Background: Given that children often present to physicians with a wet gel-based diaper, a method for using this diaper for a urine specimen was studied.
Methods: A blinded clinical laboratory trial was conducted in the microbiology laboratory. The sampling technique involved the use of oval gynecologic forceps as a template and sterile scissors to cut out samples of diapers. Each diaper sample was then vortexed in 20 mL of sterile saline and the supernatant quantitatively cultured. Diaper sample supernatant cultures with simulated infected urines (suspensions of Escherichia coli) were used.
Results: Weight measurements of the diaper samples soaked with 20 mL or more of saline yielded reproducible results (0.703 g; 95% confidence interval [CI], 0.52 to 0.88 g). Culture results (colony-forming units per liter [CFU/L] of supernatant) from diapers soaked with 25 mL of various concentrations of E coli (10(6), 10(7), 10(8), 10(9) CFU/L) showed excellent correlation with the inoculum used, and no effect of a 2-hour delay in culturing the wet diapers.
Conclusions: Our technique provides accurate and reliable estimates of bacterial concentrations in the usual range for infected urine from gel-based diapers soaked with solutions of E coli. Further evaluation of clinical implementation is needed.