Moving from bag to catheter for urine collection in non-toilet-trained children suspected of having urinary tract infection: a paired comparison of urine cultures.
Author(s): Etoubleau C, Reveret M, Brouet D, Badier I, Brosset P, Fourcade L, Bahans C, Garnier F, Blanc P, Guigonis V
Publication: J Pediatr, 2009, Vol. 154, Page 803-6
PubMed ID: 19375715 PubMed Review Paper? No
Purpose of Paper
This paper validated positive urinalysis results in bag specimens using catheter specimens from the same 192 children, all under the age of three.
Conclusion of Paper
Overall, 7.5% of results in bag urine were false positives and 29% were false negatives. Consequently, collection of bag-specimens alone for 40.1% of the children (77 of 192) would lead to a false diagnosis or diagnosis would not be determinable due to polygrowth.
Studies
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Study Purpose
This study validated positive urinalysis results in bag specimens by culture of catheter specimens from the same 192 children admitted to the emergency department, all under the age of three. Urine was collected from 550 patients after cleaning the perineum with soap and water or an antibacterial wipe into a bag fitted by a nurse in the emergency department. Bag specimens were analyzed for nitrites and leukocyte esterase using dipsticks. In the 192 cases where the urinalysis was positive, catheter specimens were collected and both the bag and catheter specimen were cultured.
Summary of Findings:
Of the bag specimens, 62.5% had only WBCs, 0.5% had only bacteria by microscopy, and the remaining 37% had both bacteria and WBCs by microscopy. Culture of the bag specimens showed single growth in 93 of the 192 specimens (48.4%), polybacterial growth in 58 (30.2%), and no growth in the remaining 41 (21.4%). Similarly, culture of the catheter specimen grew single bacteria in 102 of the 192 specimens (53.2%), no growth in 79 specimens (41.1%) and polybacterial growth in 16 specimens (8.3%). Overall, 7.5% of results in bag urine were false positives and 29% were false negatives. Consequently, collection of bag specimens alone for 40.1% of the children (77 of 192) would lead to a false diagnosis or diagnosis would not be determinable due to polygrowth compared. Twelve patients with positive catheter specimens had negative bag specimens, the majority of which had pyelonephritis.
Biospecimens
Preservative Types
- None (Fresh)
Diagnoses:
- Not specified
- Other diagnoses
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 Catheterized urine
Voided urine (spot collection)
Different urine collection procedures compared