How does pediatric urinary tract infection (UTI) develop?

Updated: Mar 19, 2019
  • Author: Donna J Fisher, MD; Chief Editor: Russell W Steele, MD  more...
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Typically, UTIs develop when uropathogens that have colonized the periurethral area ascend to the bladder via the urethra. From the bladder, pathogens can spread up the urinary tract to the kidneys (pyelonephritis) and possibly to the bloodstream (bacteremia). Poor containment of infection, including bacteremia, is more often seen in infants younger than 2 months.

Urine in the proximal urethra and urinary bladder is normally sterile. Entry of bacteria into the urinary bladder can result from turbulent flow during normal voiding, voiding dysfunction, or catheterization. In addition, sexual intercourse or genital manipulation may foster the entry of bacteria into the urinary bladder. More rarely, the urinary tract may be colonized during systemic bacteremia (sepsis); this usually happens in infancy. Pathogens can also infect the urinary tract through direct spread via the fecal-perineal-urethral route.

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