| Author . | Setting, country . | Population . | Comparison . | Diagnostic accuracy results . | Contamination results . |
|---|---|---|---|---|---|
| Morris,11 1979 | General practice, UK | n = 180. Age not mentioned | Unclear how patients were allocated. Two groups (unclear if there were 40 paired samples): MSU collected in surgeries (n = 140) vs. MSCC after cleansing with sterile water at home and supervised by nurses (n = 40) | Definitive infection (≥105 CFU/ml of a single microorganism) in 91% in the MSU group without cleansing and 92% in the MSCC group after cleansing | Contamination was defined as mixed growths of ≥ 105 CFU/ml or 104–105. Contaminated samples in 9% in the MSU group and 8% in the MSCC group |
| Bradbury,12 1988 | General practice, UK | n = 158 aged 16-75 yr. | RCT. MSU without cleansing (n = 65) vs. MSCC after cleansing with water and soup (n = 93) | Definitive infection (≥105 CFU/ml) in 16 (24.6%) cases in MSU samples and 23 (24.7%) specimens with MSCC | Contamination was defined by the presence of epithelial cells. There were 6 contaminated samples (9.2%) in the MSU group vs. 8 (8.6%) in the MSCC group |
| Bærheim,13 1990 | General practice, Norway | n = 73 aged 18-60 yr. | Paired samples. Home voided urine samples vs. MSCC after cleansing with water (n = 73) | Bacteriuria, considered with a cut-off point of ≥ 104 CFU/ml, was observed in 52 (71.2%) specimens in home voided samples and 54 (73.9%) in MSCC samples. The overall agreement rates were Κ=0.70 with a cut-off point of 104 CFU/ml and Κ=0.74 with 105 CFU/ml | Contaminated samples (coagulase-negative staphylococci and other gram-positives) in 3 (4.1%) and 7 (9.6%) samples, respectively |
| Lifshitz,14 2000 | University clinic, US | n = 242 aged 17–50 yr | RCT. Three groups: 1. Urine into a clean container (no cleansing, no midstream) (n = 77); 2. MSCC after cleansing with water and bactericidal wipe (n = 84); 3. MSCC after cleansing with bactericidal wipe and insertion of a vaginal tampon prior to urine collection (n = 81) | Definitive infection defined as the growth of a germ ≥ 104 CFU/ml in 44 specimens of the group without cleansing (57.1%), 42 in the MSCC group without tampon (50%) and 46 in the MSCC group with tampon (56.8%) | Contamination defined as mixed growth and low levels (<104 CFU/ml) of organisms commonly found on the skin and external and internal genitalia. Contaminated samples in 22 samples of the group without cleansing (28.6), 27 in the MSCC group without tampon (32.1%) and 25 patients with MSCC + tampon insertion (30.9%) |
| Eley,152016 | Emergency department, Australia | n = 240a, aged 18 or over | Pseudo-RCT. The two groups provided MSCC samples after cleansing with water and a towelette. Only verbal instructions (n = 120) vs. illustrated instructions (n = 120) | Definitive infections confirmed in 11 cases in the group assigned to verbal instructions (9.2%) and in 15 cases among those with illustrated instructions (12.5%) | Contaminated samples were defined as the presence of 10 or more epithelial cells per high power field. Differences in contamination. Contamination rates in 47 (39.2%) and 30 (25%) cases, respectively |
| Hølmkjær,16 2018 | General practice, Denmark | n = 117 aged 18 or older | Paired samples. FVU vs MSU (n = 117) | Definitive infection was considered with a cut-off point of ≥ 103 CFU/ml analysed immediately after collection. Overall agreement of the FVU and MSU collection was observed in 90 cases (76.9%) and 98 cases (83.8%), respectivelyb | No data |
| Author . | Setting, country . | Population . | Comparison . | Diagnostic accuracy results . | Contamination results . |
