- Indication of urine culture in UTI in Paediatric.

 Indication of urine culture in cases of UTI in Paediatric.

 

Urine samples should be sent for culture in:

1. having a diagnosis of acute pyelonephritis/upper urinary tract infection
2. high to intermediate risk of serious illness
3. < 3 years.
4. single positive result for leukocyte esterase or nitrite
5. Recurrent UTI.
6. Infection that does not respond to treatment within 24–48 hours, if no sample has already been sent.
7. when clinical symptoms and dipstick tests do not correlate.

- Risk factors for UTI in Children.

Risk factors for UTI (urinary tract infection) in Children.

1.  Uncircumcised male have 10 times > circumcised males . 
2. Abnormal urinary tract: Children with vesicoureteral reflux (VUR) and obstruction are at higher risk for UTI. 
3. Any condition that interferes with complete emptying of the bladder increasing the risk of bacterial colonization, such as Voiding dysfunction ,constipation,neurogenic bladder,VUR. 
4. Poor perineal hygiene. 
5. Wiping from back to front in girls 
6. Bubble bath? and Tight clothing (underwear).
7. Pinworm infestation.
8. Requiring frequent catheterization.
9. Sexual activity.

- Bartter syndrome.

 Bartter syndrome

The pathogenesis:

Failure of chloride reabsorption in the thick ascending limb of the loop of Henlé,thus resembling the pharmacological effect of furosemide (frusemide)

Bartter syndrome has been associated with 5 distinct genetic defects in loop of Henle transporters:

CCD, cortisol collecting duct; DCT, descending convoluted tubule; PGE2, prostaglandin E2; TAL, thick ascending loop of Henle.