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Contamination rates of three urine-sampling methods to assess bacteriuria in pregnant women

Title: Contamination rates of three urine-sampling methods to assess bacteriuria in pregnant women
Authors: Schneeberger, Caroline; Heuvel, ER Edwin van den; Erwich, Jan Jaap HM; Stolk, RP; Visser, CE; Geerlings, SE
Source: ISSN:0029-7844.
Publisher Information: Lippincott Williams and Wilkins Ltd.
Publication Year: 2013
Collection: Eindhoven University of Technology (TU/e): Research Portal
Description: OBJECTIVE: To estimate and compare contamination rates of three different urine-sampling methods in pregnant women to assess bacteriuria. METHODS: In this cross-sectional study, 113 pregnant women collected three different midstream urine samples consecutively: morning (first void); midstream (void without further instructions); and clean-catch sample (void after cleaning). The following end points were considered contaminants: epithelial cells, Gram-positive rods or mixed bacteria in the Gram stain, and mixed growth or skin flora in the urine culture. Intraindividual variability in contaminants was quantified with Fleiss-Cohen’s weighted ¿ statistic. Differences between samples were assessed using generalized estimating equations. RESULTS: Mainly low numbers of Gram-positive rods were more likely to be present in Gram stains of midstream samples compared with clean-catch samples (77.7% compared with 66.7%, P=.022). Morning samples showed more mixed growth compared with midstream samples (6.2% compared with 0.9%, P=.050). No consistency in quantity of contaminants was found in midstream samples compared with morning and clean-catch samples. No differences were found between the other end points in all three urine samples (P>.05). The study could detect an odds ratios of 2.0 for differences in urine-sampling methods with 80% power and 5% significance for most end points. CONCLUSION: In pregnant women, the contamination rate of midstream samples is comparable with the contamination rates of morning and clean-catch samples. The quantity of contaminants varied among the three samples collected by one woman. These results show that more complex, unpractical, and time-consuming morning and clean-catch samples are not superior. Therefore, we recommend a midstream sample to assess bacteriuria in pregnant women. LEVEL OF EVIDENCE: II
Document Type: article in journal/newspaper
File Description: application/pdf
Language: English
Relation: http://repository.tue.nl/777519
Availability: http://repository.tue.nl/777519
Rights: Copyright (c) Schneeberger, Caroline ; Copyright (c) Heuvel, ER Edwin van den ; Copyright (c) Erwich, Jan Jaap HM ; Copyright (c) Stolk, RP ; Copyright (c) Visser, CE ; Copyright (c) Geerlings, SE
Accession Number: edsbas.3952B3E3
Database: BASE