Accuracy of a new clean-catch technique for diagnosis of urinary tract infection in infants younger than 90 days of age

María Luisa Herreros, Alfredo Tagarro, Araceli García-Pose, Aida Sánchez, Alfonso Cañete, Pablo Gili, María Luisa Herreros, Alfredo Tagarro, Araceli García-Pose, Aida Sánchez, Alfonso Cañete, Pablo Gili

Abstract

Objective: To evaluate the accuracy of diagnosing urinary tract infections using a new, recently described, standardized clean-catch collection technique.

Methods: Cross-sectional study of infants <90 days old admitted due to fever without a source, with two matched samples of urine obtained using two different methods: clean-catch standardized stimulation technique and bladder catheterization.

Results: Sixty paired urine cultures were obtained. The median age was 44-days-old. Seventeen percent were male infants. Clean-catch technique sensitivity was 97% (95% CI 82% to 100%) and specificity was 89% (95% CI 65% to 98%). The contamination rate of clean-catch samples was lower (5%) than the contamination rate of catheter specimens (8%).

Conclusions: The sensitivity and specificity of urine cultures obtained using the clean-catch method through the new technique were accurate and the contamination rate was low. These results suggest that this technique is a valuable, alternative method for urinary tract infection diagnosis.

Keywords: Bladder stimulation; Catheterization; Clean-catch; Urinary tract infections; Urine sample.

References

    1. Bachur RG, Harper MB. Predictive model for serious bacterial infections among infants younger than 3 months of age. Pediatrics. 2001;108:311–6.
    1. Schroeder AR, Newman TB, Wasserman RC, Finch SA, Pantell RH. Choice of urine collection methods for the diagnosis of urinary tract infection in young, febrile infants. Arch Pediatr Adolesc Med. 2005;159:915–22.
    1. American Academy of Pediatrics. Committee on Quality Improvement. Subcommittee on Urinary Tract Infection Practice parameter: The diagnosis, treatment, and evaluation of the initial urinary tract infection in febrile infants and young children. Pediatrics. 2011;128:595–610.
    1. Verrier K, Verrier K, Banerjee J, Boddy SA Collaborating Centre for Women’s and Children’s Health; Guideline Development Group. Urinary tract infection in children: Diagnosis, treatment and long-term management. Clinical guideline. 2007:44–8.
    1. Whiting P, Westwood M, Bojke L, et al. Clinical effectiveness and cost-effectiveness of tests for the diagnosis and investigation of urinary tract infection in children: A systematic review and economic model. Health Technol Asses. 2006;10:1–154.
    1. Herreros Fernández ML, González Merino N, Tagarro García A, et al. A new technique for fast and safe collection of urine in newborns. Arch Dis Child. 2013;98:27–9.
    1. Braude H, Forfar JO, Gould JC, Forfar J, Gould J, McLeod J. Diagnosis of urinary tract infection in childhood based on examination of pared non catheter and catheter specimens of urine. Br Med J. 1967;4:702–5.
    1. Dagan R, Poell KR, Hall CB, Menegus MA. Identification of infants unlikely to have serious bacterial infection although hospitalized for suspected sepsis. J Pediatr. 1985;107:855–60.
    1. American Academy of Pediatrics. Committee on Quality Improvement. Subcommittee on Urinary Tract Infection Practice parameter: The diagnosis, treatment, and evaluation of the initial urinary tract infection in febrile infants and young children. Pediatrics. 1999;103:843–51.
    1. Robinson JL, Finlay JC, Lang ME, Bortolussi R, Canadian Paediatric Society, Infectious Diseases and Immunization Committee. Community Paediatrics Committee Urinary tract infections in infants and children: Diagnosis and management. Paediatr Child Health. 2014;19:315–25.
    1. Hoberman A, Chao H-P, Keller DM, Hickey R, David HW, Ellis Prevalence de urinary tract infection in febrile infant. J Pediatr. 1993;123:17–23.
    1. Smyth RL, Berman L, Valman HB. Current practice in managing urinary tract infections in children. Br Med J. 1988;297:1516–7.
    1. Ochoa Sangrador C, Brezmes Valdivieso MF, Grupo investigador del proyecto Sample collection methods for urine culture and analysis. An Pediatr (Barc) 2007;67:442–9.
    1. Ramage IJ, Chapman JP, Hollman AS, Elabassi M, McColl JH, Beattie TJ. Accuracy of clean-catch urine collection in infancy. J Pediatr. 1999;135:765–7.
    1. Aronson AS, Gustafson B, Svenningsen NW. Combined suprapubic aspiration and clean voided urine examination in infants and children. Acta Paediatr Scand. 1973;62:396–400.
    1. Amir J, Ginzburg M, Straussberg R, Varsano I. The reliability of midstream urine culture from circumcised male infants. Am J Dis Child. 1993;147:969–70.
    1. Karacan C, Erkek N, Senel S, Akin Gunduz S, Catli G, Tavil B. Evaluation of urine collection metods for diagnosis of urinary tract infection in children. Med Princ Pract. 2010;19:188–91.
    1. Tosif S, Baker A, Oakley E, Donath S, Babl FE. Contamination rates of different urine collection methods for the diagnosis of urinary tract infections in young children: An observational cohort study. J Paediatr Child Health. 2012;48:659–64.
    1. Altuntas N, Celebi Tayfur A, Kocak Mesut, Cem Razi H, Akkurt S. Midstream clean-catch urine collection in newborns: A randomized controlled study. Eur J Pediatr. 2015;174:577–82.

Source: PubMed

3
Abonnieren