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PubMed2003

Feasibility of using paper impregnated with urine instead of liquid urine for assessing ovarian activity.

BACKGROUND: Ovarian activity should ideally be assessed by serial non-invasive methods that require simple procedures for sample collection and storage. Measurement of urinary oestrone-3-glucuronide and pregnanediol-3 alpha-glucuronide is a non-invasive method available for assessment of ovarian activity, but transport of large numbers of urine samples is cumbersome and samples need to be stored frozen. An alternative sample collection, transport and storage procedure that is easier to handle and requires no or minimal cold storage facilities will particularly benefit studies in which ovulatory activity needs to be assessed in field settings. OBJECTIVE: To evaluate the feasibility of using paper impregnated with urine as an alternative to liquid urine for the measurement of oestrone-3-glucuronide and pregnanediol-3 alpha-glucuronide concentrations in the assessment of ovarian activity. METHODS: Urine samples collected daily throughout regular menstrual cycles were stored as liquid urine at -20 degrees C, and as paper impregnated with urine, in the refrigerator for 3 to 12 months or at room temperature for 1 to 6 months. Oestrone-3-glucuronide and pregnanediol-3 alpha-glucuronide concentrations were measured in these urine samples by enzyme immunoassay. Values obtained were correlated using Spearman's correlation test. RESULTS: The pattern of oestrone-3 glucuronide and pregnanediol-3 alpha-glucuronide concentrations estimated using paper impregnated with urine followed that of liquid urine in all storage conditions used. Values obtained by two methods correlated significantly (p < 0.001 to 0.0001) though the paper impregnated with urine gave slightly higher values. CONCLUSIONS: Paper impregnated with urine can be used to facilitate sample collection, transport and storage of urine when oestrone-3-glucuronide and pregnanediol-3 alpha-glucuronide measurements are required in a large number of serial samples to assess ovarian activity.

Estrone↗
PubMed1991

Microbial stabilization of antibiotic-containing urine samples by using the FLORA-STAT urine transport system.

The FLORA-STAT Urine Transport System (Wadley Biosciences Corp./Lymphokine Partners Ltd., Dallas, Tex.) was evaluated for its efficacy in maintaining organism count and in effectively blocking the bactericidal action of therapeutic antimicrobial agents in urine samples when the urine samples were held at room temperature. Reconstructions with 53 organism-antimicrobial combinations were performed at 0, 4, 8, and 24 h in which the FLORA-STAT system was compared with two boric acid-based systems (Urine C&S Transport Kit [Becton Dickinson VACUTAINER Systems, Rutherford, N.J.]; Sage Urine Collection Kit for Culture [Sage Products, Inc., Cary, Ill.]) and untreated urine. At 24 h, less than 1-log-unit changes in organism counts were found in 100, 92, and 10% of the urine samples without antimicrobial agents and in 97, 65, and 16% of the urine samples with antimicrobial agents for FLORA-STAT-treated, boric acid-treated, and untreated urine samples, respectively. The FLORA-STAT system was further evaluated by sending split samples prepared from laboratory-inoculated patient urine samples (57 without and 50 with antimicrobial agents) to four commercial laboratories by using their respective transport devices and procedures. Samples were also sent to a local reference laboratory which provided prompt processing. Each laboratory received independently labeled transport devices containing untreated, FLORA-STAT-treated, and preservative-treated (if provided by the commercial laboratory) samples prepared from the same urine specimen of a patient. Average estimated transport times ranged from 13 to 24 h for the commercial laboratories; the transport time was less than 4 h for the local reference laboratory.(ABSTRACT TRUNCATED AT 250 WORDS)

Anti-Bacterial Agents↗
PubMed1986

Urine pH and the relationship between urine flow and urinary prostaglandin E excretion in the rat.

