Is there an effective way to quickly collect a successful urine sample from infants?

In infants aged 1 month to 12 months from whom a urine sample is needed for culture (usually for fever), the Quick-Wee method—gentle stimulation of the suprapubic areas with a cold wet gauze for up to 5 minutes—was significantly more likely to be effective than the wait-and-catch method, generating a useful urine sample 30% of the time. One-in-four samples were contaminated, which is a rate similar to usual clean-catch urine in infants. Still, a few minutes of cold stimulation might save nearly one third of patients from needing suprapubic catheterization. (LOE = 1b)

Kaufman J, Fitzpatrick P, Tosif S, et al. Faster clean catch urine collection (Quick-Wee method) from infants: randomised controlled trial. BMJ 2017;357:j1341.  [PMID:28389435]

Randomized controlled trial (nonblinded)

Foundation

Concealed

Emergency department

These investigators enrolled 354 infants aged 1 month to 12 months who presented to an emergency department and needed to provide a clean-catch urine sample. Infants were randomized, using concealed allocation, to receive usual care (waiting until spontaneous voiding occurred) or the Quick-Wee method (gentle cutaneous suprapubic stimulation using gauze soaked in refrigerated saline). The gentle, circular rubbing continued until the infant voided or for 5 minutes. The authors included children in both groups who voided while their genital area was cleaned. Infants getting the "cold stimulation" were significantly more likely to void as compared with the "exposed to air" group (31% vs 12%; P < .001). The Quick-Wee approach also improved the likelihood of catching a successful urine sample (30% vs 9%). The rate of contamination—approximately 1 in 4—was similar in both groups.