Data from: 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
to the normality of the distribution. Risk factors for failure of the
technique were evaluated using a multivariate logistic regression model.
Results: We obtained midstream clean-catch urine in 55.6% of infants with
a median time of 52.0 s (10.0; 110.0). The success rate decreased with age
from 88.9% (newborn) to 28.6% (>1 y) (p=0.0001) and with weight,
from 85.7% (<4kg) to 28.6% (>10kg) (p=0.0004). The success
rate was 60.8% for infants without discomfort (p<0.0001). Heavy
weight and discomfort were associated with failure, with adjusted ORs of
1.47 [1.04-2.31] and 6.65 [2.85-15.54], respectively. Conclusion: Bladder
stimulation seems to be efficient in obtaining midstream urine with a
moderate success rate in our study sample. This could be an alternative
technique for infants before potty training but further randomized
multicenter studies are needed to validate this procedure.