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Urine culture from bag specimens in young children: are the risks too high?
J Pediatr. 2000 Aug; 137(2):221-6.JPed

Abstract

OBJECTIVE

To compare the risks of contaminated culture results and consequent adverse clinical outcomes in urine specimens obtained by "clean-voided" bag method versus catheterization.

STUDY DESIGN

Hospital-based cohort study of all children </=24 months with outpatient urine cultures (n = 7584) obtained from January 1993 to December 1995. Medical records were followed up for all children with contaminated culture results who had 1 or more additional cultures within 7 days of the original culture. Contamination rates of bag urine cultures from the emergency department and a pediatric test center were compared.

RESULTS

Contamination rates were 62.8% and 9.1% (P <.001) in bag versus catheter specimens, respectively. Contamination rates of bag urine specimens collected in the emergency department and pediatric test center were 56.4% versus 69. 25%, respectively. Of the 3440 contaminated urines, 132 (1.7%) resulted in 1 or more adverse clinical outcomes. Adjusted odds ratios (and 95% CI) for these outcomes in bag versus catheter specimens were as follows: 4.9 (2.3 to 10.5) for unnecessary recall, infinite for delayed diagnosis and treatment, 4.8 (1.8 to 12.4) for unnecessary treatment, 15.6 (2.1 to 116.8) for unnecessary prolonged treatment, 4.1 (1.4 to 12.1) for unnecessary radiologic investigation, and 12.4 (1.6 to 95.5) for unnecessary hospital admission.

CONCLUSIONS

The risks of the "noninvasive" bag urine culture appear to exceed its benefits.

Authors+Show Affiliations

Division of Pediatric Emergency Medicine, Department of Pediatrics, Montreal Children's Hospital, McGill University, Quebec, Canada.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

10931415

Citation

Al-Orifi, F, et al. "Urine Culture From Bag Specimens in Young Children: Are the Risks Too High?" The Journal of Pediatrics, vol. 137, no. 2, 2000, pp. 221-6.
Al-Orifi F, McGillivray D, Tange S, et al. Urine culture from bag specimens in young children: are the risks too high? J Pediatr. 2000;137(2):221-6.
Al-Orifi, F., McGillivray, D., Tange, S., & Kramer, M. S. (2000). Urine culture from bag specimens in young children: are the risks too high? The Journal of Pediatrics, 137(2), 221-6.
Al-Orifi F, et al. Urine Culture From Bag Specimens in Young Children: Are the Risks Too High. J Pediatr. 2000;137(2):221-6. PubMed PMID: 10931415.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Urine culture from bag specimens in young children: are the risks too high? AU - Al-Orifi,F, AU - McGillivray,D, AU - Tange,S, AU - Kramer,M S, PY - 2000/8/10/pubmed PY - 2000/9/23/medline PY - 2000/8/10/entrez SP - 221 EP - 6 JF - The Journal of pediatrics JO - J Pediatr VL - 137 IS - 2 N2 - OBJECTIVE: To compare the risks of contaminated culture results and consequent adverse clinical outcomes in urine specimens obtained by "clean-voided" bag method versus catheterization. STUDY DESIGN: Hospital-based cohort study of all children </=24 months with outpatient urine cultures (n = 7584) obtained from January 1993 to December 1995. Medical records were followed up for all children with contaminated culture results who had 1 or more additional cultures within 7 days of the original culture. Contamination rates of bag urine cultures from the emergency department and a pediatric test center were compared. RESULTS: Contamination rates were 62.8% and 9.1% (P <.001) in bag versus catheter specimens, respectively. Contamination rates of bag urine specimens collected in the emergency department and pediatric test center were 56.4% versus 69. 25%, respectively. Of the 3440 contaminated urines, 132 (1.7%) resulted in 1 or more adverse clinical outcomes. Adjusted odds ratios (and 95% CI) for these outcomes in bag versus catheter specimens were as follows: 4.9 (2.3 to 10.5) for unnecessary recall, infinite for delayed diagnosis and treatment, 4.8 (1.8 to 12.4) for unnecessary treatment, 15.6 (2.1 to 116.8) for unnecessary prolonged treatment, 4.1 (1.4 to 12.1) for unnecessary radiologic investigation, and 12.4 (1.6 to 95.5) for unnecessary hospital admission. CONCLUSIONS: The risks of the "noninvasive" bag urine culture appear to exceed its benefits. SN - 0022-3476 UR - https://www.unboundmedicine.com/medline/citation/10931415/Urine_culture_from_bag_specimens_in_young_children:_are_the_risks_too_high L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-3476(00)71927-5 DB - PRIME DP - Unbound Medicine ER -