Urine sampling, analysis and culture

Urine sampling has to be performed before any antimicrobial agent is administered.

Urine must be collected under defined conditions and investigated as soon as possible to confirm or exclude UTI.

How to take urine samples

In neonates, infants and non-toilet-trained children, there are four main methods to obtain urine

  • Plastic bag attached to the cleaned genitalia
  • Clean-catch urine collection
  • Transurethral bladder catheterization
  • Suprapubic bladder aspiration

In older, toilet-trained children who can void on command, after carefully retracting the foreskin and cleaning the glans penis in boys and spreading the labia and cleaning the peri-urethral area in girls, the use of clean catch, especially midstream urine, could be an acceptable technique for obtaining urine

Urine culture

Urine collection for urine cultures:

Urinalysis tools

  • Dipsticks
  • Microscopy
  • Flow imaging analysis technology

When to take urine cultures?

After negative results for dipstick, microscopic or automated urinalysis, urine culture is generally not necessary, especially if there is an alternative source of fever. If the dipstick result is positive, confirmation by urine culture is strongly recommended.

Understanding urine cultures

A negative culture with the presence of pyuria may be due to incomplete antibiotic treatment, urolithiasis, or foreign bodies in the urinary tract, and infections caused by Mycobacterium tuberculosis or Chlamydia trachomatis.

The culture of multiple organisms increases the likelihood of contamination, thus it should be repeated.

ISPN Recommendations, Acta Pediatrica 2020
UTI & VUR
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