Urinary tract infections (UTIs) are among the most common bacterial infection in childhood. Young infants are at particular risk of serious infection or sepsis if UTI is not recognised, and delay in initiating appropriate antibiotics has been associated with an increased risk of pyelonephritis or renal scarring regardless of whether a child has vesico-ureteric reflux or not.1 Making a reliable diagnosis of UTI can be challenging, in particular in young pre-continent children. Whichever urine collection method is chosen, non-invasive (clean catch, nappy pad or bag) or invasive (suprapubic aspiration or catheter insertion), obtaining a clean specimen is critical, as the gold standard for diagnosis of UTI is growth of pathogenic bacteria in sufficient number in an uncontaminated urine sample. The National Institute for Health and Care Excellence (NICE) CG54 guideline states that infants and children presenting within 24 hours with unexplained fever of ≥38°C and/or urinary symptoms should have a urine sample tested. While clean sampling methods are preferred, NICE does, as one of very few countries globally, still accommodate for nappy pad collection for UTI diagnosis, as long as the manufacturer’s instructions are followed. The reality on the ground looks different. Two recent audits from acute paediatric departments in the North East of England with a total of 178 …

中文翻译：

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诊断儿童尿路感染：是时候抛弃卫生巾了吗？

尿路感染 (UTI) 是儿童时期最常见的细菌感染之一。如果 UTI 未被识别，小婴儿发生严重感染或败血症的风险特别高，并且无论儿童是否患有膀胱输尿管反流，延迟开始使用适当的抗生素都会增加肾盂肾炎或肾脏瘢痕形成的风险。 1尿路感染的可靠诊断可能具有挑战性，尤其是在失禁前的年轻儿童中。无论选择哪种尿液收集方法，无创（清洁收集、尿布垫或袋子）或有创（耻骨上抽吸或导管插入），获得干净的标本都至关重要，因为诊断 UTI 的金标准是病原菌的生长未受污染的尿液样本中的数量足够。美国国家卫生与保健卓越研究所 (NICE) CG54 指南指出，婴儿和儿童在 24 小时内出现不明原因发烧≥38°C 和/或泌尿系统症状，应进行尿液样本检测。虽然清洁采样方法是首选，但作为全球极少数国家之一，NICE 仍然可以收集尿布垫以进行 UTI 诊断，只要遵循制造商的说明。地面上的现实看起来不同。最近两次来自英格兰东北部急诊儿科的审计，共有 178 名…… 只要遵循制造商的说明，仍然可以收集尿布垫以进行 UTI 诊断。地面上的现实看起来不同。最近两次来自英格兰东北部急诊儿科的审计，共有 178 名…… 只要遵循制造商的说明，仍然可以收集尿布垫以进行 UTI 诊断。地面上的现实看起来不同。最近两次来自英格兰东北部急诊儿科的审计，共有 178 名……