Cancer Diagnosis Program | Biorepositories and Biospecimen Research Branch

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A comparison of the initial to the later stream urine in children catheterized to evaluate for a urinary tract infection.

Author(s): Dayan PS, Chamberlain JM, Boenning D, Adirim T, Schor JA, Klein BL

Publication: Pediatr Emerg Care, 2000, Vol. 16, Page 88-90

PubMed ID: 10784208 PubMed Review Paper? No

Purpose of Paper

Conclusion of Paper

Studies

1. Study Purpose

   This study compared bacterial counts between early and late-stream catheterized urine specimens from 86 children suspected of having a UTI. After cleaning of the urethral meatus with a betadine wipe, a catheter was inserted and 3 mL of urine was collected. The collection tube was changed and the remaining urine was collected. Urine was stored on ice for less than 30 min before plating and culture. Urinalysis cell counts were determined using a Yellow International Remote Imaging System analyzer. Gram-stains were determined by an automated system. A positive culture was defined as ≥5 x 10⁴ colony forming units/mL of a single organism. An equivocal culture was defined as 10² to 5 x 10⁴ colony forming units of a single organism/mL. False positives were defined as a positive or equivocal finding in the early-stream specimen but a negative determination in the late-stream specimen.

   Summary of Findings:

   There was complete agreement in positive cultures between late-stream and early-stream specimens.  Four early-stream specimens had equivocal cultures and a negative culture in the matched late-stream specimen.  None of the late-stream cultures were equivocal. In specimens that were culture negative, early-stream specimens were more likely to have ≥5 white blood cells (WBC)/high power field (HPF) than late-stream specimens (20 versus 10, P<0.05) and this difference was mostly due to an increased number of specimens with 5-9 WBC/HPF (15 versus 6).  Similarly, bacteria were present in the urinalysis of a larger number of culture negative early-stream specimens than corresponding late-stream specimens (16 versus 10, P<0.05).

   Biospecimens

   • Bodily Fluid - Urine

   Preservative Types

   • None (Fresh)

   Diagnoses:

   • Other diagnoses

   Platform:

   Analyte	Technology Platform
   Cell count/volume	Microbiological assay
   Cell count/volume	Light microscopy
   Cell count/volume	Clinical chemistry/auto analyzer

   Pre-analytical Factors:

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

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