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Urinalysis tracks source of infection DEAR DR. DONOHUE: I am a semi-retired RN. My doctor sent me to the lab for a urinalysis. They gave me an unsterile cup to use, and the results came back positive for bacteria. The doctor was going to start me on antibiotics. I requested a second test. When I returned to the lab, the clerk reached under her desk, pulled out a cup and gave it to me. I told her it was not sterile. She argued and said it was. I asked to speak with the manager, who also said the cups were sterile. Finally, she admitted that they used to use sealed, sterile cups, but the company made them change. How many people are needlessly put on antibiotics because of this practice? I would like your opinion. -- C.M. ANSWER: If the doctor wants to know which bacterium is causing a urinary infection, then the proper procedure for obtaining a urine specimen is quite rigid. The person has to cleanse the opening that allows passage of urine to the outside, and specific directions on how to do that have to be given. Then the person urinates the first part of the stream into the toilet or bedpan. That's done to flush out any bacteria that live in the urethra, the tube that empties the bladder to the outside. The rest of the urine is then emptied into a sterile container. It's the only way to obtain valid results. For a routine urinalysis, one not asking for the identification of a bacterium, it could be acceptable to use an unsterile container, but that might not be a money-saver. If bacteria from the container contaminate the specimen, a second test will have to be done -- or the person will be prescribed antibiotics, and that's throwing money away. This lab should listen to semi-retired RNs. They know what they're doing. The booklet on urinary-tract infections covers this topic in depth. Readers can obtain a copy by writing: Dr. Donohue -- No. 1204W, Box 536475, Orlando, FL32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6.75 Can. with the recipient's printed name and address. Please allow four weeks for delivery. (c) 2006 North America Syndicate
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