چکیده (انگلیسی):

Background:Choice of urine sampling technique in urinary tract infection may impact diagnostic accuracy and thus lead
to possible over- or undertreatment. Currently no evidencebased consensus exists regarding correct sampling technique of
urine from women with symptoms of urinary tract infection in primary care. The aim of this study was to determine the
accuracy of urine culture from different sampling-techniques in symptomatic non-pregnant women in primary care.
Methods:A systematic review was conducted by searching Medline and Embase for clinical studies conducted in primary
care using a randomized or paired design to compare the result of urine culture obtained with two or more collection
techniques in adult, female, non-pregnant patients with symptoms of urinary tract infection. We evaluated quality of the
studies and compared accuracy based on dichotomized outcomes.
Results:We included seven studies investigating urine sampling technique in 1062 symptomatic patients in primary care.
Mid-stream-clean-catch had a positive predictive value of 0.79 to 0.95 and a negative predictive value close to 1 compared
to sterile techniques. Two randomized controlled trials found no difference in infection rate between
mid-stream-clean-catch, mid-stream-urine and random samples.
Conclusions:At present, no evidence suggests that sampling technique affects the accuracy of the microbiological
diagnosis in non-pregnant women with symptoms of urinary tract infection in primary care. However, the evidence
presented is in-direct and the difference between mid-stream-clean-catch, mid-stream-urine and random samples
remains to be investigated in a paired design to verify the present findings.