Is it Possible to Reduce Contamination Rates in Urine Cultures?

Introduction: We aimed to analyze the data of the patients whose urine culture was sent for one year, to determine the contamination rates and to discuss the corrective-preventive actions that can be applied to reduce the contamination rate. Materials and Methods: Patient data for the samples sent between January and December 2019 were scanned from the hospital automation system, and the findings were analyzed using the SPSS (Statistical Package for Social Sciences) for Windows 16.0 program. In order to reduce contamination rates, adult women who applied to outpatient clinics in 2020 were determined as the target group. The midstream urine collection method was prepared in an easy-to-understand way accompanied by figures and hung on the toilets, and the results were monitored for a month, followed by a detailed video prepared and made available to watch on the screen all day long in the women's restroom. Results: In 2019, 52.769 urine cultures of 54.8% pediatric and 45.2% adult patients were analyzed retrospectively. The mean age of the patients was 55.2 in adult males and 46.2 in adult females, 6.3 in boys and 7.6 in girls in children. Significant growth was detected only in 6582 (13%) of the samples. The total contamination rate was 46%, 21.5% for adult males, 59.8% for adult females, 35.6% for boys and 60.2% for girls. Analysis according to the sample type was performed in patients over three years of age and the contamination rate was 22.7% in the samples taken by catheter and 45.7% in the midstream urine (p< 0.05). It was observed that the highest contamination rate in adults was in pregnant outpatient clinics (89.6%), the lowest contamination rate was in intensive care units (17.9%), and the highest contamination rate in children was in emergency outpatient clinics (p< 0.05). Although a decrease in the contamination rate was found after written instructions in one-month follow-ups in 2020 (p< 0.05), video instructions did not have an additional corrective effect. Conclusion: The fact that the rate of contamination in urine cultures is very high compared to the data of the world and our country reveals that there is a need for more comprehensive and long-term follow-up studies within the framework of corrective actions.