At 12:05 PM 9/6/00 -0400, Gershon Segal wrote:
> >>> "David B. Toth" <[log in to unmask]> 09/06/00 04:52AM >>>
> >What is the current, unemotional wisdom regarding the method of obtaining a
> >urine sample in children?
> >Specifically, when would "bagging" be OK? Is it EVER OK?
> >Do you really have to cath every child you suspect as having a UTI ???
>Based on the recent AAP Practice Parameter: "The Diagnosis, Treatment, and
>Evaluation of the Initial Urinary Tract Infection in Febrile Infants and
>Young Children" Pediatrics , 103(4):843-852,1999 - yes, there are
>situations where it is acceptable to obtain a urine specimen for
>urinalysis (see Recommendation 4) - in a non-toxic appearing child.
>However, that urine specimen should not be sent for culture. If the UA is
>suggestive of UTI, then a second urine specimen should be obtained by
>catheterization (or suprapubic aspiration) because of the high incidence
>of false-positive cultures with bagged specimens.
>I have simply cut and pasted relevant portions of the above article.
Thank you to Dr. Segal and the three others who responded to me privately
on this matter.
Of course the consensus is that we go to cath samples rather than waste
time. We all understand the psychic trauma this involves, so I will get
back to educating our staff and parents (and myself) why we do the right
and not the easy thing.
Thanks once again,
David B. Toth, MD
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