scholarly journals Quick-Wee method Versus Standard method for urine collection in infants 1-12 month old

2021 ◽  
Vol 2 (2) ◽  
pp. 58-63
Author(s):  
Kalpana Karmacharya Malla ◽  
Sandip Kumar Singh ◽  
Brajesh Raj Chaudhary ◽  
Nabal Kishore Ray ◽  
Shivani Singh
Keyword(s):  
Urine Sample ◽  
Waiting Time ◽  
Standard Method ◽  
Parental Satisfaction ◽  
Secondary Outcome ◽  
Contamination Rate ◽  
Standard Group ◽  
Urine Collection ◽  
Sample Collection ◽  
Tract Infections

BACKGROUND: Urinary Tract infections [UTI] often presents with fever and nonspecific findings in infants less than one year. So urine sample collection is mandatory for diagnosis or exclusion. Collecting Urine sample is very challenging in infants and choosing the method of collection must balance the reliability, speed and contamination. Clinical guidelines have different recommendations so there is a need for reliable collection method. Therefore this study was conducted to determine if a simple stimulation method (Quick–wee Method) increases the rate of clean catch voiding of urine within five minutes. METHODS: A prospective age and sex matched case control study in 1-12 months children conducted from June 2017 – June 2018 in Pediatric ward of Manipal college of medical sciences, Pokhara, after Ethical clearance from Institutional review Board [IRB]. The study population was randomized to either clean catch midstream urine with stimulation [Quick–Wee method] or without stimulation [Standard method]. The primary outcome was voiding of urine within 5 minute. Secondary outcome were waiting time for voiding, successful collection, parental satisfaction, and contamination. The analysis was done using SPSS version 20 and a ‘p’value <0.05 was considered statistically significant. RESULTS: Waiting time for voiding in Quick wee group was less and statistically significant compared to standard group. There was 10% increment in voiding within 5 minutes in Quick wee group . It had higher successful urine collection rate (91.4%), slightly higher contamination rate (14.28%) but better parental satisfaction. CONCLUSIONS: Quick wee method is easy, reliable, successful method of urine collection in infants with better parental satisfaction and slightly higher contamination rate.

scholarly journals EFFECT OF URINE SAMPLE COLLECTION METHOD ON CONTAMINATION RATE OF URINE CULTURE

2009 ◽  
Vol 38 (1) ◽  
pp. 36-40
Author(s):  
Nada Mladina ◽  
Devleta Hadzic ◽  
Elvira Konjic ◽  
Zarko Mladina
Keyword(s):  
Urine Sample ◽  
Urine Culture ◽  
Contamination Rate ◽  
Sample Collection ◽  
Biochemical Tests ◽  
Urethral Catheterization ◽  
Etiologic Agents ◽  
Related Distribution ◽  
Sick Children ◽  
Serious Disease

Introduction: Urine sample for biochemical analysis must fulfill certain criterions. The sample collection must be done by following established standards so that the results of analysis are reliable. In children of various age, especially during serious disease, adequate consideration must be devoted to this procedure.Aims: To evaluate contamination rate of the urine sample according to the methods of obtaining samples and collecting specimens in seriously sick children of various age during their intensive treatment.Methods: Urine culture findings in children treated in Intensive Care Unit (ICU) of Children’s Hospital in Tuzla in period from January 2007 to the end of December 2007 were included in retrospective analysis according to the method of collecting (bag collection, urethral catheterization, clean catch). In all of the three groups the percentage of positive findings and percentage of contaminated specimens as well as sex related distribution was analyzed. The urine sample was obtained from urethral catheter only in patients with indication for urethral catheterization. Kruskal-Wallis test and regression model were used in statistical analysis. Results: A total of 662 children were treated in ICU during the observed period. The urine sample for routine biochemical tests was obtained from all patients. In 107 patients (16.2 %) urine culture examination was indicated. In 48 (44.9%) patients urine sample was obtained by bag collection, in 41 (38.3%) by clean catch, and 18 (16.8%) by urethral catheterization. In 7 patients or 6.5% urine was contaminated. The majority of contaminated specimens were collected by bag (12.5%). In 20 (18.7%) patients urine culture was positive with significant number of etiologic agents and 80 (74.8%) specimens were negative. Difference in results in three monitored groups was statistically significant which was confirmed by Kruskal-Wallis test and stepwise regression model.Conclusion: Obtaining urine sample by bag collection brings the highest risk for contamination.

