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Urinary Tract Infection—Child Care and Schools

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What is a urinary tract infection?

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), bladder, and tube that leads from the bladder to the outside (the urethra).

What are the signs or symptoms?

  • Pain when urinating or in the abdomen

  • 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 teacher/caregiver and the family?

Children with signs or symptoms of urinary tract infection should be evaluated by a health professional. Teachers/ caregivers 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.

Exclude from group 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).

Readmit to group setting?

Yes, when all the following criteria have been 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

Comment

A 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.

Adapted from Managing Infectious Diseases in Child Care and Schools: A Quick Reference Guide.

Any websites, brand names, products, or manufacturers are mentioned for informational and identification purposes only and do not imply an endorsement by the American Academy of Pediatrics (AAP). The AAP is not responsible for the content of external resources. Information was current at the time of publication.

The information contained in this publication should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.