Comparison between bladder stimulation with midstream clean-catch urine and bladder catheterization to obtain non-contaminant urine specimens in febrile children up to 6 months of age: a cross-sectional study

Abstract

Background: UTI causes approximately 7% of the cases of fever without source in children up to 6 months of age. Performing a valid diagnosis procedure includes a dipstick urine test and a urine culture. To obtain urine culture a clean and non-contaminant urine specimen is needed. Nowadays, invasive methods as bladder catheterization and suprapubic bladder aspiration are considered the Gold Standard techniques in this age’s range. A new non-invasive technique based in bladder stimulation with midstream clean-catch urine has been considered a valid technique to obtain non-contaminant urine samples in non-continent children. Objectives: The goal of this study is to determine if bladder stimulation with midstream clean-catch urine technique is at least as effective as bladder catheterization for the urine specimen collection in non-continent children up to 6 months of age in order to replace the Gold Standard technique by the new technique. Secondary objectives are determination of the needed time, analysis of the cost, calculation of complication’s frequency and evaluation of the proportion of failed procedures for each technique. Methodology: A cross-sectional study, of non-inferiority is performed in PER of three tertiary hospitals (HDJT, HVH, HSJD). The study will be performed between 2017 and 2018. Participants: All children up to 6 months of age with fever without source and a positive result in the dipstick urine test attended in Paediatric Emergency Rooms of three tertiary hospitals between April 2017 and July 2017