The relationship between urine flow and urinary prostaglandin E (PGE) excretion was investigated at constant urine pH in the anaesthetized rat. The urine pH was maintained at approximately pH 6 or pH 8 by the intravenous infusion of either ammonium chloride or sodium bicarbonate respectively. Two distinct patterns in the relationship between PGE excretion and urine flow were observed. The first showed a fall in urinary PGE excretion as the urine flow increased over the low flow range of 2-5 ml/h, and was common to both experiments. The second relationship, however, showed a marked difference between the ammonium chloride and sodium bicarbonate experiments since: (a) in acidic urine (pH 6), PGE excretion increased (P less than 0.002) with the urine flow, attaining a rate of 87 +/- 6 pmol/h (n = 6) at the highest level of flow achieved (12 ml/h); (b) in alkaline urine (pH 8), PGE excretion was significantly (P less than 0.01) higher but did not increase with urine flow, remaining constant at approximately 90 pmol/h (n = 6). The lack of any additive effect on urinary PGE excretion between increasing the urine flow and making the urine alkaline may be explained by both stimuli acting through a common mechanism, a concept which is consistent with the hypothesis that PGE may be reabsorbed in the distal nephron. The flow-dependency of urinary PGE excretion could therefore result from a reduction in reabsorption rather than the increase in passive secretion proposed previously.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1996

[Can examination of spontaneous urine samples adequately replace 24-hour-urine samples for determining excretory rate of various lithogenic and inhibitory substances in metabolic evaluation of kidney calculi patients?].

The gold standard for metabolic evaluation of stone-forming patients is the 24-h urine specimen. Recently, some authors have suggested that for routine metabolic evaluation spot urine samples are as valuable as the 24-h urine specimen. The purpose of our study, was to determine the value of the spot urine sample in comparison with the 24-h urine specimens. Eighty-eight healthy volunteers on different diets were investigated (32 vegetarians, 12 body-builders without protein concentrates, 28 body-builders on protein concentrates, and 16 subjects on a regular European diet). Using 24-h specimens, excretion rates of oxalate, calcium, sodium and potassium were determined. The concentration ratio of these electrolytes to creatinine was calculated for spot urine samples. A highly significant correlation between the excretion rates and the results of the spot urine samples was found for all parameters. However, the correlations showed considerable variations. On the other hand, we were able to show that creatinine excretion is highly dependent on daily protein intake, body weight and glomerular filtration rate. This leads to a considerable inter- and intraindividual variation in creatinine excretion. This variation of the creatinine excretion is the major cause for the variation in the results of spot urine samples. It is concluded that spot urine samples are an inadequate substitute for the 24-h urine specimen and that the 24-h urine specimen is still the basis for metabolic evaluation in stone patients.

Adolescent↗
PubMed1997

Urine samples from disposable diapers: an accurate method for urine cultures.

BACKGROUND: The method of collection of the urine sample is of paramount importance in making a diagnosis of urinary tract infection in infants and children. Squeezing urine out of disposable diapers can provide a urine sample that can be used to detect chemical abnormalities as well as a specimen suitable for microscopic examination. To date there have been no reported studies on the use of this technique for urine culture as compared with samples collected by suprapubic aspiration and catheterization. METHODS: Urine was obtained from 38 infants aged under 2 years who presented with fever with no obvious cause. All infants had urine collected either by catheterization or suprapubic aspiration and by extraction from a disposable diaper. The urine samples were cultured using standard bacteriologic techniques. RESULTS: Five infants had a urinary tract infection, as shown by a pure growth of more than 10(5) colonies/mL of a single species of bacterium. In all the cases the same result was obtained from both the diaper urine sample and the sample obtained by suprapubic aspiration or catheter. In 31 infants the urine samples collected by both techniques (diaper and catheter or suprapubic aspiration) were negative, and in only 2 infants did the diaper specimen yield a positive result, while the urine obtained by suprapubic aspiration or catheter was sterile. CONCLUSIONS: Urine obtained from a disposable diaper can provide a valid sample for diagnosing urinary tract infection. The technique is simple, and can be carried out readily in ambulatory settings with minimal equipment and expense.

Disposable Equipment↗
PubMed2006

[The value of a urine protein-to-creatinine ratio assessment in a single voided urine specimen in prediction of 24-hour proteinuria in pregnancy induced hypertension].