scholarly journals Urinary Microbiota; Which Non-invasive Urine Collection Method Should We Use?

2021 ◽  
Author(s):  
Muhammed Selcuk Ozer ◽  
Hüseyin Alperen Yıldız ◽  
Canet Incir ◽  
Dogan Deger ◽  
Ozan Bozkurt ◽  
...  
Keyword(s):  
Urine Sample ◽  
Statistical Significance ◽  
Wilcoxon Test ◽  
Urine Samples ◽  
Urine Collection ◽  
Sample Collection ◽  
Collection Method ◽  
Significant Difference ◽  
Urinary Microbiota ◽  
Bacterial Groups

Objective: The aim of this study is establish the optimal non- invaszive urine sample collection method for the microbiota studies. Methodology: 12 men with bladder carcinoma underwent first voided and midstream urine collection. Urine samples were analyzed by using V3-V4 regions of bacterial 16s ribosomal RNAs. Bacterial groups with relative abundance above 1% were analyzed in first voided urine and midstream urine samples at phylum, class, order, and family level. At the genus level, all of the identified bacterial groups’ relative abundances were analyzed. The statistical significance (p<0.05) of differences between first voided and midstream urine sample microbiota were evaluated using the Wilcoxon test. Results: According to analysis, 8 phyla, 14 class, 23 orders, 39 families, and 29 different genera were identified in the first voided and the midstream urine samples. Statistical differences were not identified between first voided and mid-stream urine samples of all bacteria groups except the Clostridiales at order level (p:0.04) and Clostridia at class level (p:0.04). Conclusions: Either first voided or midstream urine samples can be used in urinary microbiota studies as we determined that there is no statistically significant difference between them regarding the results of 16s ribosomal RNA analysis. What’s known? According to widespread acceptance, first voided urine and midstream urine should be collected separately for standard microbiologic evaluation. What’s new? We found that there is no exact statistically significant difference between two collection methods even on microbiota analysis. We believe that either first voided or midstream uyrine samples can be used in urinary microbiota studies.

scholarly journals What’s the catch? Urine sample collection from young pre-continent children: a qualitative study in primary care.

BJGP Open ◽  
2020 ◽  
Vol 4 (4) ◽  
pp. bjgpopen20X101060
Author(s):  
Jonathan Kaufman ◽  
Lena Sanci ◽  
Meredith Temple-Smith
Keyword(s):  
Primary Care ◽  
Qualitative Study ◽  
Urine Sample ◽  
Urine Samples ◽  
Future Research ◽  
Sample Collection ◽  
Structured Interviews ◽  
Barriers And Enablers ◽  
Tract Infections ◽  
Collection Methods