|---|---|---|---|---|---|
| Morris,11 1979 | General practice, UK | n = 180. Age not mentioned | Unclear how patients were allocated. Two groups (unclear if there were 40 paired samples): MSU collected in surgeries (n = 140) vs. MSCC after cleansing with sterile water at home and supervised by nurses (n = 40) | Definitive infection (≥105 CFU/ml of a single microorganism) in 91% in the MSU group without cleansing and 92% in the MSCC group after cleansing | Contamination was defined as mixed growths of ≥ 105 CFU/ml or 104–105. Contaminated samples in 9% in the MSU group and 8% in the MSCC group |
| Bradbury,12 1988 | General practice, UK | n = 158 aged 16-75 yr. | RCT. MSU without cleansing (n = 65) vs. MSCC after cleansing with water and soup (n = 93) | Definitive infection (≥105 CFU/ml) in 16 (24.6%) cases in MSU samples and 23 (24.7%) specimens with MSCC | Contamination was defined by the presence of epithelial cells. There were 6 contaminated samples (9.2%) in the MSU group vs. 8 (8.6%) in the MSCC group |
| Bærheim,13 1990 | General practice, Norway | n = 73 aged 18-60 yr. | Paired samples. Home voided urine samples vs. MSCC after cleansing with water (n = 73) | Bacteriuria, considered with a cut-off point of ≥ 104 CFU/ml, was observed in 52 (71.2%) specimens in home voided samples and 54 (73.9%) in MSCC samples. The overall agreement rates were Κ=0.70 with a cut-off point of 104 CFU/ml and Κ=0.74 with 105 CFU/ml | Contaminated samples (coagulase-negative staphylococci and other gram-positives) in 3 (4.1%) and 7 (9.6%) samples, respectively |
| Lifshitz,14 2000 | University clinic, US | n = 242 aged 17–50 yr | RCT. Three groups: 1. Urine into a clean container (no cleansing, no midstream) (n = 77); 2. MSCC after cleansing with water and bactericidal wipe (n = 84); 3. MSCC after cleansing with bactericidal wipe and insertion of a vaginal tampon prior to urine collection (n = 81) | Definitive infection defined as the growth of a germ ≥ 104 CFU/ml in 44 specimens of the group without cleansing (57.1%), 42 in the MSCC group without tampon (50%) and 46 in the MSCC group with tampon (56.8%) | Contamination defined as mixed growth and low levels (<104 CFU/ml) of organisms commonly found on the skin and external and internal genitalia. Contaminated samples in 22 samples of the group without cleansing (28.6), 27 in the MSCC group without tampon (32.1%) and 25 patients with MSCC + tampon insertion (30.9%) |
| Eley,152016 | Emergency department, Australia | n = 240a, aged 18 or over | Pseudo-RCT. The two groups provided MSCC samples after cleansing with water and a towelette. Only verbal instructions (n = 120) vs. illustrated instructions (n = 120) | Definitive infections confirmed in 11 cases in the group assigned to verbal instructions (9.2%) and in 15 cases among those with illustrated instructions (12.5%) | Contaminated samples were defined as the presence of 10 or more epithelial cells per high power field. Differences in contamination. Contamination rates in 47 (39.2%) and 30 (25%) cases, respectively |
| Hølmkjær,16 2018 | General practice, Denmark | n = 117 aged 18 or older | Paired samples. FVU vs MSU (n = 117) | Definitive infection was considered with a cut-off point of ≥ 103 CFU/ml analysed immediately after collection. Overall agreement of the FVU and MSU collection was observed in 90 cases (76.9%) and 98 cases (83.8%), respectivelyb | No data |
CFU, colony-forming unit; FVU, first voided urine; MSCC, midstream clean-catch; MSU, mid-stream urine; RCT, randomized clinical trial.
Women presenting symptoms of infection (e.g., flank pain, painful urination, and fever) for which urinalysis was clinically required.
