Abstract
Urinary tract infection (UTI) is one of the most common infections encountered by pediatricians. UTI can occur either as bladder infections (lower UTI) or infections involving the kidneys (upper UTI). Upper UTI can be an important cause for end stage renal failure as it may lead to renal scarring without inappropriate management. Therefore, we should have high index of suspicion that all febrile infants without evident focal signs have upper UTI. To make a correct diagnosis of upper UTI, urine samples for culture should be obtained by bladder catheterization before administration of antimicrobial agents. Furthermore, bacteriuria should be screened using KOVA slide immediately for the prompt treatment which alleviate the risk of renal scarring. In order to prevent recurrent UTI, all infants with first upper UTI should be screened for underlying conditions predisposing to UTI, such as vesicoureteral reflux (VUR) or lower urinary tract dysfunctions by voiding cystourethrography (VCUG). If he/she has high grade VUR by VCUG, they should receive continuous antibiotic prophylaxis for recurrent UTI based on the recent findings from the RIVUR (Randomized Intervention for Children With Vesicoureteral Reflux) trial.
