From the Guidelines
Collecting urine samples from young children should be done through catheterization or a clean catch method, as these methods provide the most accurate results with the least contamination, as recommended by the American Academy of Pediatrics 1. When collecting urine from infants and toddlers who are not toilet trained, it is essential to prioritize methods that minimize contamination.
- Adhesive collection bags can be used, but the results may not be reliable for culture, and a positive result should be confirmed through catheterization or a clean catch method 1.
- Clean catch collection involves cleaning the genital area with mild soap and water, then having a parent or caregiver catch urine in a sterile container during the child's natural voiding 1.
- For toilet-trained children, providing a sterile container and instructing them to urinate directly into it, with adult supervision as needed, is an effective method 1. To ensure accurate results, it is crucial to:
- Clean the genital area before collection
- Use a sterile container
- Transfer the sample to the laboratory promptly
- Maintain proper hand hygiene before and after collection
- Consider mid-stream collection to reduce contamination The American Academy of Pediatrics recommends catheterization or a clean catch method for collecting urine samples from young children, as these methods provide the most accurate results with the least contamination 1. By following these guidelines, healthcare professionals can ensure that urine samples are collected in a way that balances the need for uncontaminated samples with the practical challenges of collecting urine from young children who may not understand or cooperate with the process.
From the Research
Methods for Collecting Urine in Young Children
There are several methods for collecting urine in young children, each with its own advantages and limitations. These methods include:
- Non-invasive methods: urine pads, bags, clean catch
- Voiding stimulation methods: bladder-lumbar stimulation, Quick-Wee
- Invasive methods: catheter, suprapubic aspiration
Non-Invasive Methods
Non-invasive methods are convenient but can be time-consuming and are limited by sample contamination 2. These methods include:
- Urine pads
- Urine bags
- Clean catch
Invasive Methods
Invasive methods can be more reliable, but require expertise to perform and cause pain for the child 2. These methods include:
- Catheter
- Suprapubic aspiration Invasive methods, such as suprapubic aspiration and urethral catheterization, are less likely to cause contamination of the specimen 3.
Comparison of Methods
A midstream urine collector is not a good alternative to a sterile collection method during the diagnosis of urinary tract infection 4. The midstream collector did not appear to provide additional benefits to classic collection bags. A sterile collection method, such as suprapubic aspiration, catheterisation or clean catch, is still mandatory for diagnosing urinary tract infections in children who are not toilet trained 4.
Considerations for Choosing a Method
When deciding which method to use, providers must take into consideration the clinical presentation of a child as well as presenting and past medical history, while weighing benefits versus risks 3. The choice of method may also depend on the age and medical history of the child, as well as the availability of expertise and equipment.
Reducing Contamination
The use of a novel midstream urine-collection device can reduce contamination rates in urine cultures amongst women 5. However, the effectiveness of this device in reducing contamination rates in children is not well established. Proper patient selection and instructions for use are important to increase satisfaction and reduce contamination rates 6.