Reliability of clean-catch urine collection in non-toilet-trained children compared to invasive methods

Introduction: urinary tract infection in precontinent children poses diagnostic challenges, especially due to the difficulty in obtaining uncontaminated urine samples.

Methods: narrative review on clean-catch urine collection in children under 2 years, analyzing its technique, diagnostic performance and contamination rates in comparison to catheterization and suprapubic aspiration.

Results: when optimized, clean-catch urine collection can reach a sensitivity of 97% and a specificity of 89% in infants aged less than 90 days. Contamination rates range from 5-27%, higher compared to catheterization (8-15%) and suprapubic aspiration (<1%).

Conclusions: clean-catch urine collection is a feasible alternative in outpatient settings when combined with stimulation and adequate cleaning strategies. Method choice should be individualized based on age, clinical status, and resource availability.