Evaluation of the bladder stimulation technique to collect midstream urine in infants in a pediatric emergency department

Objective: Midstream clean-catch urine is an accepted method to diagnose urinary tract infection but is impracticable in infants before potty training. We tested the bladder stimulation technique to obtain a clean-catch urine sample in infants. Materials and methods: We included 142 infants under walking age who required a urine sample in a cross- sectional study carried out during a 3-months period, from September to November 2014, in the emergency department of the University Children’s Hospital of Nice (France). A technique based on bladder stimulation and lumbar stimulation maneuvers, with at least two attempts, was tested by four trained physicians. The success rate and time to obtain urine sample within 3 minutes were evaluated. Discomfort (EVENDOL score ≥4/15) was measured. We estimated the risk factors in the failure of the technique. Chi-square test or Fisher’s exact test were used to compare frequencies. T-test and Wilcoxon test were used to compare quantitative data according...

目标：中段清洁尿（midstream clean-catch urine）是诊断尿路感染的公认方法，但对于尚未进行如厕训练的婴儿而言并不适用。本研究测试了膀胱刺激技术在婴儿中获取清洁尿样的效果。
材料与方法：我们纳入了2014年9月至11月期间（为期3个月）在法国尼斯大学儿童医院急诊科需要采集尿样的142名未会行走的婴儿，开展了一项横断面研究（cross-sectional study）。由4名经过培训的医师采用基于膀胱刺激和腰部刺激手法的技术进行测试，至少尝试2次。评估指标包括成功率以及3分钟内获取尿样的时间。同时测量了婴儿的不适程度（EVENDOL评分≥4/15）。我们还分析了该技术失败的风险因素。采用卡方检验（Chi-square test）或Fisher精确检验（Fisher’s exact test）比较频率分布，根据定量数据类型分别使用t检验（T-test）和Wilcoxon检验（Wilcoxon test）进行比较……