TABLE 11.

Body-of-evidence table for clinical question 6, namely, “what is the accuracy of midstream urine collection compared to straight catheterization or suprapubic aspiration for the diagnosis of UTI in men?”^a

Study (reference), quality rating	Population and samples	Setting(s)	Time period	Results
Lipsky et al. (47), fair	66 ambulatory or hospitalized men who had acute dysuria or other irritative genitourinary symptoms, were known to have bacteriuria, or were scheduled for a urologic procedure. 76 specimens in total were obtained from the 66 men (7 patients were restudied [5 twice and 2 four times]) obtained by SPA, UFV, MSCC, and CATH. Specimens were delivered to the laboratory within 30 min of collection and immediately inoculated.	VA Medical Center, Seattle, WA	Not given	SG was defined as ≥104 CFU/ml of a single or predominant species (≥90% of the plate's growth) for MSCC and ≥103 for SPA/CATH. All other growth was considered NSG. MSCC had a sensitivity of 82.4% and a specificity of 100.0%.
Deresinski and Perkash (48), fair	53 male spinal cord injury patients who were free of indwelling catheters. 71 samples of urine were obtained, 1 by MSCC and 1 by SPA. Note that many of the MSCC specimens were collected on first void. Urine specimens were processed for culture immediately.	Spinal Cord Injury Service, VA, and Stanford University Medical Centers, Palo Alto, CA	Not given	SG was defined as any growth of >104 CFU/ml for MSCC and SPA. All other growth was considered NSG. MSCC had a sensitivity of 100% and a specificity of 100%.

^aMSCC, midstream clean-catch collection; UFV, first-void urine collection without cleansing; SPA, suprapubic aspiration; CATH, urethral catheterization; SG, significant growth; NSG, nonsignificant growth.