A study of some of the methods of urinary collection in children

Abstract

SYNOPSIS Three methods of urine collection used currently in the diagnosis of urinary tract infection in children were studied. One hundred and fifty-two hospital patients were investigated: 92 by clean-catch method, 32 by the adhesive plastic bag technique, and 28 by suprapubic bladder aspiration. Results indicate that in the great majority of children a satisfactory diagnosis can be made on bacteriological grounds by the examination of specimens passed naturally and collected with care. In a minority of cases further investigation by such means as bladder aspiration may be indicated and this gives conclusive results.To establish with certainty the presence of a bacteriuria significant of infection in children is both a difficult and important task. Care in urine collection is accepted as of crucial importance but doubt still remains as to the most reliable method applicable to children. The two main alternatives are collection by natural means and instrumentation. It is anticipated, however, that the latter method may be adopted only in a minority of cases. Certain aspects of the clean-catch and adhesive bag methods were studied in two wards of a children's hospital, and from the results of these, suprapubic bladder aspiration was carried out in a third ward on a selected group of cases.

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

“…The starred data point was the first sample from a patient whose subsequent colony counts were > 10 7 cfu/ml. The technique used to collect the paired urine for each study is indicated at the bottom Meta-analysis 1: voided urines High-quality quantitative data for voided urines There were 13 valid papers [13,[20][21][22][23][24][25][26][27][28][29][30][31] including one with two sub-studies [23], giving 14 reports on 1270 children, of whom 106 had UTIs and 1164 did not (Table 1). Most groups studied children suspected of having UTIs, one collected a clean catch sample before catheterising children for micturating cystograms [31], one screened for UTIs in healthy school children [22], and two compared different voided collection techniques in healthy children in hospital [30] or at home [29].…”

“…Twelve studies [13-17 25-28, 32, 33, 37] included 709 children, of whom 114 had UTIs and 595 did not (Table 1), but half of these only reported how many cases exceeded various pre-determined colony counts, leaving six that provided sufficient quantitative data for full analysis [13,[25][26][27][28]37]. Nearly half the subjects and two-thirds of those with UTIs were aged < 2 years.…”

“…All 23 children with UTIs who had quantitative SPA data [13,[25][26][27][28]37] had colony counts ≥ 10 5 cfu/ml (Fig. 2), and three of the five children tested for higher bacterial concentrations had counts ≥ 10 6 cfu/ml.…”

Improving clean‐catch contamination rates: A prospective interventional cohort study

“…Obtaining urine for microscopy and culture in children younger than 2 years is difficult as they are generally not toilet‐trained and will not void on demand. Different methods of urine collection include suprapubic aspiration (SPA), catheter specimen urine (CSU), clean‐catch urine (CCU) and bag specimen urine (BSU) . The American Academy of Paediatrics recommends obtaining urine by SPA or CSU, techniques which have lower contamination rates .…”

“…Different methods of urine collection include suprapubic aspiration (SPA), catheter specimen urine (CSU), clean-catch urine (CCU) and bag specimen urine (BSU). 7 The American Academy of Paediatrics recommends obtaining urine by SPA or CSU, techniques which have lower contamination rates. [8][9][10][11][12] The contamination rate for SPA and CSU ranges from 0 to 7% and 9 to 23%, respectively.…”