Faster clean catch urine collection (Quick-Wee method) from infants: randomised controlled trial

Kaufman, Jonathan; Fitzpatrick, Patrick J.; Tosif, Shidan; Hopper, Sandy M; Donath, Susan; Bryant, Penelope A; Babl, Franz E

doi:10.1136/bmj.j1341

Cited by 62 publications

(74 citation statements)

References 43 publications

(75 reference statements)

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“…Studies show that the rates of contamination in the CCU vary between 4.5 and 51%. While our catheter contamination rate was consistent with the literature [8,[13][14][15], our MS-CCU contamination rate was consistent with some studies [8,16,17], but higher than the results of other studies [9,10,14,[18][19][20][21][22]. We suggest that these variations were caused by differences in study design, study population, and different cutoff values.…”

Section: Discussionsupporting

confidence: 91%

Midstream Clean-Catch Urine Culture Obtained by Stimulation Technique versus Catheter Specimen Urine Culture for Urinary Tract Infections in Newborns: A Paired Comparison of Urine Collection Methods

Altuntaş

Alan

2019

Med Princ Pract

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Objective: The group of Herreros Fernández developed a new, safe, quick, and successful technique for collecting midstream clean-catch urine(MS-CCU) in newborns based on bladder stimulation and lumbar paravertebral massage maneuvers. The purpose of this study was to compare the contamination rates of catheter specimen urine (CSU) and MS-CCU by a lumbar/sacral stimulation technique in newborns. Materials and Methods: Full-term newborns ranging in age from 2 to 28 days who needed an investigation for a presumed urinary tract infection (UTI) were included in the study. Two samples, MS-CCU by lumbar/sacral stimulation technique and CSU, were collected consecutively for each patient. Suitable samples were obtained from 90 patients. Results: The contamination rate in MS-CCU cultures (n = 24/90, 26.66%) was higher than in CSU cultures (n = 9/90, 10%), and the difference was statistically significant (p = 0.039). Thirteen patients had UTI according to both samples (14.14%). In urine analysis, while there was no statistically significant difference in bacteriuria (p = 0.61) and nitrite positivity (p = 0.14) between patients with and without UTI, pyuria (p = 0.01) and leukocyte esterase positivity (p = 0.01) were higher in patients with UTI, and the difference was statistically significant. Conclusion: The contamination rate in MS-CCU cultures was two and a half times greater than in the CSU culture samples. Thus, MS-CCU cannot replace the catheter for the diagnosis of UTI.

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Section: Discussionsupporting

confidence: 91%

Midstream Clean-Catch Urine Culture Obtained by Stimulation Technique versus Catheter Specimen Urine Culture for Urinary Tract Infections in Newborns: A Paired Comparison of Urine Collection Methods

Altuntaş

Alan

2019

Med Princ Pract

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“…Collecting paired voided samples Although routinely collecting a second voided urine sample greatly improves diagnostic efficacy (as shown in Fig. 4), practical considerations mean it is unlikely to be adopted widely (though it is helpful that gentle suprapubic stimulation with a cold fluid-soaked gauze makes babies void more promptly [55]). However, we have found that advice to collect a second sample in selected cases after immediate point-of-care screening is consistently followed.…”

Section: Defining the Best Clinical Diagnostic Threshold For Cathetermentioning

confidence: 99%

Defining urinary tract infection by bacterial colony counts: a case for 100,000 colonies/ml as the best threshold

Coulthard

2019

Pediatr Nephrol

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“…Among infants younger than 6 months of age, a similar technique showed decrease in contamination rate from 49.2 to 27% and was as low as 16% . In another randomised controlled trial, suprapubic cutaneous stimulation with gauze soaked in cold fluid decreased contamination rates in infants younger than 1 year from 45 to 27%, although this was not statistically significant …”

Section: Discussionmentioning

confidence: 97%

Educational intervention does not reduce non‐invasive urine contamination rates in children presenting to the emergency department

Jacob

John‐Denny

Donaldson

et al. 2019

J Paediatrics Child Health

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Aim: Urinary tract infection is common in children with high contamination rates with non-invasive urine sampling (NIU). Our aims were to evaluate an educational tool for decreasing contamination rates and find factors associated with contamination. Methods: This was a prospective cohort interventional study with a review of microbiology data and medical records of all NIU specimens collected at a large tertiary children's emergency department (ED) over a 1-year period. The intervention was the provision of a urine collection kit and educational pamphlet and education of staff. NIU contamination was calculated for 6 months pre-intervention and 6 months post-intervention. The association of factors with NIU contamination was evaluated for all cohorts (age, gender, presence of diarrhoea, season, time of day, time to incubation and activity of the ED). Results: A total of 2104 NIU samples were included (median age 3 years, 52% females). There was no difference between periods in contamination rates (29.2% and 31.2%, respectively, P = 0.322). Collectively, high monthly activity of the department, age and female gender were associated with contamination. The highest contamination rates were among children aged 0-3 months and 12 years and older (38.1 and 48.9%, respectively). Conclusions: The urine collection kit and educational tool did not decrease NIU contamination rates in our ED. Contamination rates were correlated with the monthly activity of our department and female gender and were noticeably high among infants and adolescents. Given the high prevalence of urinary tract infection among these age groups, measures should be taken to reassess indications and methods for urine collection.

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Faster clean catch urine collection (Quick-Wee method) from infants: randomised controlled trial

Abstract: ObjeCtiveTo determine if a simple stimulation method increases the rate of infant voiding for clean catch urine within five minutes.Design Randomised controlled trial.setting

Cited by 62 publications

References 43 publications

Midstream Clean-Catch Urine Culture Obtained by Stimulation Technique versus Catheter Specimen Urine Culture for Urinary Tract Infections in Newborns: A Paired Comparison of Urine Collection Methods

Midstream Clean-Catch Urine Culture Obtained by Stimulation Technique versus Catheter Specimen Urine Culture for Urinary Tract Infections in Newborns: A Paired Comparison of Urine Collection Methods

Defining urinary tract infection by bacterial colony counts: a case for 100,000 colonies/ml as the best threshold

Educational intervention does not reduce non‐invasive urine contamination rates in children presenting to the emergency department

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