Urinary Tract Infection—Child Care and Schools

What is a urinary tract infection?

Urinary tract infection is an infection of one or more parts of the urinary system. The urinary system includes the kidneys, tubes that join the kidneys to the bladder (ureters), the bladder, and the tube that leads from the bladder to the outside (urethra).

What are the signs or symptoms?

Any of the following symptoms in combination or alone. Fever may be the only sign in preverbal children.

• Pain when urinating

• Abdominal pain

• Increased frequency of urinating

• Fever

• Vomiting

• Irritability in preverbal children

• Loss of toilet training after the child has had good control of urine for a period, especially when loss of control occurs in the daytime, with little warning

What are the incubation and contagious periods?

• Incubation period: Usually a few days.

• Contagious period: Urinary tract infections are not contagious.

How is it spread?

Infection usually occurs from bacteria from feces on the skin that enter the urethra, particularly in girls. Urinary tract infection is more common in children with constipation and who do not fully empty their bladders during voiding. Less commonly, it is caused by bacteria from the bloodstream entering the kidneys in young infants. Urinary tract infection is not passed from one person to another.

How do you control it?

• Have the child evaluated and treated by a pediatric health professional.

• Many people believe it is wise to teach young girls to wipe from front to back to avoid spreading fecal bacteria from the rectal into the urinary and vaginal area. No scientific evidence is available that shows the direction of wiping matters for healthy girls. However, when fecal material is present, it is usually easier to remove it by cleaning from front to back.

What are the roles of the educator and the family?

• Children with signs or symptoms of urinary tract infection should be evaluated by a pediatric health professional. Educators and the family should implement the advice of the health professional, which may include offering fluids frequently, giving prescribed medication, and gentle wiping after using the toilet.

• A pediatric health professional should see a child with symptoms of a urinary tract infection for a diagnosis and proper treatment. Ignoring urinary tract symptoms can lead to damage to the kidneys, even if the symptoms seem to go away without treatment.

Exclude from educational setting?

No, unless

• The child is unable to participate and staff members determine they cannot care for the child without compromising their ability to care for the health and safety of the other children in the group.

• The child meets other exclusion criteria (see Conditions Requiring Temporary Exclusion in Chapter 4 of Managing Infectious Diseases in Child Care and Schools: A Quick Reference Guide, 7th Edition).

Diagram of the urinary tract

AMERICAN ACADEMY OF PEDIATRICS

Anatomical illustration. Side-by-side front and side views compare female and male urinary tracts with descriptors pointing to parts of the urinary tract. On the left, text indicates the "front" and "side" views with the text "Female" underneath the illustrations. The following text labels and points to the parts of the urinary tract in each view, from top to bottom: "Kidneys, Ureters, Bladder, Anus, Vagina, and Urethra." On the right, text indicates the "front" and "side" views with the text "Male" underneath the illustrations. The following text labels and points to the parts of the urinary tract in each view, from top to bottom: "Kidneys, Ureters, Bladder, Anus, and Urethra."

Readmit to educational setting?

Yes, when all the following criteria are met:

When exclusion criteria are resolved, the child is able to participate, and staff members determine they can care for the child without compromising their ability to care for the health and safety of the other children in the group