Urine collection devices do not reduce contamination in women with suspected urinary tract infections

Reference

Hayward G, Mort S, Yu LM, et al. Urine collection devices to reduce contamination in urine samples for diagnosis of uncomplicated UTI: a single-blind randomised controlled trial in primary care. Br J Gen Pract 2022;72(716):e225-e233.

Synopsis

Contaminated urine samples are frequent in the evaluation of women with suspected urinary tract infections (UTIs); urine collection devices are being used to avoid this problem. These researchers randomized women in primary care settings who had suspected UTIs into 1 of 3 groups: use of the Peezy urine collection device (n = 395), use of the Whiz Midstream urine collection device (n = 398), or use of standard collection after instruction (n = 405). In the event that the patient was unable to use the urine collection device, she was asked to use the standard method. The urine samples were then used for dipstick analysis and were sent to a central laboratory that was unaware of group allocation for microscopy and culture. The authors defined a sample as contaminated if it had mixed growth on culture. Additionally, the researchers contacted the women 2 weeks after enrollment to assess symptoms, health care use, and health-related quality of life. Using intention-to-treat analysis, the authors report no difference in the rate of mixed growth among the 3 groups (overall = 27.4%). Device failures occurred in 25% of the Peezy device compared with 9% of the Whiz Midstream device. There was no difference in any of the other patient-reported measures.