Randomized Crossover Evaluation of Quick-Wee Versus Urine Collection Bag for Infant Urine Collection

AuthorAlireza Salaren
AuthorHamideh Golien
AuthorNazanin Yoosefianen
AuthorAlia Jalalodinien
AuthorZahra Pournamdaren
AuthorMehdi Rezvaniaminen
OrcidAlireza Salar [0000-0002-5280-0283]en
OrcidHamideh Goli [0000-0002-2182-547X]en
OrcidNazanin Yoosefian [0000-0002-2614-2918]en
OrcidAlia Jalalodini [0000-0003-3289-8583]en
OrcidZahra Pournamdar [0000-0001-9859-0106]en
OrcidMehdi Rezvaniamin [0009-0008-3886-1478]en
Issued Date2025-12-31en
AbstractBackground: Accurate diagnosis of urinary tract infection (UTI) in infants requires a minimally contaminated urine sample. Urine-collection bags are noninvasive but prone to contamination; invasive methods reduce contamination but cause discomfort. Quick-Wee, a stimulation-based clean-catch technique, may offer a faster, cleaner alternative. Objectives: To compare microscopy-defined urine contamination — white blood cells (WBCs), red blood cells (RBCs), epithelial cells, and bacteria as primary outcomes — and collection time and caregiver satisfaction as secondary outcomes, between Quick-Wee and urine-bag collection in infants using a within-subject crossover design. Methods: We conducted a randomized two-period, two-sequence (AB/BA) crossover study. Each infant provided two samples about 6 hours apart within one shift. Sequence (Quick-Wee → bag or bag → Quick-Wee) was assigned via a computer-generated list and sealed, opaque, sequentially numbered envelopes. A single trained pediatric nurse collected all samples per standard operating procedure (SOP); diapers were changed, and the peri-urethral/genital area was washed and dried before each attempt. Laboratory staff were blinded to method/sequence; samples bore anonymized codes. Primary outcomes were quantitative microscopy counts [cells/high-power field (HPF) or semi-quantitative categories]; secondary outcomes were time to collection (minutes) and caregiver satisfaction (5-point Likert). Results: Versus urine-bag collection, Quick-Wee yielded lower counts of WBC (-1.19; P < 0.001), RBC (-0.32; P = 0.007), and epithelial cells (-1.78; P < 0.001); bacterial counts did not differ (P = 0.096). Collection time was markedly shorter with Quick-Wee (10.7 ± 8.9 vs. 52.4 ± 10.3 minutes; difference -41.7; P < 0.001). Caregiver satisfaction was higher with Quick-Wee (median 5 vs. 3; P < 0.001). Conclusions: Quick-Wee is a rapid, noninvasive method that reduces several microscopy-defined contamination indices, substantially shortens collection time, and improves caregiver satisfaction compared with urine-bag collection, with no significant difference in bacterial counts. Findings support Quick-Wee as a pragmatic first-line option for infant urine collection.en
DOIhttps://doi.org/10.5812/jnms-166988en
KeywordPediatricsen
KeywordUrine Collectionen
KeywordUrinalysisen
KeywordUrinary Tract Infectionen
PublisherBrieflandsen
TitleRandomized Crossover Evaluation of Quick-Wee Versus Urine Collection Bag for Infant Urine Collectionen
TypeResearch Articleen

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