Which procedure improves the accuracy of urine testing when contamination is suspected?

Which procedure improves the accuracy of urine testing when contamination is suspected?

• A. Collect a second void sample later
• B. Clean peri-genital area and repeat with clean catch
• C. Ignore and proceed with treatment
• D. Send to culture without re-collection

Answer: (B)

Contamination in a urine sample can skew results because skin and vaginal organisms may be introduced into the specimen, making it harder to tell what’s truly in the bladder. The most effective way to improve accuracy when contamination is suspected is to clean the peri-genital area and repeat the collection using a clean catch midstream technique. Proper cleaning reduces the amount of stray bacteria from the surrounding skin or mucosa, and collecting midstream minimizes first-void organisms from the urethra. Instruct the patient to start urinating, then collect only the middle portion into a sterile container, keeping the container away from skin and mucosa (front-to-back cleaning for females, cleaning the tip for males). If contamination persists or a more sterile sample is needed, a catheterized collection may be considered. Choosing to simply collect another sample without addressing technique, or to ignore contamination or send a non-recollected sample for culture, can lead to unreliable results.

Contamination in a urine sample can skew results because skin and vaginal organisms may be introduced into the specimen, making it harder to tell what’s truly in the bladder. The most effective way to improve accuracy when contamination is suspected is to clean the peri-genital area and repeat the collection using a clean catch midstream technique. Proper cleaning reduces the amount of stray bacteria from the surrounding skin or mucosa, and collecting midstream minimizes first-void organisms from the urethra. Instruct the patient to start urinating, then collect only the middle portion into a sterile container, keeping the container away from skin and mucosa (front-to-back cleaning for females, cleaning the tip for males). If contamination persists or a more sterile sample is needed, a catheterized collection may be considered. Choosing to simply collect another sample without addressing technique, or to ignore contamination or send a non-recollected sample for culture, can lead to unreliable results.