Urine collection methods used for non-toilet-trained children in pediatric emergency departments in France: A medical practice analysis

Cousin, Élie; Ryckewaert, A.; Jorna, C. De; Arnaud, Alexis

doi:10.1016/j.arcped.2018.11.005

Cited by 6 publications

(5 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There is a clinician concern that the adhesion of the bag to sensitive skin causes moderate to severe pain when assessed on visual pain scales [ 42 ]. A study of French doctors reported bag removal as “equally to more painful” than catheter removal for females and “equally to less painful” for males [ 43 ]. Reports on the practicalities of sampling note that the bag pulls away from the skin when full and heavy, leading to sample loss [ 44 ].…”

Section: Methods Of Collectionmentioning

confidence: 99%

Urine collection methods and dipstick testing in non-toilet-trained children

Diviney

Jaswon

2020

Pediatr Nephrol

View full text Add to dashboard Cite

Urinary tract infection is a commonly occurring paediatric infection associated with significant morbidity. Diagnosis is challenging as symptoms are non-specific and definitive diagnosis requires an uncontaminated urine sample to be obtained. Common techniques for sampling in non-toilet-trained children include clean catch, bag, pad, in-out catheterisation and suprapubic aspiration. The pros and cons of each method are examined in detail in this review. They differ significantly in frequency of use, contamination rates and acceptability to parents and clinicians. National guidance of which to use differs significantly internationally. No method is clearly superior. For non-invasive testing, clean catch sampling has a lower likelihood of contamination and can be made more efficient through stimulation of voiding in younger children. In invasive testing, suprapubic aspiration gives a lower likelihood of contamination, a high success rate and a low complication rate, but is considered painful and is not preferred by parents. Urine dipstick testing is validated for ruling in or out UTI provided that leucocyte esterase (LE) and nitrite testing are used in combination.

show abstract

Section: Methods Of Collectionmentioning

confidence: 99%

Urine collection methods and dipstick testing in non-toilet-trained children

Diviney

Jaswon

2020

Pediatr Nephrol

View full text Add to dashboard Cite

show abstract

“…However, caution is needed in the interpretation of the results since the urine collection method used in this study applied a urine collection bag instead of suprapubic aspiration or transurethral catheterization. In the most recent studies, it has been confirmed that a urine collection bag is primarily used in the pediatric ED to reduce patient pain and complications associated with the collection procedure [22]. In this study, in order to minimize contamination that may occur during urine collection using a collection bag, 2% chlorhexidine was used to sterilize the urethral opening three times or more by drawing a concentric circle, and after it had completely dried, the collection bag was attached.…”

Section: Discussionmentioning

confidence: 99%

Clinical utility of procalcitonin in febrile infants younger than 3 months of age visiting a pediatric emergency room: a retrospective single-center study

et al. 2021

View full text Add to dashboard Cite

Background Fever in infants under 90 days of age is highly likely to be caused by a severe bacterial infection (SBI) and it accounts for a large number of patients visiting the pediatric emergency room. In order to predict the bacterial infection and reduce unnecessary treatment, the classic classification system is based on white blood cell (WBC) count, urinalysis, and x-ray, and it is modified and applied at each center by incorporating recently studied biomarkers such as c-reactive protein (CRP) or procalcitonin (PCT). This study analyzed the usefulness of PCT in predicting SBI when applied along with the existing classification system, including CRP, among infants less than 90 days old who visited with a fever at a single institution pediatric emergency center. Methods We retrospectively reviewed the medical records of patients younger than 3 months of age who presented with fever at the Seoul Asan Medical Center pediatric emergency room between July 2017 and October 2018. Results A total of 317 patients were analyzed, and 61 were diagnosed with SBI, among which urinary tract infection (UTI) accounted for the largest proportion (55/61, 90.2%). There were differences in WBC, neutrophil proportion, CRP, and PCT between the SBI group and the non-SBI group, and the AUC values of WBC, CRP, and PCT were 0.651, 0.804, and 0.746, respectively. When using the cut-off values of CRP and PCTs as 2.0 mg/dL and 0.3 ng/mL, respectively, the sensitivity and specificity for SBI were 49.2/89.5, and 54.1/87.5, respectively. WBC, CRP, and PCT were statistically significant for predicting SBI in multivariate analysis (odds ratios 1.066, 1.377, and 1.291, respectively). When the subjects were classified using the existing classification criteria, WBC and CRP, the positive predictive value (PPV) and negative predictive value (NPV) were 29.3 and 88.7%, respectively, and when PCT was added, the PPV and NPV were 30.7 and 92%, respectively, both increased. Conclusion PCT is useful for predicting SBI in children aged 3 months or less who visit the emergency room with a fever. It is useful as a single biomarker, and when used in conjunction with classic biomarkers, its diagnostic accuracy is further increased.

