摘要
目的:尿样本常受到严重的混合生长菌污染,本实验目的在于评估小便收集垫(UCP)这种改良方法对于降低疑有尿路感染(UTI)患儿的尿标本污染的能力。方法:2岁以下的发热患儿随机使用两种UCP方法,相同的UCP放在尿布里直到尿液完全浸透(单一UCP组); 每30 min更换一个新的UCP直到尿液浸透(更换UCP 组)。两组都使用湿度敏感声音报警器。
Aim: To evaluate a modified urine collection pad (UCP) method for its ability to reduce heavy mixed growth bacterial contamination of UCP samples in young children with suspected urinary tract infection (UTI) . Method: Febrile children under 2 years of age were randomised to two UCP methods: the same UCP kept in the nappy until urine was passed (single UCP group), or the UCP replaced with a fresh one every 30 minutes until urine was passed (replaced UCP group). In both groups a moisture sensitive audio alarm was used to signal passage of urine. Results: Eighty children were enrolled and a satisfactory sample was obtained in 68 (37 in the single UCP group and 31 in the replaced UCP group) . In 12 children (15% ), collection failed, mainly because of faecal soiling of the pad. UTI occurred in three children (4% ) . In the remaining 65 samples, heavy mixed growth ( > 105 organisms/ml) occurred in 1/31 (3% ) in the replaced UCP group compared with 10/35 (29% ) in the single UCP group (p = 0. 008). There were no adverse effects from the use of the moisture sensitive audio alarm. Conclusion: Changing the UCP every 30 minutes almost eliminates heavy mixed growth contamination of UCP samples and substantially increases the proportion of UCP results that confidendy exclude UTI. This represents a simple and clinically important improvement to the UCP method which is reliable for diagnosing and excluding UTI in young children still in nappies. It has potential for use in outpatient clinics, in the primary healthcare setting, or at home.
