Guidelines For Pediatric Urinary Tract Infections From NICE

In addition to the links in this post please see the post, Pediatric Fever and Sepsis In Children Under 5 Years, Posted on December 21, 2017.

The following are links to Urinary tract infection in under 16s: diagnosis and management
Clinical guideline [CG54] Published date: August 2007 Last updated: September 2017. Resource 1 below.

Recommendations

1.1 Diagnosis

1.2 Acute management

1.3 Imaging tests

1.4 Surgical intervention

1.5 Follow-up

1.6 Information and advice for children, young people and parents or carers

Terms used in this guideline

The following are from Urinary tract infection in children and young people
Quality standard [QS36] Published date: July 2013 Last updated: September 2017. Resource 2 below.

List of Quality Statements

Statement 1 Infants, children and young people presenting with unexplained fever of 38°C or higher have a urine sample tested within 24 hours.

Rational: It is important that a urinary tract infection is considered as a cause of feverish illness in infants, children and young people. When an infant, child or young person (under 16 years) presents to a healthcare practitioner with a temperature of 38°C or higher, and there is no obvious source of the infection, a urine sample should be tested within 24 hours to ensure prompt diagnosis and antibiotic treatment if appropriate.

Statement 2 Infants, children and young people with a urinary tract infection have risk factors for urinary tract infection and serious underlying pathology recorded as part of their history and examination.

Rationale: Presenting symptoms, findings on examination, results of urine testing and knowledge of risk factors are all important when a diagnosis of urinary tract infection is being considered. Recording of risk factors is a cumulative process as part of the history and examination of an infant, child or young person with a urinary tract infection. Recording of risk factors is also important in order to identify whether onward referral and further investigations will be needed.

Statement 3 Infants, children and young people with a urinary tract infection caused by coliform bacteria have results of microbiology laboratory testing differentiated by Escherichia coli (E. coli) or non-E. coli organisms.

Rationale: Most urine infections are caused by E. coli bacteria, which belong to a group of bacteria called coliforms.

If a urinary tract infection is caused by a non-E. coli coliform or any other type of bacteria, there is an increased risk of serious underlying pathology. NICE guidance recommends that infants, children and young people (under 16 years) with atypical urinary tract infection (which includes infection with non-E. coli organisms) should have ultrasound of the urinary tract during the acute infection. It is therefore important that laboratory test reports differentiate between E. coli and non-E. coli organisms to identify whether further investigations are needed.

Statement 4 Children and young people who have had a urinary tract infection are given information about how to recognise re-infection and to seek medical advice straight away.

Rationale: Some children and young people will experience a recurrence of urinary tract infection, and it is important that such infections are recognised and treated quickly to reduce the risk of complications.

Children and young people (and parents and carers) should be aware of the importance of seeking medical advice straight away if they think there is another urinary tract infection.