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BCH Order Code LAB239 Urine Culture

Reporting Title

URINE CULTURE

Useful For

Isolation of bacteria in urine samples.

Performing Laboratory

Boulder Community Health

Specimen Requirements

Clean catch or catheterized random urine sample.  Minimum volume 1 mL.

 

Urine Collection Information:

Submit only 1 of the following specimens:

 

Clean-Catch, Midstream Specimen

  • Container/Tube: VACUTAINER® Urine Collection Kit
  • Collection Instructions:
    • Unscrew cap of urine cup. Place cap on counter, top down. Do not contaminate interior of cap or cup.
    • Cleanse patient or instruct patient to collect a clean-catch, midstream specimen as follows:
      • Males
        • Wash hands with soap and water.
        • Cleanse the end of the penis with the 1st soap towelette beginning at urethral opening and working away from it. (In uncircumcised males the foreskin must be retracted prior to cleansing.)
        • Repeat using the 2nd clean towelette.
        • Urinate a small portion in the toilet.
        • Continue to urinate and bring the collection cup into the mid-stream to collect the urine sample.
        • Do not touch the inside or lip of the cup. 
        • Finish urinating into the toilet.
        • Place cap on cup and tighten and give specimen to nurse.
      • Females
        • Stand or sit in comfortable squatting position over the toilet.
        • Separate the folds of skin around urinary opening and cleanse area with 1st soap towelette.
        • Repeat using the 2nd clean towelette.
        • Urinate a small portion of urine into the toilet.
        • Place cup under mid-stream and continue to urinate into cup.
        • Finish urinating into toilet.
        • Place cap on cup and tighten and give specimen to nurse.

 

Catheterized Specimen – Indwelling or FOLEY Catheter

  • Collection Instructions: When antibiotics are to be started immediately, a first-morning specimen is still preferred.
    • Do not collect urine from collection bag.
    • Check to be sure there is no backflow of urine from collection bag into catheter tubing.
    • Cleanse area if tubing with sterile alcohol.
    • Puncture tubing at cleansed area with sterile 18-gauge needle attached to 10ml syringe. If system has a port that may be used instead after cleansing with alcohol.
    • Collect 1-8ml into syringe.  Remove needle and expel urine into sterile specimen container.

 

Catheter (Straight) and Suprapubic Urine - Collection must be obtained by a physician or trained health care worker.

  • Specimen Transport
    • Preferred:  Transfer specimen to C&S grey-top Vacutainer® tube which contains a preservative that stabilizes bacteria present in the specimen.   Urine in grey-top tube is stable for 48 hours at room temperature or refrigerated.
    • Alternative:  :  Refrigerate specimen with 30 minutes of collection.   Unpreserved urine is stable if refrigerated for 24 hours. 

 

NOTES:

1.  All specimens must be labeled with the patient’s name (first and last), date and actual time of collection, and type of specimen (Clean Catch, Catheter, etc).

2. If a #CIND “Culture, Urine, if Indicated” or other urine test is needed, urine must be sent in a sterile specimen cup, as well as in a Urine C&S grey-top.

 

Specimen Rejection: 

  • Unpreserved specimen >24 hours
  • Preserved specimen >48 hours
  • Specimen at ambient temperature >2 hours
  • Urine obtained from Catheter bags and FOLEY catheter tip

Specimen Transport Temperature

Refrigerate

Methodology

Culture uses semi-quantitative technique with conventional and/or rapid identification methods and antibiotic susceptibility testing when appropriate. Organisms associated with a urinary tract infection (UTI) are usually attributed to a single organism that is present at greater than 100,000 CFU/mL however a lower colony count may be clinically significant.  Isolation of two or more organisms which are greater than 10,000 CFU/mL often suggests contamination or colonization and UTI is doubtful.  For specimens contaminated with normal urogenital flora found on the urethra, bacteria that are considered uropathogens are identified. 

 

Clinical Reference:  Forbes BA, Sahm DF, Weissfeld AS, Bailey and Scott’s Diagnostic Microbiology, “Infections of the Urinary Tract”, 12th Edition, 2007 pp 842-855
 

 

Reference Values

No Growth (<1000 CFU /mL)

Day(s) Test Set Up

Monday through Sunday

Test Classification and CPT Coding

87086

87088 (presumptive identification if appropriate)

87077 (definitive identification if appropriate)

87185 (beta-lactamase test if appropriate)

LOINC Code Information

TBD