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Clean catch urine collection: Time taken and diagnostic implication. A prospective observational study
Shidan Tosif1,2,3, Jonathan Kaufman2,3,4, Patrick Fitzpatrick2,4
1Department of General Medicine, Royal Children's Hospital Melbourne, Melbourne, Victoria, Australia.
Journal of Paediatrics and Child Health
|June 16, 2017
Summary
Clean catch urine (CCU) collection in children is time-consuming and often unsuccessful. This method yields a low diagnostic rate for urinary tract infections due to contamination and collection failures.
Area of Science:
- Pediatric Emergency Medicine
- Clinical Microbiology
- Urology
Background:
- Clean catch urine (CCU) collection is a standard method for obtaining urine samples in pre-continent children.
- CCU procedures can be lengthy and may result in specimen contamination, impacting diagnostic accuracy.
Purpose of the Study:
- To evaluate the time required for CCU attempts in children.
- To assess the success rate of CCU in diagnosing or excluding urinary tract infections (UTIs).
Main Methods:
- A prospective observational study was conducted in an emergency department setting.
- Data collected included time to urine collection, success rates ('successful', 'missed', 'stopped'), and urine culture results for children aged 2-48 months.
Main Results:
- Out of 217 children and 247 attempts, the median collection time was 30.5 minutes.
- Successful collection occurred in 64% of attempts, with 39% of cultured specimens showing contamination.
- The overall estimated yield of an uncontaminated urine specimen was 45%.
Conclusions:
- CCU collection is inefficient, often unsuccessful, and prone to contamination, leading to a low diagnostic yield for UTIs.
- Clinicians can anticipate approximately a 45% probability of obtaining a definitive urine sample using the CCU method.
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