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

Abstract

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.

Correlation between urinary and serum NT-proBNP in acute bronchiolitis. A pilot study

“…Like these populations, obtaining blood samples for testing in acute bronchiolitis is technically challenging for the healthcare provider and stressful and painful for the patient, especially in cases where repeated tests are needed for monitoring evolution. Evidence shows that it is possible to collect urine non-invasively, efficiently, and quickly, especially in children under three months of age, who constitute most of the hospitalized population with bronchiolitis [22,23]. With this study, we point out that urinary NT-proBNP can be adequately analyzed with the same laboratory kit as serum NT-proBNP (Alere i) in acute bronchiolitis.…”

Outpatient urine collection methods for paediatric urinary tract infections: Systematic review of diagnostic accuracy studies

“…Diviney et al also proposed clean‐catch sampling as the preferred method, because the contamination rate was comparable to invasive methods 26 . Other studies found contamination rates of clean‐catch between 4.5% and 27%, 27–34 whereas Herreros et al 22 reported a contamination rate of 5%.…”

“…Diviney et al also proposed clean-catch sampling as the preferred method, because the contamination rate was comparable to invasive methods. 26 Other studies found contamination rates of clean-catch between 4.5% and 27%, [27][28][29][30][31][32][33][34] whereas Herreros et al 22 reported a contamination rate of 5%. In addition, the proportion of contamination can be influenced by the criteria used to define contamination, the person performing urine collection, techniques used to reduce contamination or stimulate urination, patient characteristics and setting.…”

Could Mesna and Celery Seed Cotherapy Modulate Oxidative Stress and Inflammation of the Urinary Bladder Induced by Ifosfamide in Rabbits?

“…The urine dipstick test was immersed into the urine sample to grade the scale of hematuria (from 0–3) in all groups. 18 , 19 …”