Reliability of clean-catch urine collection in not toilet-trained children compared to invasive methods

Introduction: urinary tract infection in pre-continent children poses diagnostic challenges, especially due to difficulty in obtaining uncontaminated urine samples. Methods: narrative review on clean-catch urine collection in children under 2 years, comparing its technique, diagnostic performance and contamination rates with catheterization and suprapubic aspiration. Results: clean-catch urine collection may reach 97% sensitivity and 89% specificity in infants less than 90 days when optimized. Contamination rates range from 5-27%, higher than catheterization (8-15%) and suprapubic aspiration (<1%). Conclusions: clean-catch urine collection is a feasible alternative in outpatient settings when combined with stimulation and cleaning strategies. Method choice should be individualized based on age, clinical status, and resource availability.