Contamination rates of different urine collection methods for the diagnosis of urinary tract infections in young children: an observational cohort study.
Author(s): Tosif S, Baker A, Oakley E, Donath S, Babl FE
Publication: J Paediatr Child Health, 2012, Vol. 48, Page 659-64
PubMed ID: 22537082 PubMed Review Paper? No
Purpose of Paper
This paper retrospectively investigated the effects of urine collection method, patient age and gender, urogenital abnormality, and antibiotic use on contamination rates in specimens from 599 children under the age of two.
Conclusion of Paper
Significantly lower levels of contamination were observed in catheter and suprapubic aspiration specimens compared to clean-catch urine specimens. As expected, a significantly lower percentage of specimens were contaminated when the patient was on antibiotics at the time of sampling, but there was no significant effect of urogenital abnormality, patient age, patient gender, or prior urinary tract infection on contamination levels.
Studies
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Study Purpose
This study retrospectively investigated the effects of urine collection method, patient age and gender, urogenital abnormality and antibiotic use on contamination rates in specimens from 599 children under the age of two. Microscopy and culture results from the first collection from each patient were considered and the medical history was examined for evidence of history of UTI, antibiotic use, and urogenital abnormalities. Urine was collected as bag specimen urine, clean-catch urine, from catheters, and by suprapubic aspiration. Specimens were considered contaminated if there were two or more organisms cultured and/or there was greater than 104 colony forming units (cfu)/L for specimens collected by catheter or by suprapubic aspiration or greater than 108 cfu/L for clean-catch urine, indwelling catheter specimens, or bag specimens. Growth of non-bacterial organisms such as yeast was not considered as contamination.
Summary of Findings:
Compared to clean catch-urine specimens, lower levels of contamination were observed in catheter (12% versus 26%, P=0.01) and suprapubic aspiration specimens (1% versus 26%, P<0.005) and a trend toward higher levels of contamination were found in bag specimen urine (26% versus 46%, P=0.12). As expected, a significantly lower percentage of specimens were contaminated when the patient was on antibiotics at the time of sampling (4% versus 19%, P=0.02), but there was no significant effect of urogenital abnormality, patient age, patient gender, or prior urinary tract infection on contamination levels.
Biospecimens
Preservative Types
- None (Fresh)
Diagnoses:
- Not specified
Platform:
Analyte Technology Platform Cell count/volume Macroscopic observation Cell count/volume Light microscopy Pre-analytical Factors:
Classification Pre-analytical Factor Value(s) Preaquisition Patient age <3 months
3-6 months
7-12 months
13-23 months
Biospecimen Acquisition Type of collection container/solution Bag
Clean-catch container
Biospecimen Acquisition Method of fluid acquisition Catheterized urine
Needle
Voided urine (spot collection)
Different urine collection procedures compared
Preaquisition Patient gender Female
Male