Effect of Urogenital Cleaning with Paper Soap on Bacterial Contamination Rate While Collecting Midstream Urine Specimens

Abstract

Context:Urinary tract infection (UTI) is one of the major health problems. Urine culture is considered as a gold standard method for the diagnosis of UTI. But, improper sample collection can lead to contamination with normal urogenital flora. Use of any portable disinfectant that can reduce contamination rate would be the significant help in urine culture interpretation.Aims:To observe the effect of urogenital cleaning with paper soap on bacterial contamination rate while collecting specimens.Materials and Methods:A cross-sectional comparative study was done in 600 patients aged 15-45 years, equally divided into three groups. The first group was given sterile container and instructed to collect midstream clean catch urine (MSU) after urogenital cleaning with provided piece of paper soap. The second group was given sterile container and strictly instructed to collect the MSU sample after urogenital cleansing by tap water only. The third group was given the sterile container and asked for midstream urine. Collected specimens were inoculated in CLED media, incubated aerobically for overnight at 37°C. Reporting of culture was done according to the guideline of American Society of Microbiology.Results:The contamination rate in the three groups were 6.0%, 13.0%, and 27.5%, respectively (P value < 0.05), which was statistically significant.Conclusions:Contamination rate was significantly lower in group who provided urine specimen after urogenital cleaning with paper soap. Thus, cleaning the urogenital area may reduce the need of the repeat sample to rule out actual contamination and prevent from the unnecessary antibiotic treatment.

Urine sampling techniques in symptomatic primary-care patients: a diagnostic accuracy review

“…Studies based in secondary care have found varying accuracy of voided urine samples depending on their patient group, design and gold standard [ 14 – 18 ]. However, studies investigating symptomatic, otherwise healthy women seem to essentially reproduce our findings [ 19 , 20 ].…”

Improving clean‐catch contamination rates: A prospective interventional cohort study

“…There may never be a suitable method to eliminate skin organisms that contaminate the specimen obtained via CCU. Previous studies have shown that cleaning of the perineum reduced contamination rates from 24 to 8%, but did not eliminate the incidence of contamination altogether …”

“…Previous studies have shown that cleaning of the perineum reduced contamination rates from 24 to 8%, but did not eliminate the incidence of contamination altogether. 20,22,23 Contamination rates in CCU samples trended towards being associated with gender, with female contamination rates being 16.4% and male contamination rates being 10.5%. The urinary stream in women is shorter and thus more likely to come into contact with skin prior to collection, increasing the possibility of contamination.…”

A Comparrison of Two Emergency Departments

“…The nurse could alternatively straight catheterize the patient. Patients with bacteria in their urinalysis will need a separate specimen for culture and repeat catheterizations increase urethral irritation allowing bacteria to proliferate (Shrestha, Gyawali, Gurung, Amatya, and Bhattacharya, 2013).…”