Only the MSU samples were sent to the microbiology lab for urine culture.
| Author . | Setting, country . | Population . | Comparison . | Diagnostic accuracy results . | Contamination results . |
|---|---|---|---|---|---|
| Morris,11 1979 | General practice, UK | n = 180. Age not mentioned | Unclear how patients were allocated. Two groups (unclear if there were 40 paired samples): MSU collected in surgeries (n = 140) vs. MSCC after cleansing with sterile water at home and supervised by nurses (n = 40) | Definitive infection (≥105 CFU/ml of a single microorganism) in 91% in the MSU group without cleansing and 92% in the MSCC group after cleansing | Contamination was defined as mixed growths of ≥ 105 CFU/ml or 104–105. Contaminated samples in 9% in the MSU group and 8% in the MSCC group |
| Bradbury,12 1988 | General practice, UK | n = 158 aged 16-75 yr. | RCT. MSU without cleansing (n = 65) vs. MSCC after cleansing with water and soup (n = 93) | Definitive infection (≥105 CFU/ml) in 16 (24.6%) cases in MSU samples and 23 (24.7%) specimens with MSCC | Contamination was defined by the presence of epithelial cells. There were 6 contaminated samples (9.2%) in the MSU group vs. 8 (8.6%) in the MSCC group |
| Bærheim,13 1990 | General practice, Norway | n = 73 aged 18-60 yr. | Paired samples. Home voided urine samples vs. MSCC after cleansing with water (n = 73) | Bacteriuria, considered with a cut-off point of ≥ 104 CFU/ml, was observed in 52 (71.2%) specimens in home voided samples and 54 (73.9%) in MSCC samples. The overall agreement rates were Κ=0.70 with a cut-off point of 104 CFU/ml and Κ=0.74 with 105 CFU/ml | Contaminated samples (coagulase-negative staphylococci and other gram-positives) in 3 (4.1%) and 7 (9.6%) samples, respectively |
| Lifshitz,14 2000 | University clinic, US | n = 242 aged 17–50 yr | RCT. Three groups: 1. Urine into a clean container (no cleansing, no midstream) (n = 77); 2. MSCC after cleansing with water and bactericidal wipe (n = 84); 3. MSCC after cleansing with bactericidal wipe and insertion of a vaginal tampon prior to urine collection (n = 81) | Definitive infection defined as the growth of a germ ≥ 104 CFU/ml in 44 specimens of the group without cleansing (57.1%), 42 in the MSCC group without tampon (50%) and 46 in the MSCC group with tampon (56.8%) | Contamination defined as mixed growth and low levels (<104 CFU/ml) of organisms commonly found on the skin and external and internal genitalia. Contaminated samples in 22 samples of the group without cleansing (28.6), 27 in the MSCC group without tampon (32.1%) and 25 patients with MSCC + tampon insertion (30.9%) |
| Eley,152016 | Emergency department, Australia | n = 240a, aged 18 or over | Pseudo-RCT. The two groups provided MSCC samples after cleansing with water and a towelette. Only verbal instructions (n = 120) vs. illustrated instructions (n = 120) | Definitive infections confirmed in 11 cases in the group assigned to verbal instructions (9.2%) and in 15 cases among those with illustrated instructions (12.5%) | Contaminated samples were defined as the presence of 10 or more epithelial cells per high power field. Differences in contamination. Contamination rates in 47 (39.2%) and 30 (25%) cases, respectively |
| Hølmkjær,16 2018 | General practice, Denmark | n = 117 aged 18 or older | Paired samples. FVU vs MSU (n = 117) | Definitive infection was considered with a cut-off point of ≥ 103 CFU/ml analysed immediately after collection. Overall agreement of the FVU and MSU collection was observed in 90 cases (76.9%) and 98 cases (83.8%), respectivelyb | No data |
| Author . | Setting, country . | Population . | Comparison . | Diagnostic accuracy results . | Contamination results . |
|---|---|---|---|---|---|
