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Contamination in Adult Midstream Clean-Catch Urine Cultures in the Emergency Department: A Randomized Controlled Trial.
J Emerg Nurs. 2019 Sep; 45(5):488-501.JE

Abstract

INTRODUCTION

A midstream clean-catch urine sample is recommended to obtain a urine culture in symptomatic adults with suspected urinary tract infection. The aim of this randomized controlled trial was to determine whether a novel funnel urine-collection system combined with a silver-colloidal cleaning wipe would decrease mixed flora contamination in midstream clean-catch urine cultures from ambulatory adults in the emergency department.

METHODS

In a 2x2 factorial trial, adult participants were randomized to 4 groups: (A) sterile screw-top urine collection container/cup paired with a castile-soap wipe (control group); (B) sterile screw-top urine collection container/cup paired with a colloidal silver-impregnated wipe; (C) sterile urine-collection funnel paired with a castile-soap wipe; (D) sterile urine-collection funnel paired with a colloidal silver-impregnated wipe.

RESULTS

The trial was stopped after interim analysis, as the contamination rate in the control group (30%) was markedly lower than the historical ED contamination rate (40%) at the study site. From 1,112 urinalysis results, 223 urine culture results were analyzed (190 female patients and 33 male patients). Urine contamination rates were as follows: Group A, n = 67 (29.9% contaminated); Group B, n = 69 (34.8% contaminated); Group C, n = 51 (23.5% contaminated); Group D, n = 36 (22.2% contaminated). The differences in contamination rates were not statistically different among any of the groups.

DISCUSSION

The use of a funnel urine-collection system and silver-impregnated wipe did not reduce urine-culture contamination in adult midstream clean-catch urine cultures in the emergency department.

Links

Publisher Full Text (DOI)

Authors

Lough ME
No affiliation info available
Shradar E
No affiliation info available
Hsieh C
No affiliation info available
Hedlin H
No affiliation info available

MeSH

AdultEmergency Service, HospitalFemaleHumansMaleMiddle AgedSilverSoapsUrinalysisUrinary Tract InfectionsUrine Specimen Collection

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

31445626

Clinical Trial Links

Avoiding Bacterial Contamination of Clean Catch Urine Cultures in Ambulatory Patients in the Emergency Department

Citation

Lough, Mary E., et al. "Contamination in Adult Midstream Clean-Catch Urine Cultures in the Emergency Department: a Randomized Controlled Trial." Journal of Emergency Nursing, vol. 45, no. 5, 2019, pp. 488-501.
Lough ME, Shradar E, Hsieh C, et al. Contamination in Adult Midstream Clean-Catch Urine Cultures in the Emergency Department: A Randomized Controlled Trial. J Emerg Nurs. 2019;45(5):488-501.
Lough, M. E., Shradar, E., Hsieh, C., & Hedlin, H. (2019). Contamination in Adult Midstream Clean-Catch Urine Cultures in the Emergency Department: A Randomized Controlled Trial. Journal of Emergency Nursing, 45(5), 488-501. https://doi.org/10.1016/j.jen.2019.06.001
Lough ME, et al. Contamination in Adult Midstream Clean-Catch Urine Cultures in the Emergency Department: a Randomized Controlled Trial. J Emerg Nurs. 2019;45(5):488-501. PubMed PMID: 31445626.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Contamination in Adult Midstream Clean-Catch Urine Cultures in the Emergency Department: A Randomized Controlled Trial. AU - Lough,Mary E, AU - Shradar,Edward, AU - Hsieh,Chuyun, AU - Hedlin,Haley, PY - 2019/04/09/received PY - 2019/05/25/revised PY - 2019/06/02/accepted PY - 2019/8/26/entrez PY - 2019/8/26/pubmed PY - 2020/2/13/medline KW - Emergency department KW - Midstream clean-catch urine culture KW - Urinary tract infection KW - Urine contamination KW - Urine culture KW - Urine specimen collection SP - 488 EP - 501 JF - Journal of emergency nursing JO - J Emerg Nurs VL - 45 IS - 5 N2 - INTRODUCTION: A midstream clean-catch urine sample is recommended to obtain a urine culture in symptomatic adults with suspected urinary tract infection. The aim of this randomized controlled trial was to determine whether a novel funnel urine-collection system combined with a silver-colloidal cleaning wipe would decrease mixed flora contamination in midstream clean-catch urine cultures from ambulatory adults in the emergency department. METHODS: In a 2x2 factorial trial, adult participants were randomized to 4 groups: (A) sterile screw-top urine collection container/cup paired with a castile-soap wipe (control group); (B) sterile screw-top urine collection container/cup paired with a colloidal silver-impregnated wipe; (C) sterile urine-collection funnel paired with a castile-soap wipe; (D) sterile urine-collection funnel paired with a colloidal silver-impregnated wipe. RESULTS: The trial was stopped after interim analysis, as the contamination rate in the control group (30%) was markedly lower than the historical ED contamination rate (40%) at the study site. From 1,112 urinalysis results, 223 urine culture results were analyzed (190 female patients and 33 male patients). Urine contamination rates were as follows: Group A, n = 67 (29.9% contaminated); Group B, n = 69 (34.8% contaminated); Group C, n = 51 (23.5% contaminated); Group D, n = 36 (22.2% contaminated). The differences in contamination rates were not statistically different among any of the groups. DISCUSSION: The use of a funnel urine-collection system and silver-impregnated wipe did not reduce urine-culture contamination in adult midstream clean-catch urine cultures in the emergency department. SN - 1527-2966 UR - https://www.unboundmedicine.com/medline/citation/31445626/Contamination_in_Adult_Midstream_Clean_Catch_Urine_Cultures_in_the_Emergency_Department:_A_Randomized_Controlled_Trial_ DB - PRIME DP - Unbound Medicine ER -