An accurate diagnosis of urinary tract infection (UTI) is difficult to make in any child and even more difficult to make in female and uncircumcised male children because of normally occurring periurethral flora. The 16% false-positive culture rate in female and uncircumcised male newborns found by Schlager et al1 confirms that uncircumcised male newborns receive false diagnoses of UTI regularly. Contraindicated, extreme, and irreversible surgical measures such as preputial amputation may improve the accuracy of specimen analysis but do not affect the true rate of UTI. The clinical message is that intact male and female genitalia can no longer be regarded as having a causal relationship to the development of UTI.
This study should put to rest the highly popularized hypothesis of Wiswell et al2 that intact male genitalia increase the risk for UTI. Further evidence of false UTI diagnosis is to be found in the study population
Fleiss PM. Explanation for False-positive Urine Cultures Obtained by Bag Technique. Arch Pediatr Adolesc Med. 1995;149(9):1041–1042. doi:10.1001/archpedi.1995.02170220107022
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