Prevalence and predictors of urine culture contamination in primary care: A cross-sectional study.
Michael A Hansen, Marissa Valentine-King, Roger Zoorob and 11 others
PMID 35914376WHAT IT FOUND
In two clinics, 54.9% of urine cultures were contaminated.
Women, pregnant patients and patients with obesity were more likely to have contaminated samples.
Key findings
01In primary care clinics, 54.9% of 1265 urine cultures were contaminated.
02After accounting for other factors, non-pregnant women, pregnant women and patients with obesity were more likely to have contaminated cultures.
03Among symptomatic patients, 22.9% with contaminated cultures were treated, compared with 11.6% with no growth.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was done in safety-net primary care clinics, so the contamination rate may not apply to other settings. It relied on chart notes, so symptoms, antibiotics and collection instructions may be missing or misclassified. Urinalysis results were not extracted. The study did not measure who gave collection instructions, how clear the instructions were, staff training, workload, language barriers or health literacy. It could not tell whether antibiotics were started because of symptoms or because of culture results. A coordinator extracted data, and the study did not calculate agreement between reviewers. Some patients contributed more than one culture. The study is observational, so the factors linked to contamination and positive cultures are associations, not proven causes.
The easy way to misread this
Do not conclude that better clean-catch instructions will reduce contamination or antibiotic use. This was a chart review of prevalence and associations, not a trial of an education intervention.