- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03801213
Evaluation of Urine Samples Obtained by Bladder Stimulation for the Diagnosis of Urinary Tract Infection in Infants (EEStiVeN)
Evaluation of the Bladder Stimulation, a Non-invasive Technique of Urine Collection, in Infant Less Than 6 Months to Diagnose Urinary Tract Infection: a Randomized Multicenter Study
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Urinary tract infection (UTI) is common in infants and needs to be diagnosed quickly. The risk for urinary tract infection before the age of 2 years is about 1-4% in boys and 3-8% in girls. A delay in diagnosis exposes to severe complications. In infants, the symptoms are not specific. A good urinalysis quality is therefore necessary for the diagnosis of UTI. Different techniques exist to collect urine samples in these children who do not control their urination yet: supra pubic aspiration, catheterization, urine collection bag and clean catch urine. The American Academy of Pediatrics (AAP) recommends supra pubic aspiration (1-9 % bacterial contamination) and urinary catheterization (8-14 % contamination) for collecting urine but these techniques are invasive and painful. The sterile bag is a non-invasive method of urine collection, with a high bacterial contamination rates (26-62%) leading to unnecessary antibiotic treatment. Finally, clean catch urine is an accepted urine sample to diagnose UTI according to the recommendations (13-27 % of bacterial contamination) but this method is only possible for potty-trained children. Recent studies (Herreros et al, Altuntas et al, Tran et al.) have shown that bladder stimulation, which consists of pubic tapping and lumbar massage, would be a new, effective, non-invasive and safe method of collecting urine in infants.
Bladder stimulation may be performed by a nurse or a physician. The steps of the bladder stimulation technique are as follows: (a) cleaning the genital area with warm water and soap b) bladder stimulation technique, requires the presence of 3 people: infants will be held under their armpits by a parent over the bed, with legs dangling in males and hips flexed in females. The nurse or technician will then alternate between bladder stimulation maneuvers: gentle tapping in the suprapubic area at a frequency of 100 taps per minute for 30 seconds followed by lumbar paravertebral massage maneuvers for 30 seconds. These two stimulation maneuvers will be repeated until micturition begins, or for a maximum of of 3 minutes.
However, the investigators do not have data on the bacterial contamination rate for urine sample using this new technique. the investigators hypothesize that the bladder stimulation is a technique for obtaining urine with a contamination rate equivalent to those obtained by bladder catheterization, in the diagnosis of febrile urinary tract infection in infants under 6 months of age.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: DEMONCHY DIANE, MD
- Phone Number: +33(0)492030502
- Email: demonchy.d@pediatrie-chulenval-nice.fr
Study Contact Backup
- Name: TRAN ANTOINE, MD
- Email: tran.a@pediatrie-chulenval-nice.fr
Study Locations
-
-
-
Antibes, France
- CH Antibes Juans les Pins
-
Grasse, France
- CH Grasse
-
Lille, France
- CHRU Lille
-
Nice, France
- Hôpitaux Pédiatriques de Nice CHU-Lenval
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Infants under the age of 6 months
For whom an urine sample is required for the diagnosis of a urinary tract infection as follows:
- fever > 39 °C without symptoms
- fever > 38°C and uropathy or urinary tract infection
- fever > 38°C and < 3 months
- fever > 38 °C and > 48h
- fever > 38 °C with sepsis signs
- Obtaining the authorization of the holders of parental authority
- Affiliation to French social security
Exclusion Criteria:
- Do exhibiting signs of vital distress (respiratory or circulatory or neurological)
- contraindication to bladder catheterization
- antibiotic therapy in the last 48 hours
- antibiotic prophylaxis in the last 48 hours
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Diagnostic
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Urinary catheterization
|
Urinary catheterization with pain controlled
|
Experimental: manual bladder stimulation Technique
|
manual gentle tapping in the suprapubic area at a frequency of 100 taps per minute for 30 seconds followed by lumbar paravertebral massage maneuvers for 30 seconds.
The renal and bladder stimulation will be performed in less than 3 minutes, with a maximum of two attempts spaced about 20 minutes
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Bacterial contamination rates of urine samples per bladder stimulation and urinary catheterization
Time Frame: at 48 hours after inclusion date
|
Bacterial contamination of urine sample is defined by:
|
at 48 hours after inclusion date
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Pain of bladder stimulation
Time Frame: through intervention completion, an average 30 min
|
pain is measured by Evaluation ENfant DOuLeur (EVENDOL) scale while the technique is performed.
EVENDOL is a pain scale for children under 7.
A pain scale validated for children from birth to 7 years.
