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Comparison of sterile bag, clean catch and suprapubic aspiration in the diagnosis of urinary infection in early childhood.

Author(s): Hardy JD, Furnell PM, Brumfitt W

Publication: Br J Urol, 1976, Vol. 48, Page 279-83

PubMed ID: 963408 PubMed Review Paper? No

Purpose of Paper

Conclusion of Paper

Studies

1. Study Purpose

   This study compared bacterial culture results and leukocyte counts in matched urine specimens collected by SPA, clean-catch, and bag methods from thirty inpatient pediatric patients (1 day-3 years old) within 1-6 h of each other. Specimens were either immediately transferred to the lab or stored at 4˚C until transfer. Bacteria were quantified after 18 h of culture and white cells were counted in unstained, uncentrifuged urine.

   Summary of Findings:

   Only four SPA specimens showed growth and in each case the growth was a single organism. In contrast, mixed growth was found in 22 clean-catch and 22 bag specimens and pure growth was found in four and two specimens, respectively. The same results were obtained by all three methods in only two patients with growth and three without growth. Ten-fold less growth was observed in the clean-catch specimen than the SPA and bag specimens in one of these cases and of the remaining two cases, one patient with growth in the SPA had growth of the same strain (S. aureus) as well as an additional strain (E. coli) in both the clean-catch and bag specimen and the other patient had growth of the same strain (Proteus mirabilis) as well as E. coli in the clean-catch specimen but mixed growth in the bag specimen. Importantly, a significantly higher average bacterial load was observed in bag specimens than clean-catch specimens (P<0.005).

   One of the four specimens with a growth in the SPA specimen had 2-3 WBC/mm³ and one had <2 WBC/mm³, regardless of sampling method. The remaining two specimens had counts greater than 100 WBC/mm³ in the SPA but WBC counts varied by sampling method with >20 WBC/mm3 and >50 WBC/mm³ in the clean-catch specimens and 200 WBC/mm³ and 0 WBC/mm³ in the corresponding bag specimens.  While WBC counts remained <2 in all SPA specimens without bacterial growth, one specimen had >100 WBC/mm³ in the clean-catch and 100 WBC/mm³ in the bag specimens.

   Biospecimens

   • Bodily Fluid - Urine

   Preservative Types

   • None (Fresh)

   Diagnoses:

   • Not specified

   Platform:

   Analyte	Technology Platform
   Cell count/volume	Light microscopy
   Cell count/volume	Microbiological assay

   Pre-analytical Factors:

   Classification	Pre-analytical Factor	Value(s)
   Biospecimen Acquisition	Method of fluid acquisition	Different urine collection procedures compared Needle Voided urine (spot collection)

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