Urinary tract infections are common in young children and if
untreated can lead to permanent renal scarring, meningitis and severe sepsis.
Urine samples are required to diagnose or exclude infections, however collecting
samples from pre-continent children can be difficult.
in Training Research Scholarship 2015 recipient, Dr Jonathan Kaufman (pictured),
a registrar and Paediatric Advanced Trainee at the Royal Children’s Hospital in
Melbourne, aims to use the part-time scholarship to demonstrate the viability of
an improved urine collection method. Dubbed ‘Quick-Wee’, it aims to help
clinicians collect urine samples quickly, for young children in the emergency
department and beyond.
Dr Kaufman, 35, will lead the Quick-Wee Randomised
Controlled Trial at the Royal Children’s Hospital and Murdoch Children’s
Research Institute in Melbourne, while completing a Doctor of Medical Science
degree at the University of Melbourne. The scholarship represents another career
highlight for Dr Kaufman who was awarded the Advanced Trainee Research Prize in
2014 at the Royal Children’s Hospital and Victorian Paediatric Trainee Research
Award for Excellence from the Royal Australasian College of Physicians in 2015.
He has also held leadership roles as a Deputy Chief Resident Medical Officer at
the Royal Children’s Hospital and a Paediatric Life Support Instructor for
Interest in paediatrics a natural progression
Dr Kaufman’s interest in paediatrics has grown over the years
after working as an assistant teacher and sports coach at a primary school in
Oxford, United Kingdom, during a gap year. “I’ve always enjoyed working with
kids as a sports coach, and working in my previous career as a physiotherapist I
found I really enjoyed working with children in the hospital setting,” he
Limitations with Clean Catch Urine collection method
Clinicians commonly need to collect urine samples in young
children to either diagnose or exclude urinary tract infections, however this
can be a difficult and time-consuming process as young children are rarely
toilet trained. Dr Kaufman says the idea for the Quick-Wee urine collection
method came during a night-shift while working as a Paediatric Registrar at
Geelong Hospital in Victoria.
“I was frustrated by the limitations of
our current urine collection methods and I had noticed that when you do the
routine cleaning of the perigenital region before you use a catheter or a
suprapubic needle aspirate, sometimes that cold stimulation from the cleaning
seems to trigger the children to void,” he says. “I wondered if that could be
the basis for a more formal technique for collecting non-invasive urine
Research supervisors play pivotal role
Kaufman developed his idea into a series of research trials with the help of his
supervisors. His primary supervisor and mentor is world-leading researcher in
paediatrics, A/Prof Franz Babl, a Paediatric Emergency Physician at the Royal
Children’s Hospital and Head of Emergency Research, Murdoch Children’s Research
Institute. His secondary supervisor is A/Prof Penelope Bryant, Paediatric
Infectious Diseases Physician at the Royal Children’s Hospital and Group Leader,
Murdoch Children’s Research Institute Clinical Paediatric Research Group.
‘Quick-Wee’ collection technique shows promise in pilot study
The initial baseline study analysing the current Clean Catch
Urine collection method in over 200 children at the Royal Children’s Hospital
found it was associated with lengthy waiting times for sample collection, as
well as high rates of contamination, ‘missed catches’, and collection
abandonment. Only 12% of children voided within five minutes.
Quick-Wee method is a new technique which uses gentle suprapubic stimulation
with wet gauze to trigger cutaneous voiding reflexes in young children,” Dr
Kaufman says. The pilot study in 40 children has already showed promising
results, indicating a success rate of voiding in 35% of children within five
minutes using Quick-Wee.
“We found that it was a feasible urine
collection method and importantly that the technique was well-liked by
clinicians and families,” he says.
Randomised controlled trial
The scholarship will now support a large randomised controlled
trial in 354 infants aged under one year recruited from the emergency department
to provide high-quality evidence for the Quick-Wee urine collection method.
Children will be randomised to receive either standard care or Quick-Wee, to
analyse whether the infant voids urine for clean catch collection within five
minutes. Secondary outcomes will measure successful catch of urine samples,
parental and clinician satisfaction with the technique, sample contamination
rates and subsequent clinical management.
New method hopes to inform
Dr Kaufman anticipates that if this trial confirms that
Quick-Wee is a faster and more reliable urine collection method it may
ultimately inform Australian and international guidelines for investigation of
urinary tract infections in young children in the future.
“We are hoping
that the randomised controlled trial will demonstrate that Quick-Wee is a simple
and very practical method of urine collection that can be incorporated into any
clinician’s day-to-day practice in emergency departments, hospital wards or
clinics,” he says. “We think it will help to reduce the need for painful and
distressing invasive collection methods, reduce how long patients have to wait
for urine sample collection and diagnosis, and improve parent and clinician
satisfaction with the urine collection process,” he says.
Avant scholarship opens doors
An Avant member since joining
as a medical student, Dr Kaufman says he is humbled and grateful to Avant for
the support of the scholarship.
“Particularly for junior doctors who are
combining part-time research and clinical training like myself, it’s a unique
opportunity because most of the research scholarships available are for
full-time research only,” he says. “Scholarships like this allow you to bring
your research to a higher standard and really opens the door to future
opportunities to collaborate with senior researchers, and then over time develop
more independent research and then hopefully a career which combines clinical
work and academic research.”
Does your research deserve
Applications for the 2016 Avant Doctor in Training Research
Scholarship Program are open. Twenty-two scholarships are available –
more than any other year to date – worth $450,000, for both emerging and
Apply online on the Avant website
or for more information download our Doctor in Training Research Scholarship Information
If you have any questions, please contact the Doctor in
Training Research Scholarship team at email@example.com.Applications
close 31 May 2016.
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