OBJECTIVES: Detecting proteinuria is an integral part in management of hypertensive pregnant women. The measurement of protein excretion in a 24-hour urine collection is used as the gold standard for the diagnosis and follow-up of pathologic urinary excretion. However, 24-hour urine collection is time consuming, cumbersome and often inaccurate especially during pregnancy. Pregnant women find it very inconvenient and difficult. AIM: The study was undertaken to validate the prediction of 24-hour protein excretion by a single voided urine protein-to-creatinine ratio in hospitalized hypertensive pregnant women. MATERIAL AND METHODS: The study was performed in the Pregnancy Pathology Ward, City Hospital in Gdynia in 2002-2004. Pregnant women at > or = 20 weeks with hypertension (blood pressure > or = 140/90 mmHg) with proteinuria at initial urine examination were evaluated. A protein-to-creatinine ratio was obtained from first voided urine sample next morning and then urine was collected for next 24 hours for measurement of protein excretion. RESULTS: 44 women were evaluated. A total of 56 cases of the 24-hour urine collection were analyzed. There is a close correlation between the protein-to-creatinine ratio in random urine samples and the 24-hour protein excretion measured by 24-hour urine collection. Pearson correlation coefficient R=0,85 (P<0,001, R2= 0,73). A protein-to-creatinine ratio < 0,2 (g/g) can rule out significant proteinuria (defined as 24-hour urinary protein excretion > 300 mg) with sensitivity 92,0%, specificity 90,32%, positive predictive value 88,46%, negative predictive value 93,33%. CONCLUSIONS: The protein-to-creatinine ratio of a single urine sample correlate with the 24-hour urine protein excretion. A protein-to-creatinine ratio < 0,2 (g/g) can rule out significant proteinuria.

Adult↗
PubMed1985

Effect of urine preservation on urine screening and organism identification.

Three urine preservation-transport methods were examined for their effect on rapid urine-screening procedures. Results from fresh urine specimens, screened for bacteriuria by leukocyte esterase, nitrate, Autobac, Bac-T-Screen, Auto Microbic System (AMS), and bioluminescence procedures, were compared with urine-screen results from urine specimens held for 24 hours at room temperature in chemical preservatives. Quantitative discrepancies ranged from 0%, for urine preserved with glycerin-boric acid-sodium formate and tested by AMS or leukocyte esterase, to 21% for urines in the same preservative tested by bioluminescence or nitrate. Up to 62% of the organism identifications made from preserved urine specimens tested by the AMS urine card were in error. These data suggest that it may be inadvisable to use weak organic acid-based urine preservation systems in conjunction with these urine-screen procedures.

Bacteriuria↗
PubMed1999

Frequency of urination and ultrasonographic estimation of residual urine in normal and dysuric dogs.

The aim of this study was to determine residual urine and frequency of urination in normal male and female dogs and to compare these with dogs with neurogenic and obstructive dysuria. The bladder volume before urination was estimated ultrasonographically in 99 dogs (48 normal and 51 abnormal dogs). Each animal was then taken outdoors and walked on grass for 10 minutes. The number of attempts to urinate (successful or not) was recorded. Bladder urine volume after urination was then calculated. Normal females made only one or two (100 per cent successful) attempts to urinate while males a mean of 6.9 attempts (mean 75.4 per cent successful) within 10 minutes. The residual urine per kg body weight of normal dogs varied from 0.1 to 3.4 ml kg(-1)(median 0.2 ml kg(-1)). The residual urine volumes of normal dogs were significantly less (P<0.0001) than those of dogs with neurological disorders or obstructive disease. Ultrasonographic estimation of residual urine volumes could be valuable in diagnosing suspected neurological or obstructive bladder disease and in monitoring the response to treatment.

Animals↗
PubMedDate not supplied

Intra- and interindividual variation in urine osmolality and urine specific gravity in healthy pet dogs of various ages.

