randomized crossover evaluation of quick-wee versus urine collection bag for infant urine collection

Background :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.