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Factors affecting the contamination of bag urine culture in febrile children under two years

Korean Journal of Pediatrics 2009;52(3):346-350.
Published online March 15, 2009.
Factors affecting the contamination of bag urine culture in febrile children under two years
Wook Hyun Choi, In Seok Lim
Department of Pediatrics, College of Medicine, Chung-Ang University, Seoul, Korea
2세 미만의 열성 환아에서 소변 주머니를 이용한 소변 배양 검사의 오염률에 영향을 미치는 인자
최욱현, 임인석
중앙대학교 의과대학 소아과학교실
Correspondence: 
In Seok Lim, Email: inseok@cau.ac.kr
Abstract
Purpose
: Since children under two years with suspected urinary tract infections (UTIs) cannot control urination, urine cultures in such children are usually performed via urine bags. This method is noninvasive but has a high contamination rate. We studied the contamination rate of bag urine culture in diagnosing UTI in infants under two years and the factors responsible for contamination.
Methods
: We examined patients under 2 years in whom urine culture through the urine bag method yielded over 105 colonies of a single pathogen. We defined UTI by referring to the guidelines of The Korean Society of Pediatric Nephrology, 2005. We examined the factors responsible for contamination according to sex, duration of urine collection, and whether diarrhea took place with contamination rate.
Results
: We examined 717 patients (412 males and 305 females). The contamination rate of one bag urine culture was 37.9%. Gender was not related to the contamination rate (P>0.05). Duration of urine collection showed an association with the contamination rate. The longer the duration of collecting urine, the higher was the contamination rate. Duration of urine collection was divided into three groups: first group, 02 hours; second group, 24 hours; and third group, >4 hours. Contamination rates were 30.0%, 42.2%, and 43.7% for the first, second, and third groups, respectively, with statistical significance (P=0.001). Diarrhea at admission had no impact on the contamination rate (P>0.05).
Conclusion
: The contamination rate of urine culture in the examined patients was 37.9%. Gender and diarrhea symptoms were not responsible for contamination. In infants with a suspected UTI, urine should be collected within 2 hours through the urine bag method. If urine collection takes >2 hours, the urine bag should be resterilized and reattached to the patient.
Key Words: Urinary tract infection, Infant, Urine


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