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Urinary Tract Infection

Synopsis

Urinary tract infections (UTI) are a common problem in childhood (Kass EH, 1972), affecting up to 6% of children under the age of 7 years, with a greater prevalence in boys during the first 6 months of age and a greater incidence in girls thereafter (Brandström, Esbjörner et al, 2010). According to the AAP criteria (AAP guidelines, 2011), UTI is defined as the growth of at least 105 colony forming units in a clean urine specimen. The responsible bacteria are E.Coli in 90% of cases., followed by Proteus and Pseudomonas. The clinical presentation of UTI can be very different, with a spectrum going from simple asymptomatic bacteriuria to symptoms related to the bladder involvement (polyuria, stranguria, mild fever) to the high fever and generalized illness in acute pyelonephritis (APN), sometimes reaching the gravity of a generalized sepsis (Brandström, Esbjörner et al, 2010).

In the past, the diagnostic and therapeutic pathway was considered straightforward.