Cleaning of the perineal/genital area before urine collection from toilet-trained children prevented sample contamination

摘要

QUESTIONWhen collecting a midstream urine sample from toilet-trained children, does cleaning of the perineal/genital area before collection prevent sample contamination?METHODSDesign: cluster randomised (by week) controlled trial. Allocation: not concealed. Blinding: blinded (microbiologists). Follow-up period: 48 hours.Setting: emergency department of a tertiary care paediatric centre in Montreal, Quebec, Canada.Patients: 350 toilet-trained children 2-18 years of age (45% 2-5 y, 37% 6-12 y, and 18% 13-18 y; 60% girls) who had a midstream urine sample requested for any medical reason. Children with developmental delay were excluded. Intervention: cleaning of the perineal/genital area twice, using liquid soap and gauze pads (n=179) or no cleaning (n = 171) before collecting a midstream urine sample in a sterile container. Only samples with a positive urinalysis result were sent to the microbiology laboratory for culture. Outcomes: positive urinalysis (positive leukocyte esterase or nitrites on dipstick or > =5 white blood cells per high-powered field after centrifuging) and contaminated urine culture (<10~8 colony-forming units of a single organism or a mix of > =2 organisms per litre of urine). Urinary tract infection was diagnosed by a positive urine culture (> =10~8 colony-forming units of a single pathogenic organism per litre of urine). Patient follow-up: 100% (intention-to-treat analysis).