Urinary tract infections, or UTIs, can be divided into upper tract and lower tract infections. An example of an upper UTI is pyelonephritis, in which the kidney becomes infected and inflamed. In cystitis, a lower UTI, the bladder becomes infected. Upper UTIs are particularly of concern because they can result in scarring of the kidney, high blood pressure and even kidney failure. Frequent urinary tract infections in a baby are cause for particular concern and a doctor should be consulted about the causes.
Gender
According to a 2008 study published in the "Pediatric Infectious Disease Journal," female infants are at increased risk for getting a urinary tract infection. This study evaluated the results of 18 previous studies and found that UTI prevalence was twice as high among female babies compared to male babies. One possible reason for this is that the urethra --the tube that carries urine out from the bladder--is shorter in girls, making it easier for bacteria to enter the bladder and cause infection. Another possible theory, as reported in the medical reference UpToDate, is that bacteria may more easily attach to the wall of the urethra in baby girls, making recurrent infection more likely.
Vesicoureteral Reflux
Vesicoureteral reflux is a term used to describe the back flow of urine up from the bladder to the upper urinary tract. UpToDate reports that this is actually a common structural anomaly in children, and is associated with a higher risk of recurrent UTIs. This is likely because bacteria are able to enter both the ureter and the kidney, causing infection.
Uncircumcised Penis
Baby boys who are uncircumcised and have fever are at much higher risk of being diagnosed with a UTI as compared to babies who are not circumcised. The 2008 "Pediatric Infectious Disease Journal" study states that 2.4 percent of circumcised babies with a fever turned out to have a UTI, while 20.1 percent of uncircumcised babies with fevers were found to have a urinary tract infection.
In the 2005 review "Epidemiology and Risk Factors for Urinary Tract Infections in Children," the results of 12 studies, which included more than 400,000 children, found that circumcision had a protective effect on the risk of UTI. That is, babies who were circumcised were found to have a lower than expected risk for UTI. The review suggests that the overall prevalence of UTIs among male babies who are uncircumcised is four to eight times higher than UTIs among circumcised babies. The reason for this increased risk is unclear. One possible reason is that the foreskin partially blocks the urethral meatus, which is the opening through which urine passes outside the body. Another possible reason is that the surface of uncircumcised skin differs slightly from that of circumcised skin, making it easier for bacteria to attach and cause infection.
References
- "Pediatric Infectious Disease Journal;" Prevalence of Urinary Tract Infection in Childhood: A Meta-Analysis; N. Shaikh et. al.; April 2008
- "UpToDate;" Epidemiology and Risk Factors for Urinary Tract Infections in Children; N. Shaikh and A. Hoberman; May 2010
- "Archives of Disease in Childhood;" Circumcision for the prevention of urinary tract infection in boys: a systematic review of randomised trials and observational studies; D. Singh-Grewal et. al.; August 2005
- "Journal of Urology;" Adherence of bacteria to human foreskins; E.N. Fussell et. al.; November 1988
