are lucky as your kid is a boy.

Home care -

1. You are already doing the best - avoidance of diapers for long time.

2. Change the diapers frequently even at night or during long journeys - whether soiled or not. Use a diaper maximum for 4 hours.

3. Avoid constipation as it is a definite risk factor for UTI.

4. Give him plenty of water and other fluids as constant flow of urine in the urinary tract will prevent further UTIs.

I wish your kid a speedy recovery. If you need any future medical consultation and suggestions, I will be glad to help. You can approach me at the following link. Please find the link below.
www.healthcaremagic.com/doctors/dr-sumanth-amperayani/67696

If you are happy with my interaction - kindly close the discussion and rate it.

Regards - Dr. Sumanth

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Sumanth Amperayani (2 days later)

Had done Urine RE & culture at 2 different labs.
Today got Reports which shows WBC(pus) count-10-12 in one lab and Many in another.
Urine culture report shows
1st lab-Culture to be sterile(aerobic culture at 37c for 48 hrs)
2nd lab-culture shows growth of streptococcus faecalis after 24 hrs of incubation.The sensitivity report also given

Pls suggest

Answered by Dr. Sumanth Amperayani (7 hours later)

Brief Answer:
This is not UTI

Detailed Answer:
HI...both urine routines are suggestive of infection, the 1st culture is sterile and the 2nd culture is growing streptococcus faecalis which means it is a contaminant organism found in the baby's stools. This means the urine was not collected properly for culture test.

But whatever it is , this is not UTI and you can be rest assured.

I suggest you go ahead with MCU and DMSA tests as suggested by your doctor.

I wish your kid a speedy recovery. If you need any future medical consultation and suggestions, I will be glad to help. You can approach me at the following link. Please find the link below.
www.healthcaremagic.com/doctors/dr-sumanth-amperayani/67696

If you are happy with my interaction - kindly close the discussion and rate it.

Regards - Dr. Sumanth

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sumanth Amperayani (2 days later)

Visited doctor.He has prescribed septran suspension for 1 month and has asked for MCU AND DMSA TEST on 25th dec.My query is whether this test is painful for baby and whether any precation to be taken beforehand.

Answered by Dr. Sumanth Amperayani (11 minutes later)

Brief Answer:
Suggestions on MCU and DMSA

Detailed Answer:
Hi....coming to your queries.

1. MCU is done by inserting a small catheter into the urinary tract. While doing so, the will use local anesthetic gel over the catheter. So the pain will be minimal. Through that catheter a XXXXXXX will be injected into the urinary tract and see if there us a reflux going up. DMSA needs an intravenous catheter and injection of XXXXXXX before the procedure. It is not painful.

2. No precautions for DMSA. But before MCU I suggest taking a urine culture and prove that the urine is sterile before MCU.

Regards - Dr. Sumanth

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar