Chavigny K H, Nunnally D S
Am J Obstet Gynecol. 1975 May 1;122(1):34-42. doi: 10.1016/0002-9378(75)90612-2.
A descriptive study comparing the use of the gram-positive skin cleansers Zephiran and hexachlorophene to Prepodyne, a gram-negative cleanser, was performed upon 1, 469 specimens from patients attending the prenatal clinic of a large university hospital. The period prevalence rate of symptomatic and asymptomatic bacteriuria in 1, 350 patients was 11.5 per cent. Group teaching compared to individualized teaching of the patients to collect their own aliquots did not appear to have a measurable effect upon the levels of bacteriuria. Significant differences were found at p equals 0.05 between all the serially sampled groups using the different cleansers. No significant difference was found between the two groups using only hexachlorophene when compared for differences between patient-collected and nurse-collected specimens; nevertheless, the patient-collected specimens had greater proportions of low bacterial counts than those collected by the nurses. This study indicates that carefully instructed patients in large clinic populations are more efficient than the nurses when they collect their own midstream specimens, using an adequate cleansing agent. An analysis of the rates disclosed that Zephiran cleansing had high contamination levels, whereas Prepodyne significantly reduced contamination of the specimens. However, the possible reduction of the rate of 10-5 specimens to 9.1 per cent in the group using Prepodyne did not rule out the possibility of reduced specificity, and the hazard of false-negative results occuring with the use of gram-negative skin cleansers requires further study.
一项描述性研究对1469份取自一所大型大学医院产前诊所患者的样本进行了比较，该研究对比了革兰氏阳性皮肤清洁剂洁尔灭和六氯酚与革兰氏阴性清洁剂普瑞波定的使用情况。1350名患者中有症状和无症状菌尿症的期间患病率为11.5%。与对患者进行个别指导以收集自己的等分样本相比，分组教学似乎对菌尿症水平没有可测量的影响。在使用不同清洁剂的所有连续采样组之间，发现p值等于0.05时有显著差异。在比较患者自行采集和护士采集的样本差异时，仅使用六氯酚的两组之间未发现显著差异；然而，患者自行采集的样本中低细菌计数的比例高于护士采集的样本。这项研究表明，在大型诊所人群中，经过仔细指导的患者在使用适当的清洁剂自行采集自己的中段尿样本时比护士更有效率。对发生率的分析表明，洁尔灭清洁的污染水平很高，而普瑞波定显著降低了样本的污染。然而，使用普瑞波定的组中10⁻⁵样本率可能降至9.1%，这并未排除特异性降低的可能性，并且使用革兰氏阴性皮肤清洁剂出现假阴性结果的风险需要进一步研究。
