Management of urinary tract infection.

White, Richard

doi:10.1136/adc.62.4.421

Cited by 46 publications

(4 citation statements)

References 17 publications

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“…The mean length of time to return was 1 (10) 88ewkes, McMaster, Napier, Houston, Postlethwaite An unexpected but major problem with the Dipslides was the high rate of technical failure. Altogether 20% of the Dipslides were received with one or both media detatched; presumably this occurred during postal transit.…”

Section: Resultsmentioning

confidence: 99%

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Home collection of urine specimens--boric acid bottles or Dipslides?

Jewkes

McMaster

Napier

et al. 1990

Archives of Disease in Childhood

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Sterile mid stream specimens of urine (MSSU) were obtained from 84 children in a hospital outpatient department. All 84 children collected urine at home by one of two Dipslide methods and by collection into boric acid within 24 hours of the hospital collected MSSU. The samples collected at home were posted to the hospital. Thirty six of the Dipslides (43%) and nine of the boric acid samples (10%) were not sterile but none had a pure growth of a single organism of >105 organisms/ml. In addition, 17 of the Dipslides (20%) were returned with one or both media detatched and therefore could not be relied upon to exclude urinary tract infection.In a second part to the study, 95 urines which showed a significant growth in primary culture were also cultured after storage in boric acid. Inhibition was noted in nine samples after storage in boric acid, seven of which were in underfilled bottles. Transport of specimens in boric acid produced less contamination than Dipslides but may inhibit growth in a small number of specimens. Technical One hundred and seven consecutive children (age range 2-18 years) attending the outpatient renal clinic were enrolled in the study. Only continent children participated. An MSSU was obtained from all children after perineal cleansing. The parents were instructed by experienced nursing staff to clean the perineum from front to back using 0O015% chlorhexidine with 0-15% cetrimide (Savlodil, ICI). Urine was stored immediately in a preservative free sterile container at 4°C before transfer to the laboratory for microscopy and culture on the same day.Parents were instructed to clean the perineum in the same way before home urine collection. They were asked to collect the specimens on the same day as the hospital attendance. Detailed written instructions as to how to collect the samples were given to the parents in addition to a verbal explanation at the time of the clinic attendance.The following three methods were used at home. (1) Boric acid. An MSSU was collected into a sterile bowl and 5 ml poured into a bottle containing boric acid (Sterilin) to yield a 1-3% solution. (2) Dipslide 'dip'. An MSSU was collected as above and a Dipslide was dipped into this. Excess urine was allowed to drain and the Dipslide was placed in the bottle and sealed. (3) Dipslide 'stream'. The Dipslide was held in the mid portion of the urinary stream, excess urine was allowed to drain and the slide was sealed in the bottle.All children were asked to collect a boric acid sample. They were randomly allocated to collect either a Dipslide dip sample or a Dipslide stream sample in addition to this.Parents were asked to return the specimens by first class post on the day of collection. Laboratory methodsThe length of time it took for the sample to reach the laboratory was noted.Biochemical analysis for pH, protein, blood, ketones, nitrites, and glucose was performed using Multistix (Ames).

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Section: Resultsmentioning

confidence: 99%

“….' (White 1987). 10 This is still a frequent scenario in many outpatient departments and a reliable and sufficiently robust method of collecting and transporting urine from the community to the hospital is clearly needed.…”

Section: Discussionmentioning

confidence: 99%

Home collection of urine specimens--boric acid bottles or Dipslides?

Jewkes

McMaster

Napier

et al. 1990

Archives of Disease in Childhood

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“…Die Hauptziele der Behandlung von HWI (Tab. 9) sind die Vermeidung einer Nierenschädigung und die Beseitigung der klinischen HWI-Symptome (Dysurie, Enuresis, Bauch-und Flankenschmerzen, Fieber) (24,49). Funktionell wirksame Obstruktionen als Ursache für HWI müssen chirurgisch behandelt werden.…”

Section: Therapieunclassified

Harnwegsinfektionen im Kindesalter: Pathogenese, Diagnostik und Therapie

Schofer¹,

Mannhardt²,

Beetz³

et al. 1988

Aktuel Urol

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“…One must balance the risk of invasive procedures against the risk of missing important anomalies of the urinary tract. While some authors advocate voiding cystography (VCU) and excretory urography (EU) for each child with first proven UTI [1,2], others recommend that abdominal radiograph and ultrasound (US) should be sufficient as an initial procedure [3]. Lately, papers have been published, recommending VCU and US as an initial step, stating that US can safely replace EU [4][5][6][7][8].…”

Section: Introductionmentioning

confidence: 97%

Renal ultrasound and excretory urography in infants and young children with urinary tract infection

Kenda

Silc

et al. 1989

Pediatr Radiol

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The main purpose of the study was to see whether excretory urography (EU) can be safely replaced by ultrasound (US) in children with urinary tract infection (UTI) younger than 6 years. 101 hospitalised children were admitted to the prospective study. They were all diagnosed as having UTI and were treated accordingly. All children had voiding cystography (VCU), EU and US done. US and EU correlated well in 94% of the cases. In all 6 cases with discrepancy between EU and US, the VCU was abnormal. Our results confirm the data from other authors, that VCU and US should be sufficient as an initial work-up on children with UTI, while EU should be done only in the cases with abnormal findings on either one or both of the former investigations. However, it should be kept in mind that some cases of parenchymal involvement or mild subpelvic stenosis can be missed using this protocol. If EU is obtained only in the cases with abnormal US and/or VCU, only 55 children (54%) in our group would have had an EU done.

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Management of urinary tract infection.

Cited by 46 publications

References 17 publications

Home collection of urine specimens--boric acid bottles or Dipslides?

Home collection of urine specimens--boric acid bottles or Dipslides?

Harnwegsinfektionen im Kindesalter: Pathogenese, Diagnostik und Therapie

Renal ultrasound and excretory urography in infants and young children with urinary tract infection

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