BackgroundUrinary tract infections (UTIs) are common in young pre-continent children, but collecting urine samples is challenging. Collection methods all have limitations and international guidelines have conflicting recommendations. Choice of method must balance time, resources, invasiveness, reliability, and contamination. Evidence from primary care clinicians is limited regarding barriers and enablers to sample collection, and what factors inform the choice and use of different sample collection methods.AimTo understand the barriers and enablers to collecting urine samples from young pre-continent children in primary care.Design & settingAn exploratory qualitative study performed in primary care in Australia.MethodSemi-structured interviews explored the topic of collecting a urine sample from a child aged 6 months who presented with a fever. The interviews were undertaken with 21 GPs and four practice nurses (PNs) until data saturation was reached. Interviews were audiorecorded, transcribed verbatim, coded, and underwent content and thematic analysis.ResultsFive main themes emerged including: the clinician’s knowledge and expertise; patient characteristics; parent or carer’s understanding and motivation; the collection process itself; and likely outcome of the chosen method. Non-invasive methods were strongly favoured; although, clean catch was considered time-consuming and urine bags were known to be often contaminated. Invasive methods (for example, catheterisation or suprapubic aspiration [SPA]) were rarely performed outside of remote settings. Key barriers included time and space constraints in clinics, and key enablers included parental motivation, education handouts, and voiding stimulation methods.ConclusionThis study has identified key barriers and enablers to inform education, policy, and future research for urine sample collection from pre-continent children in primary care. Guideline recommendations must consider the primary care context to ensure they are relevant and suited to real-world practice.

scholarly journals A technique for fast and safe collection of urine in newborns

2017 ◽  
Vol 5 (3) ◽  
pp. 82-84 ◽  
Author(s):  
Archana Nepal ◽  
Rydam Basnet ◽  
Rukma Acharya ◽  
Sushma Shrestha ◽  
Satish Koirala ◽  
...  
Keyword(s):  
Success Rate ◽  
Urine Sample ◽  
Urine Collection ◽  
Older Children ◽  
Sample Collection ◽  
Non Invasive ◽  
Wide Range ◽  
Safe Technique ◽  
Time Required ◽  
Mean Time

Background: Urine collection in children especially in new born is a great challenge. A wide range of clinical interventions for urine collection is described in the literature, including non-invasive and invasive methods. Mid-stream urine collection is considered the most appropriate technique for older children. Here we are testing a method for obtaining mid- stream urine sample in newborns.Objective: To test a technique of urine collection for obtaining mid-stream urine sample in newborns.Method: A prospective feasibility study of a technique of urine sample collection based on bladder and lumbar stimulation maneuvers done in 100 newborns of less than 28 days of life over a period of one month. The main variable was the success rate in obtaining a midstream urine sample collection within four minutes and secondary variables were time required to obtain the sample and associated complications.Results: Mid- stream urine sample was collected successfully in 91% of babies. Mean time required for urine collection was 59.7 seconds with standard deviation of 46.4 seconds and median time was 47 seconds. No untoward complication other than controlled crying was seen.Conclusion: This is a quick and safe technique for mid-stream urine sample collection in newborn with high success rate and minimal discomfort.Journal of Kathmandu Medical CollegeVol. 5, No. 3, Issue 17, Jul.-Sep., 2016, Page: 82-84

scholarly journals BactoSpin: Novel Technology for Rapid Bacteria Detection and Antibiotic Susceptibility Testing

Sensors ◽  
2021 ◽  
Vol 21 (17) ◽  
pp. 5902
Author(s):  
Vlad Shumeiko ◽  
Guy Hidas ◽  
Chen Nowogrodski ◽  
Yariv Pinto ◽  
Ofer Gofrit ◽  
...  
Keyword(s):  
Urine Sample ◽  
Antibiotic Susceptibility ◽  
Bacterial Infections ◽  
Resistant Bacteria ◽  
Klebsiella Pneumonia ◽  
Sample Collection ◽  
E Coli ◽  
Inappropriate Use ◽  
Antibiotic Susceptibility Test ◽  
Tract Infections

