Congratulations to Drs Woodford and George for a well researched article on urinary infections in older people (Clin Med Feb 2011 pp 80–3), a common diagnosis encountered during most medical takes. As their article states, urine samples may be hard to obtain in older patients due to incontinence or cognitive impairment, but misdiagnosis of urinary tract infections may result in inappropriate exposure to antibiotics and delay in establishing the correct diagnosis, and urine culture ‘if possible’ is advised in the appropriate clinical context.
It would have been of interest to review any evidence base, techniques or recommendations for obtaining the urine culture in this commonly encountered subset of patients. Much is written in the paediatric literature about collection of urine by collection bags, supra-pubic aspiration, or ‘in-out’ catheterisation in young children who are not able to provide a sample easily, and it would be useful to know if these techniques may also have benefit in the adult population.