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Accuracy of clean-catch urine collection in infancy
I J Ramage1, J P Chapman, A S Hollman
1Renal Unit and Department of Diagnostic Imaging, Royal Hospital for Sick Children, Glasgow, Scotland.
Insights
Clean-catch urine (CCU) collection is accurate for diagnosing urinary tract infections in infants, showing good association with suprapubic aspiration (SPA). This study encourages the use of the less invasive CCU technique.
Area of Science:
- Pediatrics
- Microbiology
- Urology
Background:
- Accurate diagnosis of urinary tract infections (UTIs) in infants is crucial for timely treatment and preventing complications.
- Traditional urine collection methods in infants can be challenging, with suprapubic aspiration (SPA) considered a gold standard but being invasive.
Purpose of the Study:
- To compare the diagnostic accuracy of clean-catch urine (CCU) collection versus suprapubic aspiration (SPA) for detecting significant bacteriuria in infants.
- To evaluate the success rate of ultrasound-guided SPA compared to non-guided SPA.
Main Methods:
- Prospective case series involving 49 infants with suspected UTIs.
- Paired urine cultures were obtained using both CCU and SPA methods.
- Sensitivity, specificity, and false-positive/negative rates were calculated; SPA success rates with and without ultrasound guidance were compared using chi-squared test.
Main Results:
- Clean-catch urine collection demonstrated a sensitivity of 88.9% and specificity of 95.0% for detecting significant bacteriuria.
- False-positive and false-negative rates for CCU were 5% and 12%, respectively.
- Ultrasound-assisted SPA had a significantly higher success rate (93%) compared to non-guided SPA (62%).
Conclusions:
- There is a good association between urine culture results obtained by CCU and SPA in infants.
- The study supports the use of the clean-catch urine collection technique as a reliable and less invasive method for diagnosing UTIs in this population.
Objective:
To compare the accuracy of cultures of urine obtained by clean-catch urine (CCU) collection and suprapubic aspiration (SPA) in infants.
Design:
Prospective case series undertaken in a pediatric teaching hospital and associated neonatal unit. Fifty-eight paired urine cultures (CCU collection and SPA) were obtained from 49 infants with suspected urinary tract infection. The primary outcome measure was the presence or absence of significant bacteriuria on both CCU collection and SPA; secondary outcome measures were the success of SPA with ultrasound guidance compared with aspiration without ultrasound guidance. Statistical analysis was done by using a chi(2) test.
Results:
A false-positive rate of 5% and a false-negative rate of 12% were recorded. Sensitivity was 88.9% (95% CI 65.3-98.6), and specificity was 95.0% (95 CI% 83.1-99. 4). Ultrasound-assisted SPA was successful in 26 of 28 patients (93%) and in 13 of 21 patients (62%) when SPA was performed without ultrasound (chi(2) = 7.08, P =.008).
Conclusions:
We conclude that there is a good association in results of culture of urine obtained by CCU collection and SPA and would encourage the use of the CCU technique.
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