Inappropriate use of antibiotics is one of the leading causes of the increasing numbers of resistant bacteria strains, resulting in 700,000 deaths worldwide each year. Reducing unnecessary use of antibiotics and choosing the most effective antibiotics instead of broad-spectrum drugs will slow the arms race between germs and humans. Urinary tract infections (UTIs) are among the most common bacterial infections. Currently, accurate diagnosis of UTI requires approximately 48 h from the time of urine sample collection until antibiotic susceptibility test (AST) results. This work presents a rapid bacterial detection device that integrates a centrifuge, microscope, and incubator. Two disposable microfluidic chips were developed. The first chip was designed for bacteria concentration, detection, and medium exchange. A second multi-channel chip was developed for AST. This chip contains superhydrophobic and hydrophilic coatings to ensure liquid separation between the channels without the need for valves. The designed chips supported the detection of E. coli at a concentration as low as 5 × 103 cells/mL within 5 min and AST in under 2 h. AST was also successfully performed with Klebsiella pneumonia isolated from a human urine sample. In addition, machine-learning-based image recognition was shown to reduce the required time for AST and to provide results within 1 h for E. coli cells. Thus, the BactoSpin device can serve as an efficient and rapid platform for UTI diagnostics and AST.

Pragmatic evaluation of a midstream urine collection technique for infants in the emergency department

CJEM ◽  
2020 ◽  
Vol 22 (5) ◽  
pp. 665-672
Author(s):  
Tighe Crombie ◽  
Robert Slinger ◽  
Nicholas J. Barrowman ◽  
Candice McGahern ◽  
Lauren Smith ◽  
...  
Keyword(s):  
Emergency Department ◽  
Contamination Rate ◽  
Urine Collection ◽  
Sample Collection ◽  
Convenience Sample ◽  
Infant Distress ◽  
Lower Back ◽  
Time Required ◽  
Urine Testing ◽  
Stimulation Technique

ABSTRACTObjectivesOur objective was to examine the performance characteristics of a bladder stimulation technique for urine collection among infants presenting to the emergency department (ED).MethodsThis prospective cohort study enrolled a convenience sample of infants aged ≤ 90 days requiring urine testing in the ED. Infants were excluded if critically ill, moderately to severely dehydrated, or having significant feeding issues. Bladder stimulation consisted of finger tapping on the lower abdomen with or without lower back massage while holding the child upright. The primary outcome was successful midstream urine collection within 5 minutes of stimulation. Secondary outcomes included sample contamination, bladder stimulation time for successful urine collection, and perceived patient distress on a 100-mm visual analog scale (VAS).ResultsWe enrolled 151 infants and included 147 in the analysis. Median age was 53 days (interquartile range [IQR] 27–68 days). Midstream urine sample collection using bladder stimulation was successful in 78 infants (53.1%; 95% confidence interval [CI] 45–60.9). Thirty-nine samples (50%) were contaminated. Most contaminated samples (n = 31; 79.5%) were reported as “no significant growth” or “growth of 3 or more organisms”. Median bladder stimulation time required for midstream urine collection was 45 seconds (IQR 20–120 seconds). Mean VAS for infant distress was 22 mm (standard deviation 23 mm).ConclusionsThe success rate of this bladder stimulation technique was lower than previously reported. The contamination rate was high, however most contaminated specimens were easily identified and had no clinical impact.

scholarly journals Implementation of a Female External Urinary Catheter Reduces Indwelling Urinary Catheter Use and Catheter-Associated Urinary Tract Infections

2020 ◽  
Vol 41 (S1) ◽  
pp. s482-s483
Author(s):  
Paul Gentile ◽  
Jesse Jacob ◽  
Shanza Ashraf
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Urinary Catheter ◽  
Improve Patient Safety ◽  
Academic Medical Center ◽  
Secondary Outcome ◽  
Successful Implementation ◽  
Urinary Catheters ◽  
Tract Infections ◽  
The Impact