| Morris,11 1979 | General practice, UK | n = 180. Age not mentioned | Unclear how patients were allocated. Two groups (unclear if there were 40 paired samples): MSU collected in surgeries (n = 140) vs. MSCC after cleansing with sterile water at home and supervised by nurses (n = 40) | Definitive infection (≥105 CFU/ml of a single microorganism) in 91% in the MSU group without cleansing and 92% in the MSCC group after cleansing | Contamination was defined as mixed growths of ≥ 105 CFU/ml or 104–105. Contaminated samples in 9% in the MSU group and 8% in the MSCC group |
| Bradbury,12 1988 | General practice, UK | n = 158 aged 16-75 yr. | RCT. MSU without cleansing (n = 65) vs. MSCC after cleansing with water and soup (n = 93) | Definitive infection (≥105 CFU/ml) in 16 (24.6%) cases in MSU samples and 23 (24.7%) specimens with MSCC | Contamination was defined by the presence of epithelial cells. There were 6 contaminated samples (9.2%) in the MSU group vs. 8 (8.6%) in the MSCC group |
| Bærheim,13 1990 | General practice, Norway | n = 73 aged 18-60 yr. | Paired samples. Home voided urine samples vs. MSCC after cleansing with water (n = 73) | Bacteriuria, considered with a cut-off point of ≥ 104 CFU/ml, was observed in 52 (71.2%) specimens in home voided samples and 54 (73.9%) in MSCC samples. The overall agreement rates were Κ=0.70 with a cut-off point of 104 CFU/ml and Κ=0.74 with 105 CFU/ml | Contaminated samples (coagulase-negative staphylococci and other gram-positives) in 3 (4.1%) and 7 (9.6%) samples, respectively |
| Lifshitz,14 2000 | University clinic, US | n = 242 aged 17–50 yr | RCT. Three groups: 1. Urine into a clean container (no cleansing, no midstream) (n = 77); 2. MSCC after cleansing with water and bactericidal wipe (n = 84); 3. MSCC after cleansing with bactericidal wipe and insertion of a vaginal tampon prior to urine collection (n = 81) | Definitive infection defined as the growth of a germ ≥ 104 CFU/ml in 44 specimens of the group without cleansing (57.1%), 42 in the MSCC group without tampon (50%) and 46 in the MSCC group with tampon (56.8%) | Contamination defined as mixed growth and low levels (<104 CFU/ml) of organisms commonly found on the skin and external and internal genitalia. Contaminated samples in 22 samples of the group without cleansing (28.6), 27 in the MSCC group without tampon (32.1%) and 25 patients with MSCC + tampon insertion (30.9%) |
| Eley,152016 | Emergency department, Australia | n = 240a, aged 18 or over | Pseudo-RCT. The two groups provided MSCC samples after cleansing with water and a towelette. Only verbal instructions (n = 120) vs. illustrated instructions (n = 120) | Definitive infections confirmed in 11 cases in the group assigned to verbal instructions (9.2%) and in 15 cases among those with illustrated instructions (12.5%) | Contaminated samples were defined as the presence of 10 or more epithelial cells per high power field. Differences in contamination. Contamination rates in 47 (39.2%) and 30 (25%) cases, respectively |
| Hølmkjær,16 2018 | General practice, Denmark | n = 117 aged 18 or older | Paired samples. FVU vs MSU (n = 117) | Definitive infection was considered with a cut-off point of ≥ 103 CFU/ml analysed immediately after collection. Overall agreement of the FVU and MSU collection was observed in 90 cases (76.9%) and 98 cases (83.8%), respectivelyb | No data |
CFU, colony-forming unit; FVU, first voided urine; MSCC, midstream clean-catch; MSU, mid-stream urine; RCT, randomized clinical trial.
Women presenting symptoms of infection (e.g., flank pain, painful urination, and fever) for which urinalysis was clinically required.
Only the MSU samples were sent to the microbiology lab for urine culture.
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