Test Details
Methodology
Culture
Result Turnaround Time
3 - 5 days
Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary.
Test Includes
Culture; quantitation, isolation, identification (additional charges/CPT code[s] may apply), and susceptibility testing of up to three organisms at >100 colonies/mL if culture results warrant (additional charges/CPT code[s] may apply). CPT coding for microbiology and virology procedures often cannot be determined before the culture is performed. Requests with only a written order and no test number indicated will be processed according to Default Testing for Routine Microbiology.
Use
This test is a semiquantitative culture used to isolate and identify bacterial causes of a urinary tract infection. It allows for isolation and identification of bacteria present in low numbers in the urinary tract by detecting up to three pathogenic bacterial organisms at levels down to 100 cfu/mL.
This test can be considered if additional workup beyond that provided by Urine Culture, Routine [008847] is needed: when recommended by a specialist for patients with urological malformations under a urologist’s care, or for in-and-out/straight catheter specimen, kidney and suprapubic aspirates or cytoscopic specimens.
Special Instructions
Unrefrigerated unpreserved urine specimens greater than two hours old may be subject to overgrowth with organisms normally present in the urethra and periurethral areas, and may yield inaccurate or misleading results. If specimens are incorrectly submitted with an order for aerobic bacterial culture, the laboratory will process the specimen for the test based on the source listed on the request form. The client will not be contacted to approve this change, but the change will be indicated on the report.
Specimen Requirements
Specimen
Urine
Volume
To minimum fill line (4 mL) on Vacutainer® gray-top urine culture transport tube with preservative (preferred)
Container
Vacutainer® gray-top urine culture transport tube with preservative (preferred). If less than 4 mL of urine is collected, usually from pediatric and geriatric patients or from a catheter, submit refrigerated in a sterile, screw cap container or tube. Do not submit low volume urine specimens in underfilled gray top tubes.
Collection Instructions
Clean catch midstream collection. First morning specimens yield highest bacterial counts from overnight incubation in the bladder, and are the best specimens. Read Patient Preparation.
Storage Instructions
Preserved: Room temperature
Unpreserved: Refrigerated for 24 hours
Patient Preparation
Patient should be instructed on the proper collection of a clean catch midstream urine specimen. Avoid contamination with normal flora from skin, rectum or vagina. If a clean catch urine cannot be obtained from an infant, obtain a bagged specimen: clean area as for a clean catch, attach U-bag, and put collected urine into a sterile container.
Clean catch specimen: Have patient urinate into a small clean disposable cup (styrofoam or “Dixie”). Afterward, collection site staff can transfer the urine to the urine culture transport tube using the special collection straw-puncture device designed for use with the Vacutainer® tubes. The numbers of bacteria in a clean unused cup are so few as to be inconsequential when the urine transport stabilizer is added. Thoroughly instruct patient for proper collection of a “clean catch” specimen. Patient must be instructed to thoroughly cleanse skin and collect a midstream specimen. The patient should be instructed to follow the directions provided with the urine collection kit as follows.
Catheterized specimen: Refers to an “in and out” catheter that is placed into the bladder solely for collection of the specimen and then withdrawn. Do not collect urine from the drainage bag when an indwelling catheter is in place because growth of bacteria can occur in the bag itself. Rather, clean catheter with an alcohol sponge, puncture with a sterile needle, and collect in sterile syringe. Catheter tips are contaminated by the urethra as they are withdrawn; do not culture them.
Male: Wash hands thoroughly with soap and water. Rinse them well and dry with a paper towel.
• Tear open the towelette packages so that the towels can be easily removed with one hand as they are needed. Do not touch any of the inside surfaces of the collection cup.
• Pull back the foreskin to expose the head of the penis completely.
• Wash the head of the penis thoroughly using first one towelette then the other. Discard the used towelettes into the toilet bowl.
• Pass a small amount of urine into the toilet bowl, then pass a sample into the container. Do not allow the container to touch the legs or penis. Keep fingers away from the rim and inner surface of the container. Fill the container half full.
• The urine specimen should be transferred to the Vacutainer® tube within 10 minutes of collection.
Female: Wash hands thoroughly with soap and water. Rinse them well and dry with a paper towel.
