Urine sample collection from young pre-continent children: common methods and the new Quick-Wee technique

BACKGROUND

Urinary tract infections (UTIs) are one of the most common bacterial infections of early childhood. However, as signs and symptoms are frequently non-specific in young children, a urine sample is required to diagnose or exclude UTI. National Institute for Health and Care Excellence (NICE) guidelines recommend that children with unexplained fever or signs suggestive of UTI should have a urine sample collected.¹

Collecting urine from pre-continent children is challenging. Collection methods all have limitations. The choice of sample collection method must balance time, resources, contamination, invasiveness, and clinician and carer preferences. Despite being so commonly required for young children, there is significant variation in international guideline recommendations for the optimal method. NICE recommends the clean catch method, other non-invasive methods such as pads if clean catch is not possible, and catheter or suprapubic aspirate (SPA) if non-invasive methods are not possible.¹

Sample contamination occurs when urine flushing over the perigenital skin collects incidental skin flora, or from inadvertent contact between skin and specimen jar. Contamination corrupts the test result. Precise contamination rates for each method of urine collection may be difficult to compare as definitions of contamination vary between centres and studies. However, perigenital skin cleaning before collection and care with collection technique may help to minimise …