Effect of urethral meatus cleansing on midstream urine contamination rate in boys

Abstract

Background Clean-catch midstream urine (MSU) remains the standard procedure for urine collection even if it's role to reduce bacterial contamination rate is unclear. Objective To compare bacterial contamination rate between clean-catch (cleaning urethral meatus with medicated soap) and non clean-catch MSU among boys. Methods An experimental study with parallel groups and block randomization was conducted. Toilet-trained boys aged 3 to 18 years, without symptoms or signs of urinary tract infection were recruited from the Pediatric Outpatient Clinic at Sardjito Hospital and from a local elementary school. Subjects with history of renal disease, those who were on under antibiotic treatment in the preceding week, or with meatal abnormality or non-cooperative were excluded. Urine specimen was collected by a trained nurse, and was cultured within one hour by personnel blinded to the assignment. Significant bacteriuria was defined as growth of a single pathogenic organism (degree of pathogenicity group I-III) with colony count 2: 105 colony forming unit/mi. Contamination was defined as any growth not fulfilling criteria for significant bacteriuria or growth of multiple organisms. Results A total of 80 boys were enrolled. The contamination rate in the clean-catch group was 13% (5 out of 40) compared with 10% (4 out of 40) in the non clean-catch group (P=l.O). The adjusted risk ratio for contamination in the clean-catch MSU group, adjusted to age and circumcision status, was 1.37 (95% CI 0.42; 4.51). Conclusion Clean-catch method does not reduce bacterial con- tamination rate of midstream urine cultures in boys

Keywords

• clean-catch
• non clean-catch
• midstream urine
• contamination rate