Évaluation de la technique de stimulation vésicale comme moyen d'obtenir des urines de qualité dans le diagnostic d'infection urinaire fébrile chez le nourrisson de moins de 6 mois : protocole de recherche

Abstract : Background: Febrile urinary tract infection (UI) is common in infants and needs to be diagnosed quickly. This diagnosis is difficult in infant because symptoms are not specifics and a good quality urinalysis is therefore essential for the diagnosis of UI certainty. The American Academy of Pediatrics recommends the supra pubic and urinary catheterization but those are invasive. Studies have shown a new method of collecting urine that is noninvasive, quick and safe: the bladder stimulation (BS). We hypothesize that the BS is a technique for obtaining urine with a contamination rate equivalent to those obtained by bladder catheterization, in the diagnosis of UI in infants under 6 months of age.
Methods/design: The trial aims to assess equivalence, regarding bacterial contamination, of urinary samples collected using urinary catheterization and using BS to diagnose UI. 770 infants under of 6 months will be enrolled. Randomization will preset which child will benefit from BS or urinary catheterization. The primary endpoints will be the validity of the urine sample, assessed by the presence of a contamination on bacterial culture.
Discussion: Only few studies have evaluated the bacterial contamination of urine sample collected using BS. Due to the high prevalence of suspected urinary tract infection, a high recruitment rate is achievable. As we analyze patients with isolated fever, the medical risk is not different that the routine clinical cares.
If our hypothesis is true and the rate of urine contamination collected by BS is acceptable, the infants included in the study will have benefited from a non-invasive and reliable means of collecting urine.
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Master Thesis
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Clémentine Ciais. Évaluation de la technique de stimulation vésicale comme moyen d'obtenir des urines de qualité dans le diagnostic d'infection urinaire fébrile chez le nourrisson de moins de 6 mois : protocole de recherche. Médecine humaine et pathologie. 2019. ⟨dumas-02188819⟩

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