Reoccurring UTI in intact baby boy

[JenLab83]

   Newbie here! Sorry if this is long, but I need get the whole story out to get the best advice! My son is now 9.5 months old and is intact. At around 3 months old he began to act very fussy ( out of the ordinary) so I took him to the doc and everything seemed fine no fever or anything but she thought we should do a urine test just to rule out a uti. We collected a sample with the bag and it came back as e-coli being cultured. Doc was quite surprised but we did a trial of antibiotics to be sure. Fussiness went away and he was doing fine. Then at 5 months old I dropped off another sample just for my own piece of mind and that he was again acting weird and it came back e-coli again! So we did antibiotics again. She consulted with pedi's and they all came to the conclusion that it was probably skin contamination because the never developed a fever.

  Then at 7 months he was again acting fussy, but I brushed it off as teething because of what the doc had said. Well, that night he spiked a fever and we were ended up in emerg. They did a catheter sample this time to avoid possible skin contamination and it came back as a raging UTI that cultured e-coli again! We did antibiotics again (a different one this time), we went and had a kidney ultrasound and a UVCG done and everything came back perfectly normal. They also did another urine test while the catheter was still in for the UVCG and it came back completely normal, UTI was cleared up! Yah!

   Then a couple weeks ago (9 months old) he began to act weird again so I dropped of a sample (collected by a bag) and it cultured e-coli again!!! Doc didn't want to do antibiotics again as she shrugged it off as skin contamination. As a few days went by he became fussier and fussier so I called and suggested a round of antibiotics again which he has just finish up a few days ago. 

   His doc sent a referral to see the pediatric urologists back in sept (takes 4-5 months to get in). I'm just so worried that she is going to say to have him circ'd. I want to avoid this at all costs, but I just don't know what else could be causing it to reoccur all the time. I almost wished we would have done a catheter sample this last time to rule out any skin contamination, at least then I would have known for sure it was the start of a UTI again or just a coincidence. Any ideas?? Thanks

[Tinijocaro]

If you imagine reading a title that said "Recurring UTI in intact baby girl", the word circumcision would never even enter your mind.  Anyone suggesting removing part of your dd's genitals due to a UTI would enrage you.  Keep that same mindset and apply it to your own situation.

Be sure that boy is getting probiotics each time he goes on an antibiotic.

Be sure you are not doing anything special in the cleaning department for your son.  A simple soak in the tub will do for 90% of the time.  Any bad messes gently use a washcloth but don't retract him.  Over cleaning can introduce bacteria to the area.

Not sure why the ecoli.  I'm sure someone else here can address that.

[MCatLvrMom2A&X]

They might suggest circ but we know now that circ will not help with UTI that was proved with newer studies..

Ask the urologist what they would do if this was a girl having repeat UTI. Like pp said make sure you are not doing anything special with cleaning and make sure that your rinse him well with clear water if he has sat in the bath with soap in it.

E. Coli is usually found in feces so if he is maybe playing in his diaper he could be spreading it to his penis.

[JenLab83]

Thats what has me stumped regarding the e-coli. He never sits in a poopy diaper, I could count on both hands how many times he has had a blow out that has caused poop to come up onto his penis. I only use baby wipes for poops and its always a clean new one when I wipe down the front of him. I don't do anything special to clean him, he just gets a bath every night and even then he just soaks in the tub, I wash his bum with a bit of soap but thats it. I sometimes wonder if its maybe a really tough bacteria to totally eliminate. I read some where a while ago about e-coli being able to form an capsule around itself which makes antibiotics useless and once the antibiotics where finished those capsules broke open again which leads to an infection a few weeks/months down the road once numbers get high enough to cause a problem. I can't remember where I read this and don't know if there is really any truth to it. 

[brant31]

Hi JenLab83! Welcome to Mothering.com

I know this situation is frustrating. I can't offer medical advice, but I did talk with a great pediatrician (some folks here know him) about what you wrote and he gave me some interesting things to think about.

