Dipslide cultures in the investigation of suprapubic urinary bladder aspirates of infants and children.

Abstract

SUMMARY Suprapubic aspirates (SPAs) of the urinary bladder obtained from 793 infants and children with suspected urinary tract infection were grown on dipslides inoculated at the bedside as well as being cultured aerobically and anaerobically. In general, the findings on dipslides were in good agreement with those in the other culture media. The majority of the 403 dipslide-positive samples contained 105 or more bacteria/ml; only in 2 % was bacterial density less than 0I/ml. There were five specimens with no growth on dipslides; however, an organism considered to be significant for the patient was isolated in the other cultures. Thus dipslides proved to be adequate for the culture of most SPAs, but samples from patients with urological problems should be studied by more complete methods.Significant bacteriuria is generally held to occur when there are at least 105 bacteria/ml ofclean-voided urine, and findings of 103/ml or less are considered to be insignificant. However, any amount of bacteria, excluding common skin contaminants, in a suprapubic aspirate (SPA) of the urinary bladder is thought to be significant.' In certain cases, only suprapubic aspiration of urine seems to offer a correct diagnosis of urinary tract infection, especially in infants and children, and complications are rare.2 4 Dipslide cultures have been found useful for the diagnosis and follow-up of urinary tract infections from clean-voided urine specimens.35-8 However, low bacterial counts have not always been reliably detected on dipslides, which of course, is insignificant for clean-voided urine.6 Therefore, we decided to investigate the occurrence of low bacterial counts in SPAs of infants and children, and to compare findings on dipslides and plates inoculated at the bedside with those of aerobic and anaerobic cultures from SPA samples taken to the laboratory in a transport medium. Material and methods PATIENTSIn the first part of the study, 469 infants and children, aged from 1 day to 15 years, were studied in the