Urinary Tract Infections Urinary Tract Infection

The Office of Evidence Based Practice is currently revising this CPG; if you have any recommendations for improving this CPG, please forward to Dr. J. Michael, EBP Medical Director, at jmichael@cmh.edu.


URINARY TRACT INFECTION

Children who present with a presumed or definite episode of cystitis or pyelonephritis. UTI is the second most common infection in children for which medical attention is sought, and is the most frequently encountered disorder of the urinary tract. Approximately 8% of girls and 2% of boys will have a UTI during childhood (Stark, 1997). The incidence of UTI during the first 3 months of life is greater in boys than girls. Thereafter, the incidence is greater in girls. Uncircumcised male infants are 10-20 times more likely to have a UTI than those who are circumcised (Wiswell, Smith & Bass, 1985).

These practice guidelines are intended to be used for infants, children and adolescents experiencing a first time UTI. They are not intended for children with:

  • bladder outlet obstruction, neurogenic bladders or other known genitourologic abnormalities
  • voiding dysfunction when uninfected
  • asymptomatic bacteriuria
  • immunodeficiencies
  • severe co-morbid conditions.

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References:
Stark H. (1997). Urinary tract infections in girls: the cost-effectiveness of currently recommended investigative routines. Pediatr Nephrology,1, 174-177.
Wiswell T.E., Smith, F.R., Bass, J.W. (1985). Decreased incidence of UTI in circumcised male infants, Pediatrics, 75, 901-3.

Revision date: 10/20/06

UTI CPG Team Members:

Team Leader: Stanley Hellerstein, M.D.
Team Facilitator: Charlotte Jacobsen, R.N., Clinic Nurse Manager

Team Members:

  • Allison Burke, R.N., M.S.N., C.P.N., Kidney Center Nurse Manager
  • Jackie Bartlett, R.N., Evidence Based Practice Program Manager
  • Lisa Carney , M.D., Hospitalist
  • Gayleene Colgan , RN, Infection Control Practioner
  • Linda Jones, R.N., M.H.A., C.N.N., Renal Section Manager
  • Jeff Michael , D.O., Emergency Medicine
  • Sandie Nabours , R.N.C., Clinical Nurse Spclst.
  • Lloyd Olson, M.D., Infectious Diseases
  • Sherri Shiddell , R.N., Surgery Nurse Clinician
  • Stevie Wilson, R.N., M.S.N., C.P.N.P., Hospitalist Section


These guidelines do not establish a standard of care to be followed in every case. It is recognized that each case is different and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time.

It is impossible to anticipate all possible situations that may exist and to prepare guidelines for each. Accordingly these guidelines should guide care with the understanding that departures from them may be required at times.

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