title: Effect of urogenital cleaning with paper soap on bacterial contamination rate while collecting midstream urine specimens.
abstract: BACKGROUND
  Urinary tract infection (UTI) is one of the major health problems. Urine culture is considered as a gold standard method for the diagnosis of UTI. But, improper sample collection can lead to contamination with normal urogenital flora. Use of any portable disinfectant that can reduce contamination rate would be the significant help in urine culture interpretation.
  
  
  OBJECTIVE
  To observe the effect of urogenital cleaning with paper soap on bacterial contamination rate while collecting specimens.
  
  
  METHODS
  A cross-sectional comparative study was done in 600 patients aged 15-45 years, equally divided into three groups. The first group was given sterile container and instructed to collect midstream clean catch urine (MSU) after urogenital cleaning with provided piece of paper soap. The second group was given sterile container and strictly instructed to collect the MSU sample after urogenital cleansing by tap water only. The third group was given the sterile container and asked for midstream urine. Collected specimens were inoculated in CLED media, incubated aerobically for overnight at 37°C. Reporting of culture was done according to the guideline of American Society of Microbiology.
  
  
  RESULTS
  The contamination rate in the three groups were 6.0%, 13.0%, and 27.5%, respectively (P value < 0.05), which was statistically significant.
  
  
  CONCLUSIONS
  Contamination rate was significantly lower in group who provided urine specimen after urogenital cleaning with paper soap. Thus, cleaning the urogenital area may reduce the need of the repeat sample to rule out actual contamination and prevent from the unnecessary antibiotic treatment.
authors.affiliation: Department of Microbiology, B. P. Koirala Institute of Health Sciences, Dharan, Nepal.
authors.forename: Rashmi
authors.initials: R
authors.lastname: Shrestha
authors.forename: Narayan
authors.initials: N
authors.lastname: Gyawali
authors.forename: Rajendra
authors.initials: R
authors.lastname: Gurung
authors.forename: Ritu
authors.initials: R
authors.lastname: Amatya
authors.forename: Shyamal Kumar
authors.initials: SK
authors.lastname: Bhattacharya
keywords: Contamination; paper soap; urine culture