Effectiveness of direct interaction and communication with patients, as one preanalytic parameter on reduction of urine culture contamination rate

BACKGROUND: Urine culture contamination is the result of mixing commensal flora of the lower urinary tract during the collection of midstream urine. As patients themselves collect urine sample, urine culture analysis depends on their collection method, which is an important preanalytical issue.OBJECTIVES: This study was conducted in the Department of Microbiology, Institute of Post Graduate Medical Education and Research and SSKM Hospital, Kolkata, during the month of May and June 2016, with aim to assess the role of communication and verbal instructions explaining “Midstream clean-catch (MSCC) technique” before collection of urine to the adult female outpatients on urine “Culture Contamination Rate” (CCR).MATERIALS AND METHODS: Three hundred and ninety-six female patients were assigned in one of the two groups: “I” (Instructed) group (n = 196) and “N” (Nothing) group (n = 200). Verbal instructions in local (Bengali) language only provided to the Group “I”. Urine samples were processed in the laboratory. Laboratory technicians and microbiologists were blinded about the groups. Urine culture results were collected from laboratory records.RESULTS: The CCR in the Group I and Group N was 6.1% and 19.5%, respectively (P < 0.001). Positive culture was observed in 31.6% (62/196) in Group I and 24.0% (48/200) in Group N, which was comparable statistically (P = 0.09). Instruction and communication have been found to be more effective at reduction of urine culture contamination among patients of the age group of 21–30 years (P < 0.001) and lower socioeconomic class (P < 0.001).CONCLUSIONS: CCR was significantly lower in the group who were provided verbal instruction for MSCC. Thus, proper collection technique may reduce the need of the repeat sample due to contamination and prevent from the unnecessary antibiotic treatment.