Background: Using alternatives to indwelling urinary catheters plays a vital role in reducing catheter-associated urinary tract infections (CAUTIs). We assessed the impact of introducing female external catheters on urinary catheter utilization and CAUTIs. Methods: In a 500-bed academic medical center, female external catheters were implemented on October 1, 2017, with use encouraged for eligible females with urinary incontinence but not meeting other standard indications for urinary catheters. Nurses were educated and trained on female external catheter application and maintenance, and infection prevention staff performed surveillance case reviews with nursing and medical staff. We determined the number of catheter days for both devices based on nursing documentation of device insertion or application, maintenance, and removal. We used the CAUTI and DUR (device utilization ratio) definitions from the CDC NHSN. Our primary outcomes were changes in DUR for both devices 21 months before and 24 months after the intervention in both intensive care units (ICUs) and non-ICU wards. We used a generalized least-squares model to account for temporal autocorrelation and compare the trends before and after the intervention. Our secondary outcome was a reduction in CAUTIs, comparing females to males. Results: In total, there were 346,213 patient days in 35 months. The mean rate of patient days per month increased from 7,436.4 to 7,601.9 after the implementation of female external catheters, with higher catheter days for both urinary catheters (18,040 vs 19,625) and female external catheters (22 vs 12,675). After the intervention, the DUR for female external catheters increased (0 vs 0.07; P < .001) and for urinary catheters the DUR decreased (0.12 vs 0.10; P < .001) (Fig. 1). A reduction in urinary catheter DUR was observed in ICUs (0.29 vs 0.27; P < .001) but not wards (0.08 vs 0.08; P = NS) (Fig. 2). Of the 39 CAUTIs, there was no significant overall change in the rate per 1,000 catheter days (1.22 vs 0.87; P = .27). In females (n = 20 CAUTI), there was a 61% reduction in the CAUTI rate per 1,000 catheter days (0.78 vs 0.31; P = .02), but no significant change in the rate in males (0.44 vs 0.56; P = .64). The CAUTI rate per 1,000 catheter days among females decreased in the ICUs (1.14 vs 0.31; P = .04) but not in wards (0.6 vs 0.33; P = .96). Conclusions: In a setting with a baseline low UC DUR, successful implementation of female external catheters further modestly reduced UC DUR and was associated with a 61% decrease in CAUTI among females in the ICU but not in wards. Further interventions to better identify appropriate patients for female external catheters may improve patient safety and prevent patient harm.Funding: NoneDisclosures: None

scholarly journals Optimizing Urine Collection Represents an Important Stewardship Opportunity in Primary Care

2021 ◽  
Vol 1 (S1) ◽  
pp. s14-s15
Author(s):  
Larissa Grigoryan ◽  
Jennifer Matas ◽  
Michael Hansen ◽  
Samuel Willis ◽  
Lisa Danek ◽  
...  
Keyword(s):  
Primary Care ◽  
Urine Culture ◽  
Multinomial Logistic Regression ◽  
Retrospective Chart Review ◽  
Improve Patient Care ◽  
Safety Net ◽  
National Institutes Of Health ◽  
Urine Collection ◽  
High Count ◽  
Tract Infections

