MAIN MENU
Return to Table of Contents
40
PERIURETHRAL CLEANING PRIOR TO URINARY CATHETERIZATION IN CHILDREN - STERILE WATER VERSUS 10% POVIDONE-IODINE
S Al-Farsi, M Oliva, R Davidson, S Richardson, S Ratnapalan
Hospital for Sick Children
BACKGROUND: Urinary catheterization is the method of choice in many institutions in North America for obtaining urine from a febrile infant. Many institutions clean the periurethral area with 10% Povidone-iodine prior to urinary catheterization which often causes irritation of the mucous membrane and skin in children with diaper rashes thus adding discomfort to an already unpleasant procedure.
OBJECTIVE: Compare urinary colonization rates in children cleaned with sterile water versus a 10% Povidone-iodine before urinary catheterization.
METHODS: Prospective randomized controlled study. All parents of children who require urinary catheterization in the emergency department will be informed about the study and all consenting patients will be randomized.
RESULTS: (Preliminary data) A total of 151 patients have been enrolled in the study until now; 76 in the Povidone-iodine group and 75 in the sterile water group. Most of the children (98%) were under 2 years of age (range from 2 days to 6 years). There were 90 females (~ 60%) and 61 males. There was no difference in the average age or sex distribution between the two groups. Total of 26 cultures (17.2%) were positive (13 in the Povidone-iodine group and 13 in the water group). The most common organism noted was E. coli 14/26. Most of the positive cultures were from female children ( 73%). Out of the 7 males with positive urine cultures one was circumcised. Only 61.5% (16/26 ) of the positive cultures tested positive for leukocytes on urine dipstick.
CONCLUSIONS: Preliminary data shows no significant differences positive urine culture rates when sterile water was compared to Povidone-iodine as the cleaning solution prior to urinary catheterization