Cell and bacterial counts in the urine of normal infants and children.

Braude, Hillel D.; Forfar, J. O.; Gould, J. C.; McLeod, J. W.

doi:10.1136/bmj.4.5581.697

Cited by 30 publications

(19 citation statements)

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“…Cell counts, bacterial counts, organisms cultured, and urinary pH are shown in the Table. The criteria for infection in catheter specimens were either or both of the cell and bacterial counts given above and, for non-catheterized specimens, one or more of the cell counts, bacterial counts, and combined cell and bacterial counts ("combined counts ") given by Braude et al (1967) In making comparison between catheter and non-catheter urines evidence of infection in the catheter urine was considered to indicate genuine infection (with the exception of two cases mentioned later).…”

Section: Resultsmentioning

confidence: 99%

“…In the collection of urine from young children, particularly females, the use of adhesive plastic bags is the simplest procedure, but even when the bags are removed as soon as urine is passed into them a considerable amount of contamination has already occurred (Braude et al, 1967). Ideal " clean-catch " midstream specimens from girls can at times be obtained only after many attempts and many hours of patience.…”

Section: Discussionmentioning

confidence: 99%

“…With the methods described by Braude et al (1967) 92 nonsatheter specimens-76 (82%) midstream and 16 (18%) bagwere obtained from 68 patients, and thereafter a catheter specinen was obtained from each of them. Catheterization was carried out by a modification of the technique described by MAcLeod et al (1963), which is effective in delaying urinary 'ract infection in paraplegic patients, often for many weeks, if a daily change of catheter is made.…”

Section: Methodsmentioning

confidence: 99%

“…These include the age and sex of the patient, method of collection of the urine, time interval between micturition and urine examination, and technique of examination employed. The method of collection of urine is most important and for two common methodsplastic adhesive bags and midstream specimens-we have suggested diagnostic levels for cell and bacterial counts related to the age and sex of the patient and the type of collection 'Braude et al, 1967).To determine the validity of these levels non-catheter and -atheter specimens of urine were obtained from 68 patients. …”

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Diagnosis of urinary tract infection in childhood based on examination of pared non-catheter and catheter specimens of urine.

Braude¹,

Forfar²,

Gould³

et al. 1967

BMJ

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The accurate diagnosis of urinary tract infection. in infancy and childhood based on examination of the urine is made difficult by the number of variables involved. These include the age and sex of the patient, method of collection of the urine, time interval between micturition and urine examination, and technique of examination employed. The method of collection of urine is most important and for two common methodsplastic adhesive bags and midstream specimens-we have suggested diagnostic levels for cell and bacterial counts related to the age and sex of the patient and the type of collection 'Braude et al., 1967).To determine the validity of these levels non-catheter and -atheter specimens of urine were obtained from 68 patients. MaterialIn most of the patients the suspicion had arisen on clinical grounds that urinary tract infection might be present-a suspicion based on suggestive symptoms such as abdominal pain, dysuria, frequency of micturition, enuresis, unexplained vromiting or anorexia, and, in the case of infants, unexplained failure to thrive. Also in a number of symptomless cases routine examination of the urine had suggested that infection might be present. Of the 68 patients 49 were female and 19 nale. The ages ranged from 9 days to 11 years (see Table). MethodsWith the methods described by Braude et al. (1967) operator holds the catheter in position an assistant slowly injects 2 ml. of solution. A return flow alongside the catheter should occur. (If it does not the catheter has been inserted too far and the solution is being injected into the bladder. This may modify bacteriological but not cytological results.) The catheter is then withdrawn and the patient left for half an hourIn young boys catheterization often causes discomfort and it is advisable to anaesthetize the posterior urethra before the second or main part of the catheterization procedure by introducing a little anaesthetic jelly (Duncaine) into the urethra immediately after the irrigation procedure.After half an hour has elapsed the operator again scrubs up.and, holding the labia apart or retracting the foreskin, using sterile swabs, the genitalia are resprayed with Polybactrin as described above and the patient is retowelled. The operator puts on sterile gloves and catheterizes the bladder, using a sterile disposable plastic tube size 9 F.G. (feeding or umbilical tube) and a non-touch technique. The assistant, controlling the other end of the catheter with forceps, directs the urine into a sterile container. Normally a few drops are collected into a first bottle, which is discarded, and the remainder of the urine into a second. In small babies there may be little urine in the bladder, and under these circumstances the first bottle has to be used for bacteriological examinations. Effect of Polybactrin Catheterization on Bacterial Growth in the UrineIn most cases the antibacterial activity of the urine obtained after catheterization was determined by means of indicator plates sown with an antibiotic-sensitive staphylococcus and filter...

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

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