Urine specific gravity (Usg) and urine osmolality (Uosm) are used routinely to assess renal concentrating ability, but limited data on these variables are available for healthy dogs. Consequently, we studied the intra- and interindividual variations in Usg and Uosm in healthy dogs as well as the influence of age and gender on these variables. Dogs were selected for health and anestrus in female dogs through the use of a detailed questionnaire. Eighty-nine owners collected morning and evening urine samples from their dogs on 2 consecutive days. In 8 dogs in which the Uosm of different samples varied more than 50%, owners collected urine for 24 hours at 2-hour intervals during the day and at 4-hour intervals at night. The possible effect of changes in adrenocortical function with age was assessed by measurements of urinary corticoid/creatinine (C/C) ratios. Among all samples, Uosm ranged from 161 to 2,830 mOsm/kg and Usg from 1.006 to > 1.050. In the morning, Uosm (1,541 +/- 527 mOsm/kg, range 273-2,620 mOsm/kg) and Usg (1.035 +/- 0.010, range 1.009-->1.050) were higher than in the evening (Uosm 1,400 +/- 586 mOsm/kg, range 161-2,830 mOsm/kg; Usg 1.031 +/- 0.012, range 1.006-->1.050). The interindividual coefficient of variation in Uosm was 34.2% for morning urine samples and 41.9% for evening samples. In 8 dogs with large differences in urine concentration, there were 2- to 3-fold increases or decreases in Uosm during the day, and the intraindividual coefficient of variation was 33.0%. There was no relation between gender and urine concentration. Urine concentration in both the morning and evening samples decreased with age. Urinary corticoid/ creatinine ratios did not change with age. It can be concluded that Uosm and Usg vary widely among healthy dogs. Urine concentration is generally lower in the evening than in the morning and is not related to gender. Urine concentration decreases with age, and this cannot be ascribed to an associated increase in endogenous corticoids. In some dogs, Uosm varies widely during the day, with an intraindividual coefficient of variation approaching the interindividual coefficient of variation. This may be regarded as a biologic variation but also could represent an early undiagnosed clinical abnormality.

Adrenal Cortex Hormones↗
PubMed1996

Comparative value of urinalysis, urine cytology and urine sIL2R in the assessment of renal disease in patients with systemic lupus erythematosus (SLE).

Serial immunological testing has been recently proposed for monitoring patients with lupus nephritis as routine serological tests have shown sub-optimal correlation with clinical status. To assess the value of urine cytology and urine sIL2R in the evaluation of patients with SLE, in particular those with lupus nephritis, we conducted a prospective double-blind study of 31 patients with SLE, during an 18-month period. A comparison of routine urinalysis with urine cytology and urine sIL2R was performed in 84 samples: 15 from patients without a history of renal involvement and 69 from patients with a history of renal involvement. A high urine cytology score (> or = 6), particularly in the presence of lymphoblasts, plasma cells or monocytes, was significantly associated with lupus nephritis in relapse. Urine sIL2R levels were significantly elevated during all SLE relapses, unrelated to the presence of renal involvement. Fifteen urine specimens were obtained at the time of a kidney biopsy: 9 with active lesions and 6 with inactive renal disease. UC score was 2.0 +/- 1.89 for those with absent activity, 8.4 +/- 3.4 for mild activity and 11.0 +/- 2.4 for moderate/severe activity (p < 0.001 between active vs inactive disease). No urinalysis parameter alone permitted distinguishing the degree of renal disease activity. In the subgroup of patients with renal disease urinalysis was overall less accurate than urine cytology or urinary sIL2R levels for predicting renal disease activity defined by biopsy. Urine cytology and urine sIL2R proved to be reliable measures of lupus activity.

Adolescent↗
PubMedDate not supplied

Two-hour urine collection for evaluating renal function correlates with 24-hour urine collection in pregnant patients.

