Prins, E. (2013) PeeSpot®, an alternative for the urine collection bag. Diagnostic examination of a urinary tract infection in diaper-wearing children with the PeeSpot®. thesis, Medicine.
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Abstract
Background: A urinary tract infection (UTI) is a common bacterial infection in children. UTIs may be difficult to recognize in young children, because the presenting symptoms are non-specific. However, it is important to diagnose and treat children with a UTI as soon as possible. Several methods are used for urine collection in diaper-wearing children. A bladder catheterization and suprapubic aspiration give most reliable results, but are invasive. A urine collection bag is often distressing, leaking and leaving red marks and the collection pads now available still need many actions before urine can be analyzed. According to current guidelines a urine sample collected by a collection bag is only used to rule out UTI. If the analysis of urine obtained by a collection bag is positive, a urine sample obtained by catheterization is necessary to rule out or prove UTI. Recently a new type of collection pad has been developed, the PeeSpot®. This is a felt of 30x10x5 mm which can absorb 1.2 ml urine and can be placed in the diaper, but has only been validated for biochemical analyses up to now. Aim: To examine if the PeeSpot®, being a fast, child-friendly method, can be used as a reliable alternative for the urine collection bag to rule out UTI in diaper-wearing children. Setting: Children’s department of Deventer Hospital, a non-academic teaching hospital, in The Netherlands. Methods: This study consists of 3 sub-studies. 1) In a laboratory study the number of bacteria of 15 urine samples of adults was counted before and after absorption by the PeeSpot® felts. 2) In a clinical study urine samples of diaper-wearing children, with and without UTI, were obtained with the PeeSpot® felts. These samples were analyzed by counting the number of bacteria with the sediMAX analyzer (a new automated sediment analyzer) and by a urinary culture and contamination rate is calculated. 3) To compare that contamination rate to other methods of urine collection we did a retrospective study. In this sub-study all urine samples of children 0-42 months old obtained in our hospital in 2012 were evaluated and with their urinary culture results contamination rates are calculated for urine collected by collection bag and catheterization. Results: 1) The laboratory study shows that bacteria are fully recovered from the PeeSpot® felt. 2) The clinical study gives a contamination rate of 94% for the PeeSpot®. There is no significant difference found between the two sexes, age on collection date, time span the felts stayed in the diaper and the four different wards where samples were obtained and number of bacteria counted or urinary culture results. 3) The retrospective study shows that contamination rate for catheterization is 0-44% and for a urine collection bag 80-87%. The difference between the contamination rate of the PeeSpot® and the collection bag turns out not to be significant in this study. Conclusion: We found that urine samples obtained with the PeeSpot® give a high contamination rate, but comparable to the contamination rate of a urine collection bag. Under certain conditions the PeeSpot® could be an alternative, more child-friendly method for the collection bag to rule out UTI, but further research is necessary with more urine samples of children with proven UTI.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Dassel, A.C.M. |
| Supervisor name: | Hessels, J. and Zwet, W.C. van der and Deventer Ziekenhuis |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:46 |
| Last Modified: | 25 Jun 2020 10:46 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/703 |
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