A COMPARATIVE STUDY OF BACTERIAL CULTURES AND COLONY COUNTS IN PAIRED SPECIMENS OF URINE OBTAINED BY CATHETER VERSUS VOIDING FROM NORMAL INFANTS AND INFANTS WITH URINARY TRACT INFECTION
Bacteriologic studies, including cultures and colony counts, of catheterized and voided specimens of urine from infants (all under 2 years of age) were carried out in three groups: Group I, paired specimens (catheter and clean-voided); Group II, random non-clean-voided specimens; Group III, clean-voided and catheter specimens in a group of infants with clinical evidence of urinary tract infection. In 70% of the Group I patients there was complete "diagnostic" correlation between catheter and clean-voided specimens if one accepts the figure of 1,000 colonies/ml of urine as the dividing line between a true bacteriuria and contamination, as established in this clinic for those over 2 years of age. While a 96% "diagnostic" correlation between clean-voided and catheter specimens is observed if the line between "contamination" and "infection" is placed at 10,000 colonies/ml, and this figure corresponds to the 98% correlation figure found in the group over 2 years of age, it is our feeling that the critical count should remain at 1,000 colonies/ml of urine for both infants and children. Repeat examination of clean-voided or catheter specimens should resolve all equivocal findings. Proper "strapping" of boy and girl infants after careful cleansing of perineum, vulva or prepuce and glans will provide satisfactory samples of urine for bacteriologic study. Where doubtful results are obtained, the study of more than one specimen of urine is absolutely necessary. Catheterization, under certain circumstances, may be necessary to clarify doubtful findings, but this should be carried out with the full realization of the risk of introducing infection.