OBJECTIVE: We sought to determine if 2-h urine collection for the assessment of urine protein excretion and creatinine clearance correlates with 24-h urine collection in pregnant patients with renal disease. METHODS: We enrolled patients of gestational ages ranging from 8-41 weeks, admitted as inpatients and having undergone evaluation for renal function (n = 59). We obtained the following samples: 1) 2-h urine, and 2) 24-h urine. We measured serum creatinine concentration, urinary protein, creatinine concentration, and creatinine clearance. The data was analyzed using descriptive analysis, two-way ANOVA, univariate linear regression analysis, and Bland-Altman plot comparing the efficacy of 2-h urine results with 24-h urine results. RESULTS: We analyzed the data on 51 patients. Total proteinuria calculated by protein/creatinine (P:C) ratio in the 2-h group correlated with the total protein measured in the 24-h group (1,840.8 +/- 786 and 1,944 +/- 1,060 mg [mean +/- SE], respectively, r2 = 0.95, P < 0.0001). Creatinine clearance correlated in the 2- and 24-h groups (111 +/- 42 and 122.5 +/- 50 ml/min, respectively; r2 = 0.73, P < 0.001). CONCLUSION: Two-hour urine sampling offers the same clinical information as 24-h urine collection for the evaluation of renal function. Use of 2-h urine collection reduces the time of evaluation and diagnosis, whereby increasing patient compliance and reducing errors in performance of the tests.

Adult↗
PubMed2003

European multicentre validation trial of two new non-invasive tests for the detection of Helicobacter pylori antibodies: urine-based ELISA and rapid urine test.

AIM: Non-invasive tests for the assessment of Helicobacter pylori status are now an integral part of the management strategies for patients with dyspepsia. The aim of this study was to evaluate a urine based antibody ELISA and a near patient urine test for the diagnosis of H. pylori infection in a European population. METHODS: Urine samples were collected from 449 patients (240 females, 209 males, mean age 54 years), with dyspeptic symptoms but no previous H. pylori eradication therapy, at five centres in four European countries. All patients underwent GI endoscopy and biopsies were taken for H. pylori diagnosis. Urine samples were analysed using an IgG ELISA (URINELISA) and a near patient urine test (RAPIRUN). In addition, a serum IgG ELISA (Pyloriset-EIA-GIII), a whole blood test (Pyloriset-Screen) and a 13C-urea breath test were performed. RESULTS: The sensitivity of the urine based ELISA and the near patient urine test was 90% and 82%, and the specificity 68% and 83%, respectively. The accuracy of the serum ELISA and the whole blood test was comparable with the urine based test. CONCLUSION: The urine based ELISA and the near patient urine test are just as accurate as the serological tests. This comparable accuracy and complete non-invasiveness of the former gives it an advantage over blood based tests. This limits the application of these tests in general practice.

Antibodies, Bacterial↗
PubMed2006

Urine protein-to-creatinine ratio in an untimed urine collection is a reliable measure of proteinuria in lupus nephritis.

OBJECTIVE: To evaluate the accuracy of urine protein-to-creatinine (P/C) ratio in an untimed urine specimen as compared with 24 h total protein excretion for measurement of proteinuria in patients with lupus nephritis. METHODS: Proteinuria in patients with lupus nephritis was assessed by 24 h total protein excretion and spot urine P/C ratio. Correlation and limits of agreement between the two methods were evaluated. The discriminant cutoff values for spot urine P/C ratio in predicting 24 h protein 'threshold' excretion of > or =0.3, > or =0.5, > or =1.0 and > or =3.5 g/day were determined using receiver operating characteristic curves. RESULTS: A total of 165 samples were available for assessment with 21.8% excluded due to inadequate collection. A strong correlation (r = 0.91, P < 0.0001) was found between spot urine P/C ratio and 24 h urine protein excretion. Bland-Altman plot showed the two tests had acceptable limits of agreement in low level of protein excretion (-0.86 to +0.92 g/day when protein excretion was <2.0 g/day). The limits became wider as the protein excretion increased. The spot urine P/C ratios of 0.45 (sensitivity 0.92; specificity 0.88), 0.7 (0.92; 0.89) and 1.84 (1.0; 0.86) mg/mg reliably predicted 24 h urine total protein equivalent 'thresholds' at > or =0.5, 1.0 and 3.5 g/day. CONCLUSION: This study supports the recommendation of using spot urine P/C ratio in screening and monitoring proteinuria in patients with lupus nephritis. However, in assessing the exact amount of proteinuria, the urine P/C ratio may have unacceptably wide limits of agreement in high protein excretion range.

