Bacteriuria in the puerperium: an evaluation of methods for collecting urine specimens

Five hundred and eighteen puerperal patients were screened for bacteriuria by examination of clean-catch, midstream urine specimens using the dip-slide cultivation technique. Bladder urine from 105 patients showing 10(4) or more bacteria per milliliter of midstrean urine was obtained by suprapubic bladder aspiration and cultivated, along with two consecutive midstream specimens. The bacteriologic results in these specimen categories are compared. Of 23 patients showing growth in the midstream samples compatible with a true bacteriuria, 18 had sterile puncture urine specimens. Consecutive contaminated midstream specimens from the same patient usually yielded growth of the same bacterial species. It is concluded that a diagnosis of bacteriuria in the puerperium cannot be based upon cultural results of midstream specimens alone. In several of the bladder urine specimens, microogranisms being nonpathogenic in the urinary tract and residing normally in the vaginal flora were found, probably due to the traumatic effect of partus. In Oslo the frequency of bacteriuria among women post partum is estimated at a maximum of 1 per cent.