Advertisement

European Journal of Pediatrics

, Volume 174, Issue 5, pp 577–582 | Cite as

Midstream clean-catch urine collection in newborns: a randomized controlled study

  • Nilgun AltuntasEmail author
  • Asli Celebi Tayfur
  • Mesut Kocak
  • Hasan Cem Razi
  • Serpil Akkurt
Original Article

Abstract

We aimed to evaluate a recently defined technique based on bladder stimulation and paravertebral lumbar massage maneuvers in collecting a midstream clean-catch urine sample in newborns. A total of 127 term newborns were randomly assigned either to the experimental group or the control group. Twenty-five minutes after feeding, the genital and perineal areas of the babies were cleaned. The babies were held under the armpits with legs dangling. Bladder stimulation and lumbar paravertebral massage maneuvers were only applied to the babies in the experimental group. Success was defined as collection of a urine sample within 5 min of starting the stimulation maneuvers in the experimental group and of holding under the armpits in the control group. The success rate of urine collection was significantly higher in the experimental group (78 %) than in the control group (33 %; p < 0.001). The median time (interquartile range) for sample collection was 60 s (64.5 s) in the experimental group and 300 s (95 s) in the control group (p < 0.0001). Contamination rates were similar in both groups (p = 0.770).

Conclusion: We suggest that bladder stimulation and lumbar paravertebral massage is a safe, quick, and effective way of collecting midstream clean-catch urine in newborns.

Keywords

Clean-catch midstream urine Contamination Midstream urine sample Newborn 

Abbreviations

CG

The control group

CCU

Clean-catch urine

EG

The experimental group

SBU

Sterile bag urine

SPA

Suprapubic aspiration

UC

Urine catheterization

UTI

Urinary tract infection

CFU

Colony-forming units

Notes

Funding source

No funding was secured for this study.

Financial disclosure

The authors have no financial relationships relevant to this article to disclose.

Conflict of interest

The authors have no conflicts of interest to disclose.