You surmised correctly that e-coli is ubiquitous -- and pernicious. It's present in the colon and finds its way not only onto external parts of our bodies, but also onto loads of inanimate things. It's most often found on mucosal surfaces and makes its way to other skin. For this reason, many doctors believe that a bag test for e-coli is most useful for drawing any conclusions when it comes back negative; about 15% of babies test positive even when they don't have anything going on internally. The source could be anything, from contact with feces (however fleeting) to someone changing his diaper who has recently flushed a toilet or touched any other surface with e-coli and just brushed against the baby's skin. All of us, infants included, are colonized with lots of bacteria and e-coli is just part of the mix. It doesn't always mean an imminent infection. A reasonable approach to a positive bag collection is to do a catheter sample for confirmation, before starting any antibiotics.

It may be of interest to you that a study from Sweden found that a prior course of antibiotic treatment was in fact a risk factor for developing a full-blown UTI in infants, as your son had at 7 months after his first two rounds of antibiotics. The theory is that the antibiotics readily kill off beneficial bacterial flora, but some of the more resilient "bad" bacteria remain and then take over.

There is nothing in your son's experience to suggest that his foreskin is a problem in all this or that circumcision would help improve his health.

[JenLab83]

Thank you so much for that piece of info. Circumcision is the absolute last thing I want to do, so I think when we go to see the urologist we'll see what she has to say but I would like to try other options (prophylactic antibiotics or just treating when they arise) first. I keep telling myself and also reading that circumcision is not a guarantee to correct reoccurring UTI's but its just something that keeps looming in the back of my mind. Its just very stressful for me always anticipating a cranky baby with another infection. Thanks again 

[Contented73]

Hi there -- are you breastfeeding?  Also, what are you doing in terms of probiotics?  I would be very concerned that after so many rounds of antibiotics, his bacterial balance is extremely disrupted, which could (potentially) lead to more extreme UTI problems.  Hugs to you, and good for you for doing your research ahead of time!

[JenLab83]

No I wasn't able to breastfeed. I have never heard of and doc never talked about probiotics before reading about them on this forum. I definitely will be asking about them when we finally ever get into see the urologist, or if anyone has any info on them I would like to hear it. Can I buy them anywhere? Is there any harm in giving them even if he doesn't need them? Is there a certain dosage for babies? Thanks 

[mama24-7]

Originally Posted by JenLab83 

No I wasn't able to breastfeed. I have never heard of and doc never talked about probiotics before reading about them on this forum. I definitely will be asking about them when we finally ever get into see the urologist, or if anyone has any info on them I would like to hear it. Can I buy them anywhere? Is there any harm in giving them even if he doesn't need them? Is there a certain dosage for babies? Thanks 

your doc is unlikely to know much about probiotics because only one major pharma company that i know of makes them.  especially since your son isn't bf'd, its even more importnat that he gets probees since he's not getting them from you (no judgement, just facts).  a child's flora is different until about about 5-7, the natural age of weaning.  so, there are probees for littles & for adults, w/ different dominate bacteria.  he needs help w/ all of these risk factors, to make it so his body can get populated w/ the correct bacteria (for life) and not bad bacteria & yeast, etc.

a great book all about probiotics is Bacteria for Breakfast.  i don't know if you can get it at the major book stores or not; it's been a long time since i bought it.  and i don't know where on MDC you can look about it because i did all my research elsewhere.  oh, and this comapny has some explanations, etc. on thier website that might help you to start w/ this: www.customprobiotics.com

and, you can PM me, but i'm notorious about not getting back w/ people.  hopefully someone else will chime in w/ where to go on MDC for this kind of info.

best wishes,

Sus

[JenLab83]

He has just recently started eating a small container of probiotic yogurt everyday, does that count for anything? Thanks for the info

[mama24-7]

Originally Posted by JenLab83 

He has just recently started eating a small container of probiotic yogurt everyday, does that count for anything? Thanks for the info

Unless it is just cultured cow milk (or some other kind of milk), then no, IMO, it does not count.  There is lots of other stuff in commercial yogurt that negates any possibility of good stuff.  You can get raw or reg. milk, heat it to between 105-110 degrees, add a powdered probiotic (or open a capsule, but it should be intended for infants/children), put it in a thermos for 24 hours & you have yogurt.  The other reason why commercial yogurt isn't going to get you much, is it's not strains that are specific to a child less than 5-7 years old.  The book I mentioned discusses this in detail.  I know, you've got loads of time on your hands to read & research ;-).

Sus