NORCET 2 - 2021 (shift-1)
Child Health Nursing (Pediatrics)
Easy
What is the most common bacterial cause of UTI in a child?
Appeared in: NORCET 2 - 2021 (shift-1)
Explanation
- E. coli is the most frequent pathogen, causing the vast majority of UTIs in children.
- It is a gram-negative bacterium that originates from the child's own gut flora and ascends the urinary tract.
- Virulence factors, such as pili (fimbriae), enable E. coli to adhere to the uroepithelial cells, resisting the flushing action of urine and establishing an infection.
Why Other Options Were Wrong
- Option A: Streptococcus is a much less common cause of pediatric UTIs compared to E. coli.
- Option B: Epstein-Barr Virus (EBV) is a virus. The question specifically asks for a bacterial cause of UTI.
- Option C: While some Staphylococcus species can cause UTIs, they are not the most common cause in the general pediatric population.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Etiology of Pediatric Urinary Tract Infections (UTIs) as background academic context rather than a clinical decision trigger.
- Prompt diagnosis and treatment of pediatric UTIs are critical to prevent complications like renal scarring, which can lead to future hypertension and chronic kidney disease.
- Nurses are central to obtaining a proper urine specimen (e.g., clean-catch, catheterization). An uncontaminated sample is essential for accurate diagnosis and effective treatment, preventing the misuse of antibiotics.
- Educating parents on prevention is a key nursing role. This includes teaching proper perineal hygiene (wiping front-to-back in girls), encouraging complete and regular bladder emptying, and managing constipation, which is a known risk factor.
How to Approach the Question
- First, analyze the question to identify the key constraints: 'most common', 'bacterial cause', 'UTI', and 'child'.
- The keyword 'bacterial' is a critical filter. Immediately scan the options to eliminate any non-bacterial agents. In this case, 'EBV' (a virus) can be ruled out.
- Next, consider the context: a 'child' with a 'UTI'. Access your knowledge of common infectious disease etiologies.
- Recall that for UTIs, the source of infection is typically the patient's own gut flora due to anatomical proximity. The most abundant facultative anaerobe in the colon is E. coli.
- Compare the remaining bacterial options (Streptococcus, Staphylococcus, E. coli). Based on prevalence, E. coli is overwhelmingly the most frequent cause of community-acquired UTIs in all age groups, including children.
- Select E. coli as the answer that best fits the 'most common' criterion.
Concept Tested & Keywords
- Concept Tested: Etiology of Pediatric Urinary Tract Infections (UTIs)
- Stem keywords: most common, bacterial cause, UTI, child
- Lead-in keywords: What is
- Clinical cues: Age/sex group narrows the expected diagnosis, intervention, or normal reference range.
- Negative lead-in flag: false
Question ID
QTaSfT2K4eO226lOLJMEA6
Reference Book
E6 Ghai Essential Pediatrics(pp 26-904 of 913) p. 507-509
E6 Text Book Of Pediatric Nursing 3rd Panchali Pal — Part 2 (pp 239-476 of 713) p. 196-198
E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 1069-1071
Practise the full NORCET 2 - 2021 (shift-1)
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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