Abstract
Background: Sign and symptoms of urinary tract infections (UTI) are not specific in infants and young children, fever being the commonest sign. Therefore, collecting urine samples for culture is required to diagnose or exclude UTI. Obtaining a clean catch urine sample in neonates and infants is a great challenge as it is unpredictable, time consuming and requires lot of patience. Objectives: The objectives of the study were to determine the effect of bladder and lumbar stimulation technique (BLST) for collection of midstream urine in newborns and to evaluate contamination rates of urine samples collected. Methods: An experimental research was conducted in BPKIHS, Dharan, Nepal including total of 54 term newborns. Urine culture was indicated for different reasons to the admitted newborns. They were randomly assigned either to the experimental group or the control group. Twenty-five minutes after feeding, the genitals and perineal area of the babies were cleaned. The newborns were held under the armpits with legs dangling. Bladder and Lumbar stimulation technique was only applied to the newborns in the experimental group. Success was defined as collection of urine sample within 5 minutes (<300s) of starting the stimulation maneuver in the experimental group and of holding under the armpits in the control group. Results: The success rate of urine collection was significantly higher in the experimental group (88.88%) than in the control group (25.92%) p<0.001. The median time for sample collection was 1.07 minutes (64.2s) [IQR=1.52minutes (91.2s)] in experimental group and 1.52minutes (91.2s) [IQR= 2.78 minutes (166.8s) for control group (p=0.069). Contamination was not found in urine samples collected by BLST in experimental group. Conclusion: The study suggests that bladder and lumbar stimulation technique is safe, quick and effective way of collecting midstream clean catch urine in newborns.
Highlights
Urinary tract infection is one of the most important sources of infection in children under 5 years of age [1]
Few studies hypothesize that the use of some stimulation technique that facilitate emptying of bladder in situation of bladder dysfunction could facilitate the collection of midstream urine samples in newborns, and developed a new non invasive technique based on bladder stimulation and lumbar paravertebral massage maneuver [5, 6, 7]
The study was conducted in pediatric emergency, pediatric wards, neonatal intensive care unit (NICU), nursery and neonatal ward of B.P
Summary
Urinary tract infection is one of the most important sources of infection in children under 5 years of age [1]. Objectives: The objectives of the study were to determine the effect of bladder and lumbar stimulation technique (BLST) for collection of midstream urine in newborns and to evaluate contamination rates of urine samples collected. Urine culture was indicated for different reasons to the admitted newborns They were randomly assigned either to the experimental group or the control group. Success was defined as collection of urine sample within 5 minutes (
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