Score ranges from 0 to 15. Treatment threshold: 4/15.
|
through intervention completion, an average 30 min
|
Pain of bladder catheterization
Time Frame: through intervention completion, an average 30 min
|
pain is measured by Evaluation ENfant DOuLeur (EVENDOL) scale while the technique is performed.
EVENDOL is a pain scale for children under 7.
A pain scale validated for children from birth to 7 years.
Score ranges from 0 to 15. Treatment threshold: 4/15.
|
through intervention completion, an average 30 min
|
Diagnostic performance of the dipstick urine test
Time Frame: through intervention completion, an average 30 min
|
The diagnostic performance of the urinary dipstick will be established through sensitivity , specificity, positive predictive value and negative predictive value taking as Gold Standard cytobacteriological examination of the urine (ECBU). Diagnostic performance, as well as accuracy, will be established in each of the two groups. The sensitivity and specificity will be calculated as well as their 95% confidence intervals calculated using the method of the Wilson score |
through intervention completion, an average 30 min
|
Risk factors associated with the failure of the bladder stimulation technique
Time Frame: through intervention completion, an average 30 min
|
for a urinary sample quantity < 2 ml or no urinary sample collected; potential risk factors for failure will be collected (pain, Wight, sex, age, last food and time since las collect urine)
|
through intervention completion, an average 30 min
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: DEMONCHY DIANE, MD, Fondation Lenval - Nice Children Hôpitaux Pédiatriques de Nice
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 18-HPNCL-03
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Urinary Tract Infection Bacterial
-
Inmunotek S.L.CompletedUrinary Tract Infection BacterialSpain, United Kingdom
-
Adaptive Phage Therapeutics, Inc.United States Department of DefenseTerminatedUrinary Tract Infection BacterialUnited States
-
Centre Hospitalier Annecy GenevoisHopital Foch; APHP; Sorbonne University; Hopitaux Civils de Colmar; CH Annecy GenevoisCompletedUrinary Tract Infection Bacterial
-
Impatients N.V. trading as myTomorrowsInmunotek S.L.No longer availableUrinary Tract Infections | Bladder Infection | Recurrent Urinary Tract Infection | Urinary Tract Infection Bacterial | Chronic Urinary Tract InfectionCzechia, Denmark, Serbia, France, Germany, Turkey, Belgium, Finland, Luxembourg, Netherlands, Norway, Romania, Slovakia, Slovenia, Sweden
-
Thomas BenfieldRecruitingUrinary Tract Infection Bacterial | Gram-negative BacteremiaDenmark
-
Wuerzburg University HospitalUniversity of Bristol; University of Georgia; LMU Klinikum; University of Wuerzburg and other collaboratorsRecruitingMedication Adherence | Antibiotic Resistant Infection | Urinary Tract Infection Lower Acute | Urinary Tract Infection Bacterial | Cystitis AcuteGermany
-
Ludwig-Maximilians - University of MunichRecruitingInfections | Urinary Bladder Diseases | Urinary Tract Infections | Bladder Cancer | Infection, Bacterial | Urinary Tract Disease | Infection, Hospital | Infection WoundGermany
-
TC Erciyes UniversityCompletedNephrolithiasis | Urinary Tract Infection BacterialTurkey
-
Cwm Taf University Health Board (NHS)Cardiff UniversityCompletedSexually Transmitted Diseases, Bacterial | Antimicrobial Resistance | Bacterial Urinary Tract InfectionUnited Kingdom
-
GlaxoSmithKlineBiomedical Advanced Research and Development AuthorityCompletedInfections, BacterialUnited States
Clinical Trials on urinary catheterization
-
Cukurova UniversityTÜBİTAKNot yet recruitingThe Urinary Catheterization Training on Skills, Satisfaction and Self-Confidence in Nursing StudentsCatheter-Related Infections | Urinary Catheterization
-
Raed SalimCompleted
-
Rigshospitalet, DenmarkLundbeck FoundationCompletedPostoperative Urinary Retention (POUR)Denmark
-
Okan UniversityCompleted
-
Navamindradhiraj UniversityCompletedUrinary Tract Infections | Postoperative Urinary Retention | Epidural AnesthesiaThailand
-
Children's Hospital of Eastern OntarioThe Physicians' Services Incorporated FoundationTerminatedNeonatal Urinary Tract InfectionCanada
-
University Hospital, GrenobleCompleted
-
Atrium Medical CenterMaastricht UniversityUnknown
-
Hospital Civil de GuadalajaraInstituto Jalisciense de CancerologiaRecruiting
-
Zhejiang Cancer HospitalCompletedUterine Cervical NeoplasmsChina