In a young child who cannot give a clean-catch sample, urine collected in an adhesive bag is easily contaminated by skin flora and a positive culture is unreliable. Use a clean-catch sample if possible, or a catheter or suprapubic sample when a reliable result is needed before antibiotics.
A bag sample can help exclude infection if it is negative on dipstick, but not to confirm it.
- Avoid culture of a bag specimen to diagnose infection.
- Obtain a clean-catch sample where the child can cooperate.
- Use a catheter or suprapubic sample when you need a reliable culture before treatment.
- Take the sample before the first dose of antibiotic.
- Check local guidance on the age at which each method is used.
Why it matters
A contaminated bag culture leads to unnecessary antibiotics and unnecessary imaging.
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