Guillain-Barré syndrome associated with Campylobacter enteritis in a child

Abstract

Given the large study size and the observed rates of urinary contamination in the compared groups, the likelihood of having failed to detect a true 5% reduction in the rate of contamination by the cleansing procedure was very small (P beta --- 0.08). The difference in the rate of urinary contamination among the cleansed versus uneleansed boys (10% vs 5%) was not statistically significant using chisquare analysis. DISCUSSION The clean-catch midstream void technique has been the method of choice for collecting a urine specimen for culture since the late 1950s) This method replaced the bladder catheterization method because it is noninvasive and not associated with the small but significant rate of procedure-related bacteriuria? With careful clean-catch technique, the risk of specimen contamination is only minimally increased over that of bladder catheterization. Study of the clean-catch technique was primarily carried out in adult women 3'5 and recommendations for its use included a tedious cleansing and urine-collection process under the supervision of trained medical personnel. Despite evidence in women that this cumbersome method can be simplified without increasing specimen contamination rates,6, 7 recent cleansing technique recommendations ~, 2 are usually followed. A recent study in adult men demonstrated that urine culture results were not affected by circumcision status or cleansing of the meatus. Midstream collection decreased contamination rates but did not affect positive culture rates) An epidemiologic study published more than 25 years ago noted bacterial contamination in only 15 of 1647 urine specimens collected from schoolaged boys without specific preparation prior to voiding. 9 Despite this evidence, the current recommendation of that study I and others 2 includes meatal cleansing of males before collection of a urine specimen for culture. This study was designed to evaluate the influence of meatal cleansing on specimen contamination rates in healthy boys. We were not able to provide data on the impact of circumcision status, because only 4% of the subjects were uncircumcised. We demonstrated that meatal cleansing does not decrease specimen contamination rates and that contamination rates following no cleansing are acceptably low, Cleansing of the urethral meatus prior to collecting a urine specimen for culture from circumcised boys has no demonstrable benefit.