This approach couples feeding with bladder stimulation and was successful in 86% of newborns with a mean time of 57 seconds.

As an alternative to these methods, Herreros et al described a new non-invasive technique for obtaining a mid-stream CCU sample in newborns. Alternative techniques, such as a urine collection bag attached to the perineum or a clean catch urine (CCU), offer non-invasive approaches to urine collection but are undesirable as cultures obtained using a bag have a false positive rate approaching 90% and CCU can be time consuming. These methods are painful and invasive, yet are considered the gold standard approaches to urine collection in infants as the culture obtained has a sensitivity and specificity of >95%. The American Academy of Pediatrics (AAP) recommends obtaining a urine specimen for urinalysis and culture via suprapubic aspiration (SPA) or catheterization, particularly for infants requiring immediate antimicrobial therapy. Urinary tract infection (UTI) is the most common serious bacterial infection among febrile infants, occurring in 7% of children less than 24 months of age evaluated for fever without a source. The results of this study may then lead to a change in practice where the bladder stimulation technique will be used preferentially for infants requiring a urinalysis and urine culture. In addition, the investigators hypothesize that the bladder stimulation technique will be well tolerated by patients, and preferred by providers and parents when compared with catheterization. In training over 120 PED staff, the investigators aim to demonstrate that minimal training is required to perform this technique. This study, however, will be the first to demonstrate the feasibility of incorporating this technique into clinical practice in a busy, urban, academic pediatric emergency department (PED). Previous studies have demonstrated that the bladder stimulation technique is a quick and non-invasive approach to collecting urine in young infants with a contamination rate similar to the current more invasive gold standard, catheterization. Why Should I Register and Submit Results?.

Bladder stimulator