Adult↗
PubMed2006

Comparison of Multistix PRO dipsticks with other biochemical assays for determining urine protein (UP), urine creatinine (UC) and UP:UC ratio in dogs and cats.

BACKGROUND: Urine protein: urine creatinine (UP:UC) ratio determined from the quantitative measurement of protein and creatinine in a single urine sample is the best feasible assessment of clinically significant proteinuria in dogs and cats. A dipstick that measures urine protein, urine creatinine, and UP:UC ratio has been used in human medicine and could have application for veterinary practice. OBJECTIVE: The objective of this study was to compare the Multistix PRO dipstick (Bayer Corporation, Elkhart, IN, USA) to other biochemical methods for determination of urine protein and creatinine, and UP:UC ratio in canine and feline urine. METHODS: A complete urinalysis, including sulfosalicylic acid (SSA) precipitation, was performed on urine samples submitted to our laboratory between February and April 2003 from 100 dogs and 49 cats. Urine protein and creatinine concentrations were determined by the Multistix PRO dipstick using a Clinitek 50 analyzer (Bayer) and compared with the results of SSA precipitation and quantitative biochemical analysis. The UP:UC ratios from the dipstick results (calculated by the Clinitek 50 and also manually) were compared with those calculated from quantitative values. Pearson product-moment correlation analysis and diagnostic sensitivity and specificity (using quantitative results as the gold standard) were determined. RESULTS: For both canine and feline urine, protein and creatinine concentrations determined by the Multistix PRO correlated closely with quantitative concentrations for protein (dogs r = .78, P = .0001; cats r = .87, P = .0001) and creatinine (dogs r = .78, P = .0001; cats r = .76, P = .0001). The Multistix PRO was more sensitive and less specific than SSA precipitation for diagnosing clinically significant proteinuria. UP:UC ratios obtained by manual calculation of dipstick results correlated best with quantitative UP:UC ratios in dogs, and had higher specificity but lower sensitivity for the diagnosis of proteinuria. In cats, UP:UC ratios determined by the dipstick method did not correlate (r = -.24, P = .0974) with quantitative values. CONCLUSIONS: The Multistix PRO, with manual calculation of UP:UC, may be a good alternative for the diagnosis of clinically significant proteinuria in dogs, but not cats. Dipstick creatinine concentration should be considered as an estimate.

Animals↗
PubMed2004

Analysis of pyrimidine synthesis "de novo" intermediates in urine and dried urine filter- paper strips with HPLC-electrospray tandem mass spectrometry.

BACKGROUND: The concentrations of the pyrimidine "de novo" metabolites and their degradation products in urine are useful indicators for the diagnosis of an inborn error of the pyrimidine de novo pathway or a urea-cycle defect. Until now, no procedure was available that allowed the analysis of all of these metabolites in a single analytical run. We describe a rapid, specific method to measure these metabolites by HPLC-tandem mass spectrometry. METHODS: Urine or urine-soaked filter-paper strips were used to measure N-carbamyl-aspartate, dihydroorotate, orotate, orotidine, uridine, and uracil. Reversed-phase HPLC was combined with electrospray ionization tandem mass spectrometry, and detection was performed by multiple-reaction monitoring. Stable-isotope-labeled reference compounds were used as internal standards. RESULTS: All pyrimidine de novo metabolites and their degradation products were measured within a single analytical run of 14 min with lower limits of detection of 0.4-3 micromol/L. The intra- and interassay variation for urine with added compounds was 1.2-5% for urines and 2-9% for filter-paper extracts of the urines. Recoveries of the added metabolites were 97-106% for urine samples and 97-115% for filter-paper extracts of the urines. Analysis of urine samples from patients with a urea-cycle defect or pyrimidine degradation defect showed an aberrant metabolic profile when compared with controls. CONCLUSION: HPLC with electrospray ionization tandem mass spectrometry allows rapid testing for disorders affecting the pyrimidine de novo pathway. The use of filter-paper strips could facilitate collection, transport, and storage of urine samples.

