We would like to thank Drs Robson and Leung for their comments. As they state, our study does not support the use of bag specimens for the diagnosis of UTIs because a bag specimen results in a high false-positive rate. A bag specimen may be useful, however, when the physician would like to examine the urine in a healthy infant and is willing to withhold antibiotics until urine culture results are reported. If the culture is positive for pathogens, it may be a reflection of the periurethral flora, or it may mean that the urinary tract is infected. To differentiate between periurethral colonization of urine and a UTI, an in-and-out catheter or suprapubic aspiration is recommended for specimen collection. Obviously, if antibiotic therapy has already begun, the diagnosis of periurethral colonization of the urine vs UTI will be impossible to differentiate. Urine bag collection is reliable only if
Schlager TA, Hendley JO, Lohr JA, Dudley SM, Hayden GF. Explanation for False-positive Urine Cultures Obtained by Bag Technique-Reply. Arch Pediatr Adolesc Med. 1995;149(9):1042–1043. doi:10.1001/archpedi.1995.02170220107024
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