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International Urogynecology Journal
Published in: International Urogynecology Journal 6/2020

Open Access 01-06-2020 | Urinary Tract Infection | Original Article

A revalidation and critique of assumptions about urinary sample collection methods, specimen quality and contamination

Authors: Linda Collins, Sanchutha Sathiananthamoorthy, Jennifer Rohn, James Malone-Lee

Published in: International Urogynecology Journal | Issue 6/2020

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Abstract

Introduction and hypothesis

Midstream urine (MSU) is key in assessing lower urinary tract syndrome (LUTS), but contingent on some assumptions. The aim of this study was to compare the occurrence of contamination and the quality of substrates obtained from four different collections: MSU, catheter specimen urine (CSU), a commercial MSU collecting device (Peezy) and a natural void. Contamination was quantified by differential, uroplakin-positive, urothelial cell counts.

Methods

This was a single blind, crossover study conducted in two phases. First, we compared the MSU with CSU using urine culture, pyuria counts and differential counting of epithelial cells after immunofluorescence staining for uroplakin III (UP3). Second, we compared the three non-invasive (MSU, Peezy MSU™, natural void) methods using UP3 antibody staining only.

Results

The natural void was best at collecting bladder urinary sediment, with the majority of epithelial cells present derived from the urinary tract. CSU sampling missed much of the urinary sediment and showed sparse culture results. Finally, the MSU collection methods did not capture much of the bladder sediment.

Conclusion

We found little evidence for contamination with the four methods. Natural void was the best method for harvesting shed urothelial cells and white blood cells. It provides a richer sample of the inflammatory exudate, including parasitised urothelial cells and the microbial substrate. However, if the midstream sample is believed to be important, the MSU collection device is advantageous.
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Metadata
Title
A revalidation and critique of assumptions about urinary sample collection methods, specimen quality and contamination
Authors
Linda Collins
Sanchutha Sathiananthamoorthy
Jennifer Rohn
James Malone-Lee
Publication date
01-06-2020
Publisher
Springer International Publishing
Published in
International Urogynecology Journal / Issue 6/2020
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-020-04272-x

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