Argininosuccinic Aciduria↗
PubMed1985

Effect of collection time and exercise restriction on the prediction of urine protein excretion, using urine protein/creatinine ratio in dogs.

Nonproteinuric and proteinuric dogs were studied to determine whether the urine protein/creatinine ratio from a 24-hour urine sample could be used to predict urine protein excretion. Urine protein/creatinine ratios estimated from urine produced during daylight hours and from that produced during nighttime hours were compared to determine whether time of sample collection influenced the prediction of the urine protein excretion value. Urine protein/creatinine ratios in urine from male dogs were compared with those from female dogs to determine whether sex had an influence on the value. Hospitalized and nonhospitalized dogs were used to determine the effect of exercise restriction. The urine protein/creatinine ratio varied significantly between healthy and proteinuric dogs (P = 0.0001). It was not influenced by collection period or sex. Animals not confined to hospital cages had a significantly lower urine protein/creatinine ratio than did hospitalized animals confined to a cage (P = 0.003).

Animals↗
PubMed1996

[Urinary tract infection in infants: use of urine specimens obtained by suprapubic bladder aspiration in order to determine the reliability of culture specimen of urine collected in perineal bag].

OBJECTIVE: To determine if culture specimens of urine collected in perineal bags is reliable in detecting urinary tract infections in infants. MATERIAL AND METHODS: A prospective study was carried out in a pediatric emergency room of an urban teaching hospital. Forty-eight infants, 12 months old or less, requiring an uncontaminated urine specimen due to the evaluation of febrile illness, suspected urinary tract infection or to a previously contaminated urine culture specimen. Two consecutive urine specimens were collected for culture. A urine specimen was collected in a perineal bag and afterwards all patients underwent suprapubic bladder aspiration. Cultures were considered positive if pure growth of more than 1.000 colonies/ml developed in the suprapubic aspiration urine specimen. RESULTS: Thirty-two infants had coincident cultures in both urine specimens. A positive culture specimen of urine collected in a perineal bag (pure growth of more than 100,000 colonies/ml) had high sensitivity (100%) and high specificity 88.6% in predicting positive cultures from urine obtained by suprapubic aspiration. CONCLUSION: A urine culture specimen meticulously collected with a perineal bag is a good screening method for detecting urinary tract infection in low risk infants.

Escherichia coli↗
PubMed2004

Midstream urine culture and sensitivity test is a poor predictor of infected urine proximal to the obstructing ureteral stone or infected stones: a prospective clinical study.

PURPOSE: This prospective study was performed to determine if midstream urine (MSU) culture and sensitivity (C&S) alone could adequately predict infected urine proximal to the obstructing ureteral stone or the infected stones. Can pelvic urine C&S predict infected stones? MATERIALS AND METHODS: A prospective clinical study was performed on all patients undergoing ureterorenoscopy and lithotripsy for ureteral stones with obstruction between December 1, 2000 and January 31, 2002. We obtained MSU, renal pelvic urine and fragmented stones for culture and sensitivity. An analysis of the data was performed to assess statistical association. RESULTS: A total of 73 patients who fulfilled the criteria were recruited. Of these patients 25 (34.3%) had positive stone culture, 43 (58.9%) had positive pelvic urine and 21 (28.8%) patients had positive MSU C&S. Stone and pelvic C&S were positive simultaneously in 17 (23.3%) cases, MSU and stone C&S were positive in 8 (10.9%) cases, whereas pelvic and MSU C&S were positive in 13 (16.4%) cases (p = 0.03). MSU C&S had a sensitivity of 30.2% and specificity of 73% to detect pelvic urine C&S positivity. MSU C&S had a low positive predictive value and negative predictive value (NPV) in relation to infected pelvic urine (positive predictive value = 0.62, NPV = 0.42). Pelvic urine C&S had a NPV of 0.73 in detecting noninfected stones. CONCLUSIONS: The results of this study suggest that in obstructive uropathy secondary to a stone MSU C&S is a poor predictor of infected urine proximal to the obstruction and infected stones.

Adolescent↗