Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2020 Jan;56(1):142-147.
doi: 10.1111/jpc.14542. Epub 2019 Jun 19.

Educational intervention does not reduce non-invasive urine contamination rates in children presenting to the emergency department

Ron Jacob  1 , Blessy John-Denny  1 , Katherine Donaldson  1 , Brent White  2 , Alexander Outhred  1   3 , Mary E McCaskill  1
Affiliations
Review

Educational intervention does not reduce non-invasive urine contamination rates in children presenting to the emergency department

Ron Jacob et al. J Paediatr Child Health. 2020 Jan.

Abstract

Aim: Urinary tract infection is common in children with high contamination rates with non-invasive urine sampling (NIU). Our aims were to evaluate an educational tool for decreasing contamination rates and find factors associated with contamination.

Methods: This was a prospective cohort interventional study with a review of microbiology data and medical records of all NIU specimens collected at a large tertiary children's emergency department (ED) over a 1-year period. The intervention was the provision of a urine collection kit and educational pamphlet and education of staff. NIU contamination was calculated for 6 months pre-intervention and 6 months post-intervention. The association of factors with NIU contamination was evaluated for all cohorts (age, gender, presence of diarrhoea, season, time of day, time to incubation and activity of the ED).

Results: A total of 2104 NIU samples were included (median age 3 years, 52% females). There was no difference between periods in contamination rates (29.2% and 31.2%, respectively, P = 0.322). Collectively, high monthly activity of the department, age and female gender were associated with contamination. The highest contamination rates were among children aged 0-3 months and 12 years and older (38.1 and 48.9%, respectively).

Conclusions: The urine collection kit and educational tool did not decrease NIU contamination rates in our ED. Contamination rates were correlated with the monthly activity of our department and female gender and were noticeably high among infants and adolescents. Given the high prevalence of urinary tract infection among these age groups, measures should be taken to reassess indications and methods for urine collection.

Keywords: clean catch urine; contamination; emergency medicine; paediatric; urinary tract infection.

PubMed Disclaimer

Comment in

  • Letter to the editor.
    Henson R, Collins A, Zia S, Coplin B, Akkad R, Hamby T. Henson R, et al. J Paediatr Child Health. 2019 Nov;55(11):1407-1408. doi: 10.1111/jpc.14645. J Paediatr Child Health. 2019. PMID: 31691417 No abstract available.

References

    1. Shaikh N, Morone NE, Bost JE, Farrell MH. Prevalence of urinary tract infection in childhood. Pediatr. Infect. Dis. J. 2008; 27: 302-8.
    1. Korbel L, Howell M, Spencer JD. The clinical diagnosis and management of urinary tract infections in children and adolescents. Paediatr. Int. Child Health 2017; 37: 273-9.
    1. Coulthard MG, Lambert HJ, Vernon SJ, Hunter EW, Keir MJ, Matthews JNS. Does prompt treatment of urinary tract infection in preschool children prevent renal scarring: Mixed retrospective and prospective audits. Arch. Dis. Child. 2014; 99: 342-7.
    1. Shaikh N, Mattoo TK, Keren R et al. Early antibiotic treatment for pediatric febrile urinary tract infection and renal scarring. JAMA Pediatr. 2016; 170: 848-54.
    1. Shaikh N, Craig JC, Rovers MM et al. Identification of children and adolescents at risk for renal scarring after a first urinary tract infection. JAMA Pediatr. 2014; 168: 893-900.

LinkOut - more resources