Cystitis laboratory findings: Difference between revisions
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**Clean Catch collection from Urine bag | **Clean Catch collection from Urine bag | ||
Of all these methods suprapubic aspiration has the least contamintaion rate that is around 1%, while that for transurethral catheterisation has 6-12% and clean catch urine collected in a bag can have the highest contamination rate of 16-63% | Of all these methods suprapubic aspiration has the least contamintaion rate that is around 1%, while that for transurethral catheterisation has 6-12% and clean catch urine collected in a bag can have the highest contamination rate of 16-63%.<ref name="pmid27542848">{{cite journal| author=Labrosse M, Levy A, Autmizguine J, Gravel J| title=Evaluation of a New Strategy for Clean-Catch Urine in Infants. | journal=Pediatrics | year= 2016 | volume= 138 | issue= 3 | pages= | pmid=27542848 | doi=10.1542/peds.2016-0573 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27542848 }} </ref><ref name="pmid22537082">{{cite journal| author=Tosif S, Baker A, Oakley E, Donath S, Babl FE| title=Contamination rates of different urine collection methods for the diagnosis of urinary tract infections in young children: an observational cohort study. | journal=J Paediatr Child Health | year= 2012 | volume= 48 | issue= 8 | pages= 659-64 | pmid=22537082 | doi=10.1111/j.1440-1754.2012.02449.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22537082 }} </ref><ref name="pmid10931415">{{cite journal| author=Al-Orifi F, McGillivray D, Tange S, Kramer MS| title=Urine culture from bag specimens in young children: are the risks too high? | journal=J Pediatr | year= 2000 | volume= 137 | issue= 2 | pages= 221-6 | pmid=10931415 | doi=10.1067/mpd.2000.107466 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10931415 }} </ref> With any technique the rate of contamination can be decreased by discarding the initial stream of urine and collecting and using the middle stream of urine so that the bacteria already present on the skin or he catheter do not effect the results. <ref name="pmid21873693">{{cite journal| author=Subcommittee on Urinary Tract Infection, Steering Committee on Quality Improvement and Management. Roberts KB| title=Urinary tract infection: clinical practice guideline for the diagnosis and management of the initial UTI in febrile infants and children 2 to 24 months. | journal=Pediatrics | year= 2011 | volume= 128 | issue= 3 | pages= 595-610 | pmid=21873693 | doi=10.1542/peds.2011-1330 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21873693 }} </ref> <ref name="pmid10784208">{{cite journal| author=Dayan PS, Chamberlain JM, Boenning D, Adirim T, Schor JA, Klein BL| title=A comparison of the initial to the later stream urine in children catheterized to evaluate for a urinary tract infection. | journal=Pediatr Emerg Care | year= 2000 | volume= 16 | issue= 2 | pages= 88-90 | pmid=10784208 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10784208 }} </ref> | ||
===Urinalysis=== | ===Urinalysis=== | ||
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Steven C. Campbell, M.D., Ph.D.
Overview
Presence of signs and symptoms of cystitis like dysuria, noctuira, frequency and urgency increase the probability of confirmation of Cystitis as the diagnosis. Laboratory tests used in the diagnosis and confirmation of cystitis include urinalysis and urine culture. Laboratory findings consistent with the diagnosis of cystitis include pyuria and either white blood cells (WBCs) or red blood cells (RBCs) on urinalysis and a positive urine culture.[1]
Laboratory Findings
- A urine sample is require to do urinalysis and urine culture to look for the causative organisms. Careful collection is required to minimise the contamination of the sample to decrease the false positive results.
- Collection of urine from toilet trained children and adults by clean catch method is easy. Sample collection in children who are not toilet trained can be difficult and is achieved by either of these methods:[2]
- Suprapubic aspiration
- Catheterizaion across urethra
- Clean Catch collection from Urine bag
Of all these methods suprapubic aspiration has the least contamintaion rate that is around 1%, while that for transurethral catheterisation has 6-12% and clean catch urine collected in a bag can have the highest contamination rate of 16-63%.[2][3][4] With any technique the rate of contamination can be decreased by discarding the initial stream of urine and collecting and using the middle stream of urine so that the bacteria already present on the skin or he catheter do not effect the results. [5] [6]
Urinalysis
- A urinalysis commonly reveals white blood cells (WBCs) or red blood cells (RBCs).
- Pyuria: >5-10 WBC/hpf or 27 WBC/microliter
- Dipstick:
- Nitrate reductase test: The nitrate reductase test is a test to differentiate between bacteria based on their ability or inability to reduce nitrate (NO3) to nitrite (NO2) using anaerobic respiration.
- Leukocyte esterase: Leukocyte esterase (LE) is a urine test for the presence of white blood cells and other abnormalities associated with infection.
Urine Culture
- A urine culture (clean catch) or catheterized urine specimen may be performed to determine the type of bacteria in the urine and the appropriate antibiotic for treatment.
- Most patients with urinary tract infection will have > 100,000 colonies of organism.
Bacterial Culture
Viral Culture
Fungal Culture
References
- ↑ Shaikh N, Morone NE, Lopez J, Chianese J, Sangvai S, D'Amico F; et al. (2007). "Does this child have a urinary tract infection?". JAMA. 298 (24): 2895–904. doi:10.1001/jama.298.24.2895. PMID 18159059.
- ↑ 2.0 2.1 Labrosse M, Levy A, Autmizguine J, Gravel J (2016). "Evaluation of a New Strategy for Clean-Catch Urine in Infants". Pediatrics. 138 (3). doi:10.1542/peds.2016-0573. PMID 27542848.
- ↑ Tosif S, Baker A, Oakley E, Donath S, Babl FE (2012). "Contamination rates of different urine collection methods for the diagnosis of urinary tract infections in young children: an observational cohort study". J Paediatr Child Health. 48 (8): 659–64. doi:10.1111/j.1440-1754.2012.02449.x. PMID 22537082.
- ↑ Al-Orifi F, McGillivray D, Tange S, Kramer MS (2000). "Urine culture from bag specimens in young children: are the risks too high?". J Pediatr. 137 (2): 221–6. doi:10.1067/mpd.2000.107466. PMID 10931415.
- ↑ Subcommittee on Urinary Tract Infection, Steering Committee on Quality Improvement and Management. Roberts KB (2011). "Urinary tract infection: clinical practice guideline for the diagnosis and management of the initial UTI in febrile infants and children 2 to 24 months". Pediatrics. 128 (3): 595–610. doi:10.1542/peds.2011-1330. PMID 21873693.
- ↑ Dayan PS, Chamberlain JM, Boenning D, Adirim T, Schor JA, Klein BL (2000). "A comparison of the initial to the later stream urine in children catheterized to evaluate for a urinary tract infection". Pediatr Emerg Care. 16 (2): 88–90. PMID 10784208.