Background: Urine cultures are the most common microbiological tests in the outpatient setting and heavily influence treatment of suspected urinary tract infections (UTIs). Antibiotics for UTI are usually prescribed on an empiric basis in primary care before the urine culture results are available. However, culture results may be needed to confirm a UTI diagnosis and to verify that the correct antibiotic was prescribed. Although urine cultures are considered as the gold standard for diagnosis of UTI, cultures can easily become contaminated during collection. We determined the prevalence, predictors, and antibiotic use associated with contaminated urine cultures in 2 adult safety net primary care clinics. Methods: We conducted a retrospective chart review of visits with provider-suspected UTI in which a urine culture was ordered (November 2018–March 2020). Patient demographics, culture results, and prescription orders were captured for each visit. Culture results were defined as no culture growth, contaminated (ie, mixed flora, non-uropathogens, or ≥3 bacteria isolated on culture), low-count positive (growth between 100 and 100,000 CFU/mL), and high-count positive (>100,000 CFU/mL). A multivariable multinomial logistic regression model was used to identify factors associated with contaminated culture results. Results: There were 1,265 visits with urine cultures: 264 (20.9%) had no growth, 694 (54.9%) were contaminated, 159 (12.6%) were low counts, and 148 (11.7%) were high counts. Encounter-level factors are presented in Table 1. Female gender (adjusted odds ratio [aOR], 15.8; 95% confidence interval [CI], 10.21–23.46; P < .001), pregnancy (aOR, 13.98; 95% CI, 7.93–4.67; P < .001), and obesity (aOR, 1.9; 95% CI 1.31–2.77; P < .001) were independently associated with contaminated cultures. Of 264 patients whose urine cultures showed no growth, 36 (14%) were prescribed an antibiotic. Of 694 patients with contaminated cultures, 153 (22%) were prescribed an antibiotic (Figure 1). Conclusions: More than half of urine cultures were contaminated, and 1 in 5 patients were treated with antibiotics. Reduction of contamination should improve patient care by providing a more accurate record of the organism in the urine (if any) and its susceptibilities, which are relevant to managing future episodes of UTI in that patient. Optimizing urine collection represents a diagnostic stewardship opportunity in primary care.Funding: This study was supported by the National Institute of Allergy and Infectious Diseases of the National Institutes of Health (grant no. UM1AI104681). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.Disclosures: None

scholarly journals Antimicrobial Stewardship Standards and Patient Safety: A Case Study in Blood Culture Contamination

2021 ◽  
Vol 1 (S1) ◽  
pp. s36-s36
Author(s):  
Connie Schaefer
Keyword(s):  
Blood Culture ◽  
Healthcare System ◽  
Antimicrobial Stewardship ◽  
Standard Method ◽  
Broad Spectrum ◽  
Emergency Departments ◽  
Blood Cultures ◽  
Contamination Rate ◽  
Broad Spectrum Antibiotics ◽  
Contamination Events

Background: Blood culture is a crucial diagnostic tool for healthcare systems, but false-positive results drain clinical resources, imperil patients with an increased length of stay (and associated hospital-acquired infection risk), and undermine global health initiatives when broad-spectrum antibiotics are administered unnecessarily. Considering emerging technologies that mitigate human error factors, we questioned historically acceptable rates of blood culture contamination, which prompted a need to promote and trial these technologies further. In a 3-month trial, 3 emergency departments in a midwestern healthcare system utilized an initial specimen diversion device (ISDD) to draw blood cultures to bring their blood culture contamination rate (4.4% prior to intervention) below the 3% benchmark recommended by the Clinical & Laboratory Standards Institute. Methods: All emergency department nursing staff received operational training on the ISDD for blood culture sample acquisition. From June through August 2019, 1,847 blood cultures were drawn via the ISDD, and 862 were drawn via the standard method. Results: In total, 16 contamination events occurred when utilizing the ISDD (0.9%) and 37 contamination events occurred when utilizing the standard method (4.3%). ISDD utilization resulted in an 80% reduction in blood culture contamination from the rate of 4.4% rate held prior to intervention. Conclusions: A midwestern healthcare system experienced a dramatic reduction in blood culture contamination across 3 emergency departments while pilot testing an ISDD, conserving laboratory and therapeutic resources while minimizing patient exposure to unnecessary risks and procedures. If the results obtained here were sustained and the ISDD utilized for all blood culture draws, nearly 400 contamination events could be avoided annually in this system. Reducing unnecessary antibiotic use in this manner will lower rates of associated adverse events such as acute kidney injury and allergic reaction, which are possible topics for further investigation. The COVID-19 pandemic has recently highlighted both the importance of keeping hospital beds available and the rampant carelessness with which broad-spectrum antibiotics are administered (escalating the threat posed by multidrug-resistant organisms). As more ambitious healthcare benchmarks become attainable, promoting and adhering to higher standards for patient care will be critical to furthering an antimicrobial stewardship agenda and to reducing treatment inequity in the field.Funding: NoDisclosures: None

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