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Urinary tract infections are common in infants. Obtaining urine from pre-continent children can be difficult and time consuming. The method of collection must balance reliability, speed, low rate of contamination, and invasiveness.
According to the American Academy of Pediatrics, midstream clean-catch urine is an acceptable method to diagnose urinary tract infections. However, it is impractical in pre-continent children.
Recently, two quick, safe and effective methods have been reported in the literature:
However, advanced age, high weight, and level of discomfort during bladder stimulation were significantly associated with failure to obtain urines.
Urinary tract infections (UTI) are common in infants. The diagnosis of a UTI has important implications for follow-up, and delayed treatment can result in morbidity, including renal scarring and serious bacterial infection.
Obtaining urine from pre-continent children can be difficult and time consuming, the method of collection must balance reliability, speed, low rate of contamination, and invasiveness The actual guidelines recommend suprapubic aspiration or bladder catheterization for collection of urine sample in pre-continent children, but these methods are invasive.
The most common way to collect urines in infants is the use of a sterile collection bag. This is an easy technique, but time consuming and responsible for high rate of contamination, leading to false positives.
According to the American Academy of Pediatrics, midstream clean-catch urine is an acceptable method to diagnose urinary tract infection. However, it is impractical in pre-continent children.
Recently, two quick, safe and effective methods have been reported in the literature:
However, advanced age, high weight, and level of discomfort during bladder stimulation were significantly associated with failure to obtain urines.
Futhermore, even if urine collection in pre-continent children most often concerns urinary tract infections, these techniques could also be used to look for a metabolic abnormality, an uropathy or a nephropathy (urine electrolyte concentrations, proteinuria, hematuria).
The aim of the study is to compare the effectiveness of two non-invasive midstream urine collection methods in pre-continent children : "the Quick-Wee method" and "the Bladder stimulation method".
The investigators will also compare in the two groups the time required to obtain urine sample, the comfort of the infant during urine collection and the quality of urines.
Finally, for each technique will be analyzed the risk factors associated with failure in obtaining urine sample
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| bladder stimulation | Experimental |
| |
| Quick wee | Active Comparator |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| bladder stimulation | Other | The bladder stimulation technique requires the presence of 2 people:
|
| Measure | Description | Time Frame |
|---|---|---|
| volume of urine collection to measure the effectiveness of two techniques | measure of success of the urine collection technique is determined by collecting at least 2 millimeters of urine in less than 5 minutes | at the end of intervention completion, an average 30 minutes |
| Measure | Description | Time Frame |
|---|---|---|
| time needed to obtain urines | measure of times needed to obtain urines in minutes and seconds | at the end of intervention completion, an average 30 minutes |
| patient comfort | 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. |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Centre Hospitalier Universitaire de Sainte-Justine | Montreal | Canada | ||||
| Centre Hospitalier Antibes Juan les Pins |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 34531206 | Derived | Marchal S, Janicot J, Salicis J, Demonchy D, Herisse AL, Olla M, Rancurel A, Haas H, Berard E, Breaud J, Bernardor J, Ribet C, Freyssinet E, Donzeau D, Desmontils J, Schori-Fortier C, Fontas E, Tran A. Quick-Wee versus bladder stimulation to collect midstream urine from precontinent infants under 1 year of age: a study protocol for a randomised controlled trial (ES.Stimquick.U). BMJ Open. 2021 Sep 16;11(9):e046324. doi: 10.1136/bmjopen-2020-046324. |
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| ID | Term |
|---|---|
| D014552 | Urinary Tract Infections |
| ID | Term |
|---|---|
| D007239 | Infections |
| D014570 | Urologic Diseases |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
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|
| Quick wee | Other | The Quick wee technique requires the presence of only one person: Stimulation of the suprapubic area by circular movements, with a cold and wet compress held by sterile forceps. Collection of urine in a sterile container. |
|
| through intervention completion, an average 30 minutes |
| Bacterial contamination rates of urine samples | Measure of bacterial contamination of urine sample is by:
| at 48 hours after inclusion |
| collection of patient data to define risk factors associated with the failure of the bladder stimulation techniques | collection patient data : pain, weight, sex, age, last food and time since last collect urine The goal is to define potential risk factors to failure urine collection (urinary sample quantity < 2 millimeters or no urinary sample collected) | through intervention completion, an average 30 minutes |
| Antibes |
| France |
| Hôpitaux Pédiatriques de Nice CHU-Lenval | Nice | France |
| D000091642 | Urogenital Diseases |
| D052801 | Male Urogenital Diseases |