• Tear open the towelette packages so that the towels can be easily removed with one hand as they are needed. Do not touch any of the inside surfaces of the collection cup.
• Remove undergarments and sit on the toilet seat with legs spread widely apart.
• With one hand, spread labia apart to expose the vulva. Keep this hand in place during the washing and urinating procedure.
• Use one towelette to wash the vulva well passing the towelette only from front to back, not back and forth. Repeat this procedure using the second towelette. Discard the used towelettes into the toilet bowl.
• Begin urinating into the toilet bowl then, without stopping the stream, insert the collection cup to collect the specimen. Do not allow the container to touch the legs, vulva, or clothing. Keep fingers away from the rim and inner surface of the container. Fill the container about half full.
• The urine specimen should be transferred to the Vacutainer® tube within 10 minutes of collection.
Causes for Rejection
Unrefrigerated, unpreserved specimen greater than two hours old; unlabeled specimen or name discrepancy between specimen and request label; specimen in expired transport container; specimen received after prolonged delay (usually more than 48 hours for urine); specimen collected from a Foley catheter bag; specimen in nonsterile or leaking container
References
LOINC® Map
| Order Code | Order Code Name | Order Loinc | Result Code | Result Code Name | UofM | Result LOINC |
|---|---|---|---|---|---|---|
| 008086 | Urine Culture, Urology Workup | 630-4 | 008086 | Urine Culture, Urology Workup | 630-4 | |
| Order Code | 008086 | |||||
| Order Code Name | Urine Culture, Urology Workup | |||||
| Order Loinc | 630-4 | |||||
| Result Code | 008086 | |||||
| Result Code Name | Urine Culture, Urology Workup | |||||
| UofM | ||||||
| Result LOINC | 630-4 |
| Order Code | Order Name | Result Code | Result Name | UofM | Result LOINC | |
|---|---|---|---|---|---|---|
| Reflex 1 | 997600 | Result | 997191 | Result 1 | 630-4 | |
| Reflex 1 | ||||||
| Order Code | 997600 | |||||
| Order Name | Result | |||||
| Result Code | 997191 | |||||
| Result Name | Result 1 | |||||
| UofM | ||||||
| Result LOINC | 630-4 | |||||
| Order Code | Order Name | Result Code | Result Name | UofM | Result LOINC | |
|---|---|---|---|---|---|---|
| Reflex 1 | 997600 | Result | 997192 | Result 2 | 630-4 | |
| Reflex 1 | ||||||
| Order Code | 997600 | |||||
| Order Name | Result | |||||
| Result Code | 997192 | |||||
| Result Name | Result 2 | |||||
| UofM | ||||||
| Result LOINC | 630-4 | |||||
| Order Code | Order Name | Result Code | Result Name | UofM | Result LOINC | |
|---|---|---|---|---|---|---|
| Reflex 1 | 997600 | Result | 997193 | Result 3 | 630-4 | |
| Reflex 1 | ||||||
| Order Code | 997600 | |||||
| Order Name | Result | |||||
| Result Code | 997193 | |||||
| Result Name | Result 3 | |||||
| UofM | ||||||
| Result LOINC | 630-4 | |||||
| Order Code | Order Name | Result Code | Result Name | UofM | Result LOINC | |
|---|---|---|---|---|---|---|
| Reflex 1 | 997600 | Result | 997194 | Result 4 | 630-4 | |
| Reflex 1 | ||||||
| Order Code | 997600 | |||||
| Order Name | Result | |||||
| Result Code | 997194 | |||||
| Result Name | Result 4 | |||||
| UofM | ||||||
| Result LOINC | 630-4 | |||||
| Order Code | Order Name | Result Code | Result Name | UofM | Result LOINC | |
|---|---|---|---|---|---|---|
| Reflex 1 | 997600 | Result | 997195 | Antimicrobial Susceptibility | 23658-8 | |
| Reflex 1 | ||||||
| Order Code | 997600 | |||||
| Order Name | Result | |||||
| Result Code | 997195 | |||||
| Result Name | Antimicrobial Susceptibility | |||||
| UofM | ||||||
| Result LOINC | 23658-8 | |||||