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Urine Contamination in Nontoilet-trained and Uncircumcised Boys.
Urology. 2016 Sep; 95:171-4.U

Abstract

OBJECTIVE

To assess any differences between the initial and midstream urine samples from nontoilet-trained, uncircumcised boys. Contamination during urine collection makes the diagnosis of urinary tract infections (UTIs) difficult in nontoilet-trained children, especially in uncircumcised boys. Whether the contamination comes mainly from the initial stream or the contact between urine and perineal skin is not known in this population.

MATERIALS AND METHODS

A prospective diagnostic study between early and midstream urine samples was conducted on asymptomatic patients with no suspicion of UTI. The clean void method was performed in nontoilet-trained boys under general anesthesia. The exclusion criteria were circumcision, older than 3 years of age, recent antibiotics treatment, and recent UTI. Urinalysis and urine culture were performed, allowing a comparison between early and midstream urine samples.

RESULTS

Forty-four patients were enrolled in the study, and 31 satisfactory samples were obtained. A higher contamination rate was found in the early stream (n = 16; 51%) than in the midstream (n = 5; 16%) (P < .01). The positive culture from the early stream sample was statistically associated with a lower age (P = .02). The contamination rate of the first stream is 3-fold higher than for the midstream when collecting urine for urine culture.

CONCLUSION

The clean void method in nontoilet-trained, uncircumcised boys provides low-quality urine samples for both early and midstream urine samples. The benefit of catching midstream urine samples for the diagnosis of UTI in this population is even more important when the children are young.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Ballouhey Q
Department of Pediatric Surgery, Children's Hospital, Limoges, France. Electronic address: q.ballouhey@gmail.com.
Fourcade L
Department of Pediatric Surgery, Children's Hospital, Limoges, France.
Couve-Deacon E
Department of Bacteriology, University Hospital, Limoges, France.
Cros J
Department of Pediatric Anesthesia, Children's Hospital, Limoges, France.
Lescure V
Department of Pediatric Surgery, Children's Hospital, Limoges, France.
Bahans C
Department of Pediatrics, Children's Hospital, Limoges, France.
Chainier D
Department of Bacteriology, University Hospital, Limoges, France.
Garnier F
Department of Bacteriology, University Hospital, Limoges, France.
Guigonis V
Department of Pediatrics, Children's Hospital, Limoges, France.

MeSH

Child, PreschoolCircumcision, MaleHumansInfantMaleProspective StudiesStem CellsToilet TrainingUrinalysisUrinary Tract InfectionsUrineUrine Specimen Collection

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27289027

Citation

Ballouhey, Quentin, et al. "Urine Contamination in Nontoilet-trained and Uncircumcised Boys." Urology, vol. 95, 2016, pp. 171-4.
Ballouhey Q, Fourcade L, Couve-Deacon E, et al. Urine Contamination in Nontoilet-trained and Uncircumcised Boys. Urology. 2016;95:171-4.
Ballouhey, Q., Fourcade, L., Couve-Deacon, E., Cros, J., Lescure, V., Bahans, C., Chainier, D., Garnier, F., & Guigonis, V. (2016). Urine Contamination in Nontoilet-trained and Uncircumcised Boys. Urology, 95, 171-4. https://doi.org/10.1016/j.urology.2016.05.056
Ballouhey Q, et al. Urine Contamination in Nontoilet-trained and Uncircumcised Boys. Urology. 2016;95:171-4. PubMed PMID: 27289027.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Urine Contamination in Nontoilet-trained and Uncircumcised Boys. AU - Ballouhey,Quentin, AU - Fourcade,Laurent, AU - Couve-Deacon,Elodie, AU - Cros,Jérôme, AU - Lescure,Victor, AU - Bahans,Claire, AU - Chainier,Delphine, AU - Garnier,Fabien, AU - Guigonis,Vincent, Y1 - 2016/06/08/ PY - 2016/03/21/received PY - 2016/05/19/revised PY - 2016/05/31/accepted PY - 2016/6/12/entrez PY - 2016/6/12/pubmed PY - 2017/9/30/medline SP - 171 EP - 4 JF - Urology JO - Urology VL - 95 N2 - OBJECTIVE: To assess any differences between the initial and midstream urine samples from nontoilet-trained, uncircumcised boys. Contamination during urine collection makes the diagnosis of urinary tract infections (UTIs) difficult in nontoilet-trained children, especially in uncircumcised boys. Whether the contamination comes mainly from the initial stream or the contact between urine and perineal skin is not known in this population. MATERIALS AND METHODS: A prospective diagnostic study between early and midstream urine samples was conducted on asymptomatic patients with no suspicion of UTI. The clean void method was performed in nontoilet-trained boys under general anesthesia. The exclusion criteria were circumcision, older than 3 years of age, recent antibiotics treatment, and recent UTI. Urinalysis and urine culture were performed, allowing a comparison between early and midstream urine samples. RESULTS: Forty-four patients were enrolled in the study, and 31 satisfactory samples were obtained. A higher contamination rate was found in the early stream (n = 16; 51%) than in the midstream (n = 5; 16%) (P < .01). The positive culture from the early stream sample was statistically associated with a lower age (P = .02). The contamination rate of the first stream is 3-fold higher than for the midstream when collecting urine for urine culture. CONCLUSION: The clean void method in nontoilet-trained, uncircumcised boys provides low-quality urine samples for both early and midstream urine samples. The benefit of catching midstream urine samples for the diagnosis of UTI in this population is even more important when the children are young. SN - 1527-9995 UR - https://www.unboundmedicine.com/medline/citation/27289027/Urine_Contamination_in_Nontoilet_trained_and_Uncircumcised_Boys_ DB - PRIME DP - Unbound Medicine ER -