Urinalysis

And we break it down two different ways.

And so we have by obtaining a UA, depending on whether it's a cath or a clean catch sample, we have different thresholds, either before urine culture results or after urine culture results.

that also incorporate the amount of pyuria that needs to be present in order to keep in mind that we do see asymptomatic bacteria and contamination that won't have the level of pyuria that you would expect with a UTI.

And so the new guidelines will reveal some new thresholds for those.

Mm

... like a UA type of stuff? Is that-

Yeah, the UA.

Um, so before they were really using kind of vague [laughs] pyuria and/or bacteriuria, significant pyuria, uh, was documented.

Um, but now they're giving us age-specific thresholds for the urinalysis, which is exciting.

But right now we're just gonna talk about UTI.

Uh-huh.

If the baby is less than 22 days old, um, they should get culture and UA, uh, by catheter, and of course, other laboratory tests associated with the febrile infant guidelines, and we should be starting antimicrobial therapy.

...

but, um, these other parameters being like a UA type of stuff.

Is that-

Yeah, the UA.

Um, so before they were really using kind of vague [laughs] pyuria and/or bacteriuria, significant pyuria, uh, was documented.

Um, but now they're giving us age-specific thresholds for the urinalysis, which is exciting.

But right now we're just gonna talk about UTI.

Mm-hmm.

But if you get a cath, you're gonna be more specific, but you'll be maybe slightly less sensitive.

So if you cross the pond over to England, they're gonna tell you, "The way we want you to collect urine in a baby," this is in the NICE guidelines, which is in England, "is to take a cotton ball, put it in the child's diaper, squeeze it into a test tube, and then send that for UA and culture." And I hope that there are people out there that are sort of getting the heebie-jeebies.

I've always been told we have to cath the babies, and I do believe we should cath the babies, and the guideline will say, "Cath the baby." So we're not totally in agreement with England.

Where that comes from is the decision about what is your fear of a UTI? If you think UTI is a calamitous thing you can never miss, you should probably get a clean catch.

So that's fever and, uh, and, uh, and, um-

Pyuria without-

UA.

Yeah.