Urine Sampling and Culture in the Diagnosis of Urinary Tract Infection: A Review Article

Abstract

Quick Response Code Abstract: Among patients with symptoms suggestive of a Urinary tract infection (UTI) which includes dysuria and frequency, the diagnosis can be confirmed by sending a cleancatch specimen for culture and for urinalysis. One suggested exception recommended by most experts is a symptomatic young woman with pyuria detected by urinalysis dipstick who has apparently uncomplicated cystitis. It has been proposed that the findings are sufficiently diagnostic that an empiric course and usually three days of antimicrobial therapy can be initiated without performing a urine culture. Children who are toilet trained can provide clean voided urine samples. Clean voided bag urine samples are acceptable for urinalysis in infants and children between two months and two years of age who have unexplained fever and do not appear ill enough to require immediate antimicrobial therapy. If the sample suggests infection, then a catheterized urine specimen should be obtained for confirmatory testing and urine culture. Suprapubic aspiration and transurethral bladder catheterization are invasive but are the only valid ways to collect urine for culture in febrile young infants under two months of age and older infants and children with unexplained fever who are younger than two years of age and ill enough to merit immediate antimicrobial therapy. The use of portable ultrasound to visualize the bladder increases the success rate for both suprapubic aspiration and transurethral bladder catheterization. In this review article, we will cover urine sampling, procedure, culture, and dipstick as a tool of UTI analysis in both adults and children.