References

  1. 1.
    Alam MT, Coulter JB, Pacheco J, Correia JB, Ribeiro MG, Coelho MF, Bunn JE (2005) Comparison of urine contamination rates using three different methods of collection: clean-catch, cotton wool pad and urine bag. Ann Trop Paediatr 25(1):29–34CrossRefPubMedGoogle Scholar
  2. 2.
    Altuntas N, Turkyilmaz C, Sonmez K, Atalay Y (2013) Is intestinal hypermotility a contraindication for suprapubic aspiration of the bladder? HK J Paediatr 18:122–124Google Scholar
  3. 3.
    American Academy of Pediatrics, Committee on Quality Improvement, Subcommittee on Urinary Tract Infection (2011) Practice parameter: the diagnosis, treatment, and evaluation of the initial urinary tract infection in febrile infants and young children. Pediatrics 128(3):595–610CrossRefGoogle Scholar
  4. 4.
    Amir J, Ginzburg M, Straussberg R, Varsano I (1993) The reliability of midstream urine culture from circumcised male infants. Am J Dis Child 147:969–970PubMedGoogle Scholar
  5. 5.
    Aronson AS, Gustafson B, Svenningsen NW (1973) Combined suprapubic aspiration and clean voided urine examination in infants and children. Acta Paediatr Scand 62:396–400CrossRefPubMedGoogle Scholar
  6. 6.
    Beeson PB (1958) The case against the catheter. Am J Med 24(1):1–3CrossRefPubMedGoogle Scholar
  7. 7.
    Boshell BR, Sanford JP (1958) A screening method for the evaluation of urinary tract infections in female patients without catheterization. Ann Intern Med 48(5):1040–1045CrossRefPubMedGoogle Scholar
  8. 8.
    Chang SL, Shortliffe LD (2006) Pediatric urinary tract infections. Pediatr Clin North Am 53(3):379–400CrossRefPubMedGoogle Scholar
  9. 9.
    Dasgupta P, Haslam C, Goodwin R, Fowler CJ (1997) The ‘Queen Square bladder stimulator’: a device for assisting emptying of the neurogenic bladder. Br J Urol 80:234–237CrossRefPubMedGoogle Scholar
  10. 10.
    Davies P, Greenwood R, Benger J (2008) Randomised trial of vibrating bladder stimulator the time to pee study. Arch Dis Child 93:423–424CrossRefPubMedGoogle Scholar
  11. 11.
    Finnell SM, Carroll AE, Downs SM (2011) Subcommittee on urinary tract infection. Technical report-diagnosis and management of an initial UTI in febrile infants and young children. Pediatrics 128(3):749–770CrossRefGoogle Scholar
  12. 12.
    Herreros Fernández ML, González Merino N, Tagarro García A, Pérez Seoane B, de la Serna MM, Contreras Abad MT, García PA (2013) A new technique for fast and safe collection of urine in newborns. Arch Dis Child 98:27–29CrossRefPubMedGoogle Scholar
  13. 13.
    Jansson UB, Hanson M, Hanson E, Hellström AL, Sillén U (2000) Voiding pattern in healthy children 0 to 3 years old: a longitudinal study. J Urol 164(6):2050–2054CrossRefPubMedGoogle Scholar
  14. 14.
    Kalager T, Digranes A (1979) Unusual complication after suprapubic bladder puncture. Br Med J 1(6156):91–92CrossRefPubMedCentralPubMedGoogle Scholar
  15. 15.
    Karacan C, Erkek N, Senel S, Akin Gunduz S, Catli G, Tavil B (2010) Evaluation of urine collection methods for the diagnosis of urinary tract infection in children. Med Princ Pract 19(3):188–191CrossRefPubMedGoogle Scholar
  16. 16.
    Lohr JA, Donowitz LG, Dudley SM (1989) Bacterial contamination rates in voided urine collections in girls. J Pediatr 114(1):91–93CrossRefPubMedGoogle Scholar
  17. 17.
    Moustaki M, Stefos E, Malliou C, Fretzayas A (2007) Complications of suprapubic aspiration in transiently neutropenic children. Pediatr Emerg Care 23(11):823–825CrossRefPubMedGoogle Scholar
  18. 18.
    Prasad RS, Smith SJ, Wright H (2003) Lower abdominal pressure versus external bladder stimulation to aid bladder emptying in multiple sclerosis: a randomized controlled study. Clin Rehabil 17(1):42–47CrossRefPubMedGoogle Scholar
  19. 19.
    Saez-Llorens X, Umana MA, Odio CM, Lohr JA (1989) Bacterial contamination rates for non-clean-catch and clean-catch midstream urine collections in uncircumcised boys. J Pediatr 114(1):93–95CrossRefPubMedGoogle Scholar
  20. 20.
    Subcommittee on Urinary Tract Infection, Steering Committee on Quality Improvement and Management, Roberts KB (2011) Urinary tract infection: clinical practice guideline for the diagnosis and management of the initial UTI in febrile infants and children 2 to 24 months. Pediatrics 128(3):595–610CrossRefGoogle Scholar
  21. 21.
    Tosif S, Baker A, Oakley E, Donath S, Babl FE (2012) 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 48(8):659–664CrossRefPubMedGoogle Scholar
  22. 22.
    Vaillancourt S, McGillivray D, Zhang X, Kramer MS (2007) To clean or not to clean: effect on contamination rates in midstream urine collections in toilet-trained children. Pediatrics 119(6):1288–1293CrossRefGoogle Scholar
  23. 23.
    You Lau A, Wong S-N, Yip K-T, Fong K-W, Po-Siu Li S, Que T-L (2007) A comparative study on bacterial cultures of urine samples obtained by clean-void technique versus urethral catheterization. Acta Paediatr 96:432–436CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Nilgun Altuntas
    • 1
    Email author
  • Asli Celebi Tayfur
    • 2
  • Mesut Kocak
    • 3
  • Hasan Cem Razi
    • 3
  • Serpil Akkurt
    • 3
  1. 1.Department of Pediatrics, Division of NeonatologyKecioren Training and Research HospitalKeciorenTurkey
  2. 2.Department of Pediatrics, Division of NephrologyKecioren Training and Research HospitalAnkaraTurkey
  3. 3.Department of PediatricsKecioren Training and Research HospitalAnkaraTurkey

Personalised recommendations