When viewing this topic in a different language, you may notice some differences in the way the content is structured, but it still reflects the latest evidence-based guidance.

Urinary tract infections in children

Последний просмотренный: 17 Aug 2025
Last updated: 05 Jun 2025

Резюме

Определение

Анамнез и осмотр

Ключевые диагностические факторы

  • fever >102.2°F (>39°C)
  • irritability (neonates and infants)
  • poor feeding (neonates and infants)
  • suprapubic tenderness
  • costovertebral angle tenderness
Полная информация

Другие диагностические факторы

  • foul-smelling urine (infants, older children, and adolescents)
  • dysuria (preschool age, older children, and adolescents)
  • urinary frequency (older children and adolescents)
  • abdominal/flank pain (infants, older children, and adolescents)
  • vomiting
  • ill appearance (neonates)
  • gross hematuria (older children and adolescents)
  • new-onset urinary incontinence (toddlers, older children, and adolescents)
Полная информация

Факторы риска

  • age <1 year
  • female sex
  • uncircumcised boys in the first year of life
  • previous UTI
  • bladder and bowel dysfunction
  • vesicoureteral reflux
  • sexual activity
  • no history of breastfeeding
  • anatomic abnormalities or previous surgery to the urinary tract
  • immunosuppression
  • protein-energy malnutrition
Полная информация

Диагностические исследования

Исследования, которые показаны в первую очередь

  • urine dipstick
  • urine microscopy
  • urine culture
Полная информация

Исследования, проведение которых нужно рассмотреть

  • urine flow cytometry
  • blood culture
  • complete blood count
  • inflammatory markers
  • fungus urine culture
  • serum creatinine, BUN and electrolytes
  • renal and/or bladder ultrasound
  • dimercaptosuccinic acid (DMSA) scan
  • voiding cystourethrogram (VCUG)
Полная информация

Алгоритм лечения

Начальные

vesicoureteral reflux: no history of febrile UTIs

Острый

age ≤2 months

age >2 months

ПРОДОЛЖЕНИЕ

recurrent UTIs

Составители

Авторы

Joana Dos Santos, MD, MHSc, FRCPC

Assistant Professor of Pediatrics

Medical Pediatric Urologist

The Hospital for Sick Children

Toronto

Ontario

Canada

Раскрытие информации

JDS declares that she has no competing interests.

Выражение благодарностей

Dr Joana Dos Santos would like to gratefully acknowledge Dr Beatrice Goilav, Dr Frederick Kaskel, Dr Mary Anne Jackson, and Dr Rene VanDeVoorde, previous contributors to this topic.

Раскрытие информации

BG, FK, MAJ, and RV declare that they have no competing interests.

Рецензенты

Martin Koyle, MD, MSc, FAAP, FACS, FRCS(Eng), FRCSC

Professor

Department of Surgery and Institute of Health Policy, Management and Evaluation

Staff Pediatric Urologist

The Hospital for Sick Children

Toronto

Ontario

Canada

Раскрытие информации

MK declares that he has no competing interests.

Daniel T. Keefe, MD, FRCSC

Pediatric Urology Fellow

The Hospital for Sick Children

Toronto

Ontario

Canada

Раскрытие информации

DTK declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Список литературы

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Основные статьи

European Association of Urology. Guidelines on paediatric urology. 2024 [internet publication].Полный текст

National Institute for Health and Care Excellence. Urinary tract infection in under 16s: diagnosis and management. Jul 2022 [internet publication].Полный текст

Mattoo TK, Shaikh N, Nelson CP. Contemporary management of urinary tract infection in children. Pediatrics. 2021 Feb;147(2):e2020012138.Полный текст  Аннотация

American College of Radiology. ACR appropriateness criteria: urinary tract infection - child. 2023 [internet publication].Полный текст

Peters CA, Skoog SJ, Arant BS Jr, et al; American Urological Association. Management and screening of primary vesicoureteral reflux in children: AUA guideline. 2017 [internet publication].Полный текст

Статьи, указанные как источники

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Urinary tract infections in children images
  • Differentials

    • Appendicitis
    • Gastroenteritis
    • Kawasaki disease
    Больше Differentials
  • Guidelines

    • Paediatric urology: urinary tract infections in children
    • Guidelines on paediatric urology: urinary tract infections in children
    Больше Guidelines
  • Patient information

    Urinary tract infections in children

    More Patient information
  • padlock-lockedLog in or subscribe to access all of BMJ Best Practice

Use of this content is subject to our disclaimer