Urine collection methods in precontinent children treated at the pediatric emergency department.

AIM
To describe the urine collection methods used in precontinent children presenting at the Pediatric Emergency Department (PED) and compare results and contamination rates.


METHODS
Retrospective observational cohort study that included 1678 urine cultures collected in infants <24 months of age between January 2016 and December 2019. Urine cultures were compared based on collection technique, sex and patient age.


RESULTS
In total, 60.4% of samples were collected by clean-catch urine collection (CCUC), 26.4% by urethral catheterization (UC) and 13.2% by urine bag (UB). Contamination rates were 2.9% (95% CI 1.3, 4.4) for UC, 11.3% (95% CI 9.3, 13.2) for CCUC and 23.4% (95% CI 17.8, 29.0) for UB. Significant differences in contamination rates were found between UC and CCUC in the 6-12-month age group (1.9% [95% CI 0.0-4.0] versus 12.0% [95% CI 7.2-16.8] [p<0.0009]), and between UC and UB for all ages.


CONCLUSIONS
CCUC is the most common method for urine culture collection in infants <24 months of age at the PED in our center. UC has the lowest contamination rates, but significant differences were only observed between CCUC and UC in the 6-12-month age group. CCUC is a non-invasive alternative for urine collection in infants.