Urine Culture Specimens Research Articles

Is the clean-catch midstream void procedure necessary for obtaining urine culture specimens for men: Lipsky BA, Inui TS, Plorde JJ, et al Am J Med 76:257–262 Feb 1984

Is the clean-catch midstream void procedure necessary for obtaining urine culture specimens for men: Lipsky BA, Inui TS, Plorde JJ, et al Am J Med 76:257–262 Feb 1984

Is the clean-catch midstream void procedure necessary for obtaining urine culture specimens from men?: Lipsky, B. A. et al. 1984. Am. J. Med. 76:257–262

Is the clean-catch midstream void procedure necessary for obtaining urine culture specimens from men?: Lipsky, B. A. et al. 1984. Am. J. Med. 76:257–262

Is the clean-catch midstream void procedure necessary for obtaining urine culture specimens from men?

To determine whether the results of voided urine cultures in men are affected by meatal cleansing, midstream sampling, or circumcision status, 308 paired (initial and midstream) specimens were collected from 254 urology clinic patients. Half of the patients cleansed their urethral meatus with povidone-iodine prior to voiding. The circumcision status of all patients was noted. The rates of true bacteriuria (growth of 10 4 or greater colony-forming units/ml urine with a single predominant species) and contamination (growth of 10 3 or greater colony-forming units/ml urine with two or more colonial types) were compared in the various collection technique subgroups. Neither the bacteriuria nor contamination rates were significantly different (p > 0.05) in circumcised and uncircumcised patients, or in those who cleansed their meatus and those who did not. Contamination, but not bacteriuria, rates were higher in initial as compared with midstream specimens. These data suggest that the clean-catch midstream void procedure is unnecessary for obtaining routine voided urine culture specimens from men.

"The best laid plans . . .": an evaluation of a patient education program.

Graphic instructions for the collection of clean-voided urine specimens were posted in outpatient clinic bathrooms. These signs were intended to supplant clinic staff verbal instructions and to improve patients' ability to perform this procedure correctly. To assess the impact of the signs, the contamination rates were determined for urine culture specimens for the 6-month periods immediately preceding and following their introduction. The contamination rate for 306 consecutive specimens submitted before the signs were hung (12 per cent) was significantly lower (p = 0.004) than for the 360 specimens submitted afterward (20.6 per cent). Further, the incidence of true bacteriuria was significantly higher before the signs were posted (21.8 per cent) than afterward (15.2 per cent) (p = 0.02). There was no reported change in the provision of verbal instructions by clinic personnel, and the signs provoked some negative reactions from patients and visitors. This unexpected adverse outcome of a well-intended patient education effort is reported so that others may profit from the authors' mistakes.

Prospective randomized double-blind comparison of moxalactam and tobramycin in treatment of urinary tract infections

In a prospective, randomized, double-blind trial, a regimen of 250 mg of moxalactam every 12 hours was compared with 1.0 mg/kg of tobramycin every eight hours in the treatment of urinary tract infections. One hundred and eleven patients were entered into the study; results in 63 (18 men and 45 women) were evaluable for both efficacy and toxicity. Thirty evaluable patients received moxalactam, and 33 received tobramycin. The mean duration of therapy in each group was seven days. There were six treatment failures in the moxalactam group and 10 failures in the tobramycin group (p > 0.4). Nephrotoxicity, defined as an increase in serum creatinine levels to 0.5 mg/dl or more, did not occur in either group. Thirteen patients in the moxalactam group and one in the tobramycin group had enterococci isolated from a urine culture specimen during or after therapy. It is concluded that use of the moxalactam regimen Is as effective and safe as use of the tobramycin regimen in the treatment of urinary tract infections. The clinical significance of the enterococcal isolates associated with moxalactam therapy is yet to be determined.

PERCUTANEOUS NEPHROPYELOCENTESIS AND ANTEGRADE URETEROGRAPHY: A FLUOROSCOPICALLY ASSISTED DIAGNOSTIC TECHNIC IN CANINE UROLOGY

Fluoroscopically assisted percutaneous nephropyelocentesis and/or antegrade ureterography was performed on six dogs. These technics were useful for obtaining renal pelvic urine specimens for culture. Percutaneous nephropyelocentesis confirmed diagnoses of pyelonephritis. Injection of a radiopaque contrast medium into the ureter or renal pelvis was useful in evaluating the ureter in those dogs in which excretory urography provided insufficient detail. No complication was associated with the technics.

