Bacterial contamination rates for non-clean-catch and clean-catch midstream urine collections in boys

Abstract

Standard practice for collecting a midstream urine specimen for bacterial culture includes cleansing the urethral meatus to decrease specimen contamination, 1. 2 This study was performed to determine whether meatal cleansing affects the rate of bacterial contamination of midstream urine specimens collected from healthy male children. METHODS One hundred two healthy boys between the ages of 2 and 14 years were studied. Seventy-five percent were older than 5 years of age. All of the boys were toilet trained, had no history of renal disease or urinary tract infections, had no congenital or acquired meatal abnormality, .had received no antibiotics for more than 1 week, and had no fever at the time of study. The urine specimens were obtained at the University of Virginia Children's Medical Center Clinic and at local elementary schools. Prior to producing a urine specimen, each subject was individually instructed by medical personnel on midstream collection technique, but most were not supervised during the collection process. The first urine specimen obtained was without meatal cleansing (non-clean-catch urine). This specimen was collected in a sterile wide-mouth container with screw lid (Superior Plastic Products Corp., Cumberland, R.I.). Twenty-four hours or more after the first specimen collection, a second specimen was collected following meatal cleansing with 2% Castile soap (clean-catch urine) using a standard clean-catch kit (Medline Industries, Inc., Northbrook, Ill.). The specimens obtained in the clinic were processed immediately in an on-site microbiology laboratory. The specimens obtained in the schools were immediately stored in ice and transported within 1 hour to the same laboratory for immediate processing. Urinalyses and cultures were performed using standard methods. The culture media utilized were trypticase soy