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Diagnosing urinary tract infection in children: time to ditch the pad?
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  • Published on:
    It's not time to ditch the pad: pads have a place
    • Mervyn S Jaswon, Hon' Consultant Paediatrician Department of Paediatrics, Whittington Hospital, London
    • Other Contributors:
      • James Diviney, Paediatric Intensive Care Registrar

    26th January 2022

    To the Editor

    Archives of Disease in Childhood

    re Diagnosing urinary tract infection in children: time to ditch the pad?

    Harkensee C, Clennett J, Wilkinson S, et al

    Arch Dis Child 2021; 106: 935-936

    We read with interest the article by Harkensee et al, (1) suggesting that the urinary collection pad (UCP) no longer had a role in obtaining samples for diagnosis of urinary tract infections (UTI). Whilst it is well established that there is an unacceptably high rate of contamination with UCPs making them unsuitable for microbiological culture, and that the preferred (non-invasive) method for obtaining a sample for culture is by 'clean catch' +/- stimulation or Quick-Wee method, we would suggest that the UCP has a role in screening for UTI, by dipstick analysis of the aspirated pad sample for leucocyte esterase (LE) and nitrites (2). It would be useful, in a paediatric 'acute referral clinic' or Emergency Department, in infants or children, with non-specific abdominal pain, or fever without a focus, where a combination of a negative test for both LE and nitrites can be reasonably used to exclude UTI, and equally a positive LE and nitrite result would indicate a high likelihood of a UTI and the need to obtain a 'clean catch' or catheter specimen for microbiological analysis (3). The advantages of the UCP are that it allows 'point of care' dipstick analysis with inf...

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    Conflict of Interest:
    None declared.