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An Accurate Method to Obtain Urine for Culture in Men With External Catheters

An Accurate Method to Obtain Urine for Culture in Men With External Catheters Abstract • Results of urine cultures from 26 male nursing home patients wearing external catheters, collected by a simple standardized technique, were compared with culture results from the same patients obtained by sterile in-and-out catheterization. The culture results were the same in 22 (85%) of the matched specimens, and specimens collected by the standardized technique were 100% sensitive and 94% specific in detecting significant growth of pathogenic organisms. In contrast, 13 (57%) of 23 specimens collected from patients with external catheters by the nursing home staff using their routine technique yielded three or more organisms and were considered contaminated. These results suggest that it is possible to obtain a urine specimen that reflects bladder urine in the vast majority of patients with external catheters, and thus potentially avoid the need for in-and-out catheterization when diagnosing and planning treatment for urinary tract infections in this population. (Arch Intern Med 1987;147:286-288) References 1. Resnick NM, Yalla SB: Management of urinary incontinence in the elderly. N Engl J Med 1985;313:800-805.Crossref 2. Ouslander JG, Uman GW: Urinary incontinence: Opportunities for research, education, and improvements in medical care in the nursing home setting , in Schneider E (ed): The Teaching Nursing Home: A New Approach to Geriatric Research and Medical Care . New York, Raven Press, 1985, pp 173-196. 3. Nicolle LE, Bjornson J, Harding GMK, et al: Bacteriuria in elderly institutionalized men. N Engl J Med 1983;309:1420-1425.Crossref 4. Brocklehurst JC, Dillane JB, Griffiths L, et al: The prevalence and symptomology of urinary infection in an aged population. Gerontol Clin 1968;10:242-253.Crossref 5. Garbaldi RA, Brodine S, Matsumiya S: Infections among patients in nursing homes: Policies, prevalence, and problems. N Engl J Med 1981; 305:731-735.Crossref 6. Magnussen MH, Robb SS: Nosocomial infections in a long-term care facility. Am J Infect Control 1980;8:12-17.Crossref 7. Cohen ED, Hierholzer WJ, Schilling CR, et al: Nosocomial infections in skilled nursing facilities: A preliminary survey. Public Health Rep 1979;94:162-165. 8. Irvine PW, Van Buren N, Crossley K: Causes of acute hospitalization of nursing home residents: The role of infection. J Am Geriatr Soc 1984;32: 103-107. 9. Gordon WZ, Kane RL, Rothenberg D: Acute hospitalization in a home for the aged. J Am Geriatr Soc 1985;33:519-523. 10. Ouslander JG, Fowler E: Incontinence in Veterans Administration nursing home care units. J Am Geriatr Soc 1985;33:33-40. 11. Kunin CM: Detection, Prevention and Management of Urinary Tract Infections . Philadelphia, Lea & Febiger, 1979. 12. Hirsh DD, Fainstein V, Musher DM: Do condom catheter collecting systems cause urinary tract infection? JAMA 1979;242:340-341.Crossref 13. Johnson ET: The condom catheter: Urinary tract infection and other complications. South Med J 1983;76:579-582.Crossref 14. Grahn D, Norman DC, White M, et al: Validity of urinary catheter specimen for diagnosis of urinary tract infection in the elderly. Arch Intern Med 1985;145:1858-1860.Crossref 15. Berquist D, Bronnestam R, Hedelin H, et al: The relevance of urinary sampling methods in patients with indwelling Foley catheters. Br J Urol 1980;52:92-95.Crossref 16. Wong ES, Hooten TM: Guidelines for prevention of catheter-associated urinary tract infections. Infect Control 1981;2:125-130. 17. Igou J: Incontinence in nursing homes: Research and educational issues from the nursing perspective. Clin Geriatr Med 1986;2:873-885. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

An Accurate Method to Obtain Urine for Culture in Men With External Catheters

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References (20)

Publisher
American Medical Association
Copyright
Copyright © 1987 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1987.00370020104045
Publisher site
See Article on Publisher Site

Abstract

Abstract • Results of urine cultures from 26 male nursing home patients wearing external catheters, collected by a simple standardized technique, were compared with culture results from the same patients obtained by sterile in-and-out catheterization. The culture results were the same in 22 (85%) of the matched specimens, and specimens collected by the standardized technique were 100% sensitive and 94% specific in detecting significant growth of pathogenic organisms. In contrast, 13 (57%) of 23 specimens collected from patients with external catheters by the nursing home staff using their routine technique yielded three or more organisms and were considered contaminated. These results suggest that it is possible to obtain a urine specimen that reflects bladder urine in the vast majority of patients with external catheters, and thus potentially avoid the need for in-and-out catheterization when diagnosing and planning treatment for urinary tract infections in this population. (Arch Intern Med 1987;147:286-288) References 1. Resnick NM, Yalla SB: Management of urinary incontinence in the elderly. N Engl J Med 1985;313:800-805.Crossref 2. Ouslander JG, Uman GW: Urinary incontinence: Opportunities for research, education, and improvements in medical care in the nursing home setting , in Schneider E (ed): The Teaching Nursing Home: A New Approach to Geriatric Research and Medical Care . New York, Raven Press, 1985, pp 173-196. 3. Nicolle LE, Bjornson J, Harding GMK, et al: Bacteriuria in elderly institutionalized men. N Engl J Med 1983;309:1420-1425.Crossref 4. Brocklehurst JC, Dillane JB, Griffiths L, et al: The prevalence and symptomology of urinary infection in an aged population. Gerontol Clin 1968;10:242-253.Crossref 5. Garbaldi RA, Brodine S, Matsumiya S: Infections among patients in nursing homes: Policies, prevalence, and problems. N Engl J Med 1981; 305:731-735.Crossref 6. Magnussen MH, Robb SS: Nosocomial infections in a long-term care facility. Am J Infect Control 1980;8:12-17.Crossref 7. Cohen ED, Hierholzer WJ, Schilling CR, et al: Nosocomial infections in skilled nursing facilities: A preliminary survey. Public Health Rep 1979;94:162-165. 8. Irvine PW, Van Buren N, Crossley K: Causes of acute hospitalization of nursing home residents: The role of infection. J Am Geriatr Soc 1984;32: 103-107. 9. Gordon WZ, Kane RL, Rothenberg D: Acute hospitalization in a home for the aged. J Am Geriatr Soc 1985;33:519-523. 10. Ouslander JG, Fowler E: Incontinence in Veterans Administration nursing home care units. J Am Geriatr Soc 1985;33:33-40. 11. Kunin CM: Detection, Prevention and Management of Urinary Tract Infections . Philadelphia, Lea & Febiger, 1979. 12. Hirsh DD, Fainstein V, Musher DM: Do condom catheter collecting systems cause urinary tract infection? JAMA 1979;242:340-341.Crossref 13. Johnson ET: The condom catheter: Urinary tract infection and other complications. South Med J 1983;76:579-582.Crossref 14. Grahn D, Norman DC, White M, et al: Validity of urinary catheter specimen for diagnosis of urinary tract infection in the elderly. Arch Intern Med 1985;145:1858-1860.Crossref 15. Berquist D, Bronnestam R, Hedelin H, et al: The relevance of urinary sampling methods in patients with indwelling Foley catheters. Br J Urol 1980;52:92-95.Crossref 16. Wong ES, Hooten TM: Guidelines for prevention of catheter-associated urinary tract infections. Infect Control 1981;2:125-130. 17. Igou J: Incontinence in nursing homes: Research and educational issues from the nursing perspective. Clin Geriatr Med 1986;2:873-885.

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Feb 1, 1987

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