Overnight refrigeration of urine specimens for culture.

Some authorities state that urine may be refrigerated overnight and still be satisfactory for quantitative bacteriologic evaluation. The papers cited appear to us to be inadequate. Four hundred and fourteen urine cultures were evaluated comparing colony count before and after overnight refrigeration. Overnight refrigeration appears to be a satisfactory means of urine preservation for culture.

Prevalence of Mycoplasma hominis and Ureaplasma urealyticum (T strains) in urine of adolescents.

Adolescent children were surveyed for colonization with Mycoplasma hominis and Ureaplasma urealyticum by culturing urine specimens. Rates were compared between three study groups: (i) 397 children attending parochial schools, (ii) 293 children attending an adolescent clinic specializing in adjustment problems, and (iii) 86 children attending a renal clinic. The recovery rate was higher among postpubertal girls attending the renal clinic (33%) and the adolescent clinic (26%) than among students attending parochial high school (males 2%, females 8%). Girls had approximately eightfold higher rates than boys of the same age. Isolation of Mycoplasmataceae was associated with certain sociological determinants, such as dating, cigarette smoking, and coming from a broken home, but also with abnormal findings (protein, leucocytes) in urine.

An Evaluation of the Current Therapeutic Regimen for Renal Tuberculosis

Renal tuberculosis will continue to be a potentially lethal disease and must be considered a diagnostic possibility in all patients with infection in order to discover it in time. Multiple drug regimens have withstood the test of time and it appears that triple drug therapy is more efficacious than 2 drugs since triple drugs permit the skipping of 1 or another of the medications with less danger of relapse. Rifampin is a new drug that is well tolerated and efficacious, although expensive. We recommend continuous use of triple drugs for 2 years at least with the continuance of pyridoxine. We advise an excretory urogram, the collection of 3 urine specimens for culture and the passage of ureteral catheters every 6 months during treatment and every 12 months thereafter for 10 years. We do not consider relapse an indication for an operation but for further therapy, using medications to which the patient’s organism is proved susceptible by bacteriologic means. Under modern conditions an operation is rarely necessary.

URINE MICROSCOPY AS AN AID TO DETECTION OF BACTERIURIA

Fresh, uncentrifuged urine specimens obtained from children attending a renal clinic were examined microscopically for leucocytes and bacteria, and the results were compared with quantitative bacterial cultures. Of the 51 specimens giving colony-counts ≥10 5 per ml., 6 (12%) showed no microscopical bacteriuria and 22 (43%) contained <10 leucocytes per c.mm.; only 3 specimens (6%) showed neither bacteria nor excess cells. Of the 186 uninfected specimens, bacteria were seen microscopically in 32 (17%) and an excess of leucocytes in 27 (15%); in only 9 (5%) were both observed. Leucocyte-counting alone is therefore an unreliable technique, but microscopy for both bacteria and leucocytes affords a simple and rapid method of preselecting urine specimens for culture, with a high probability of predicting the correct result. While not suitable for population screening, it is ideal for use in hospital clinics and wards, as well as in general practice.

Pitfalls of Colony Count Of Urine Cultures

To the Editor:— In the collection of a urine specimen for culture, great emphasis is placed on plating out the specimen immediately, lest there be gross error in the colony count from bacterial multiplication while the urine sits on the shelf. Yet the physician rarely questions either the length of time the urine remains in the bladder (ie, the time of previous voiding) or the specific gravity of the urine. A person with a urinary tract infection may have urinary frequency both from the irritability of the inflamed bladder as well as from a high fluid intake, thereby decreasing the time of previous voiding as well as the specific gravity of the urine. Both of these would decrease the colony count. A series of patients with cystitis were subjected to sequential urine cultures in an attempt to compare the effect on colony count of incubation in the bladder with that

Suprapubic Aspiration of Urine in Premature and Term Infants

The purpose of this brief communication is to familiarize pediatricians with the advantages and ease of suprapubic needle aspiration of the urinary bladder in small infants when urine specimens for culture are needed. The technique has been used successfully in adults. Pryles et al. reported on percutaneous suprapubic aspiration of the bladder in 42 children, including 6 babies 3 to 6 months of age; however, use of this procedure in the neonatal period has not been previously reported. Contaminated urine specimens from neonatal infants are commonly encountered. We have studied 62 randomly selected, uncircumcised premature male infants. Using meticulous care in cleansing and handling of the specimens by the technique of Pryles et al.