Diagnosing UTI in Children is it Time to Ditch the Pad

• 21 Sep 2020 08:50:14 AM
• |Pediatic Urology

Dear All,

Urine Collection for Detecting UTI in Pre toilet trained Children, notably in neonates, is difficult and have high rates of contamination.

Pads have been considered as a method for Urine Collection as it is simple. The other methods of Clean Catch, Catheterisation and Suprapubic Aspiration etc are cumbersome in young children for collection of Urine Samples.

A recent yet to be published article from UK addresses this aspect and have concluded that it is time to ditch the Pad as it is not a reliable way at collection of Urine sample for detection of UTI.

https://adc.bmj.com/content/archdischild/early/2020/09/16/archdischild-2020-320290.full.pdf

I would like to know from our experts as to which method of Urine Collection they prefer in Neonates and Pre Toilet trained children suspected to have UTI

I am sure the preferences will vary with the experts. A knowledge of preferred practices among us will help us immensely.

With warm regards,

Venu 

Comments(2)

• 

  shriram joshi

  22 Sep 2020 10:59:36 AM

  I could not open the link venu has sent. Colony count to diagnose uti in infants is 50,000. In neonates it is 10,000. SP aspiration even a single colony is diagnostic.

  Stick on bags and disposable pads carry a  high contamination rate are no more recommended. However stick on bags can be used for routine urine examination. A dipstick is also good and requires a few drops of urine.

  SP aspiration and catheterization are invasive. Parents don't like it. Mid stream sample is difficult but achievable. When the bladder is full ( you have to keep a good watch for neonates, infants empty bladder frequently) tickle SP area, put few drops of saline on the root of penis. You will be surprised how often child passes urine! SP aspiration is easiest below 6 months when bladder is still an abdominal organ. Child will need mild sedation. Older children it is safer to do under USg. If you are going to catheterise, 6/F nelaton catheter is best .

  SSJ
  
  
  

  
  

• 

  Dr. Anil Takvani

  23 Sep 2020 05:09:49 PM

  Thanks S S Joshi sir to share couple of practical points/ideas of collecting mid stream urine from pre toilet trained children.