show abstract

“…However, caution is needed in the interpretation of the results since the urine collection method used in this study applied a urine collection bag instead of suprapubic aspiration or transurethral catheterization. In the most recent studies, it has been con rmed that a urine collection bag is primarily used in the pediatric ED to reduce patient pain and complications associated with the collection procedure [22]. In this study, in order to minimize contamination that may occur during urine collection using a collection bag, 2% chlorhexidine was used to sterilize the urethral opening three times or more by drawing a concentric circle, and after it had completely dried, the collection bag was attached.…”

Section: Discussionmentioning

confidence: 99%

Clinical utility of procalcitonin in febrile infants younger than 3 months of age visiting a pediatric emergency room: A retrospective single-center study

park

Byun

Lee

et al. 2021

Preprint

View full text Add to dashboard Cite

BackgroundFever in infants under 90 days of age is highly likely to be caused by a severe bacterial infection (SBI) and it accounts for a large number of patients visiting the pediatric emergency room. In order to predict the bacterial infection and reduce unnecessary treatment, the classic classification system is based on white blood cell (WBC) count, urinalysis, and x-ray, and it is modified and applied at each center by incorporating recently studied biomarkers such as c-reactive protein (CRP) or procalcitonin (PCT). This study analyzed the usefulness of PCT in predicting SBI when applied along with the existing classification system, including CRP, among infants less than 90 days old who visited with a fever at a single institution pediatric emergency center.MethodsWe retrospectively reviewed the medical records of patients younger than 3 months of age who presented with fever at the Seoul Asan Medical Center pediatric emergency room between July 2017 and October 2018.ResultsA total of 317 patients were analyzed, and 61 were diagnosed with SBI, among which urinary tract infection (UTI) accounted for the largest proportion (55/61, 90.2%). There were differences in WBC, neutrophil proportion, CRP, and PCT between the SBI group and the non-SBI group, and the AUC values of WBC, CRP, and PCT were 0.651, 0.804, and 0.746, respectively. When using the cut-off values of CRP and PCTs as 2.0 mg/dL and 0.3 ng/mL, respectively, the sensitivity and specificity for SBI were 49.2/89.5, and 54.1/87.5, respectively. WBC, CRP, and PCT were statistically significant for predicting SBI in multivariate analysis (odds ratios 1.066, 1.377, and 1.291, respectively). When the subjects were classified using the existing classification criteria, WBC and CRP, the positive predictive value (PPV) and negative predictive value (NPV) were 29.3% and 88.7%, respectively, and when PCT was added, the PPV and NPV were 30.7% and 92%, respectively, both increased.ConclusionPCT is useful for predicting SBI in children aged 3 months or less who visit the emergency room with a fever. It is useful as a single biomarker, and when used in conjunction with classic biomarkers, its diagnostic accuracy is further increased.

show abstract

Urine collection methods used for non-toilet-trained children in pediatric emergency departments in France: A medical practice analysis

Cited by 6 publications

References 20 publications

Urine collection methods and dipstick testing in non-toilet-trained children

Urine collection methods and dipstick testing in non-toilet-trained children

Clinical utility of procalcitonin in febrile infants younger than 3 months of age visiting a pediatric emergency room: a retrospective single-center study

Clinical utility of procalcitonin in febrile infants younger than 3 months of age visiting a pediatric emergency room: A retrospective single-center study

Contact Info

Product

Resources

About