Urine Culture, Prenatal, With Group B Streptococcus Susceptibility Reflex

CPT: 87086
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Test Details

Use

Evaluation of pregnant women for asymptomatic bacteriuria has been recommended.1

Methodology

Culture

Additional Information

A single culture is about 80% accurate in the female; two containing the same organism with count of 105 or more represents 95% chance of true bacteriuria; three such specimens mean virtual certainty of true bacteriuria.2 If the patient is receiving antimicrobial therapy at the time the specimen is collected, any level of bacteriuria may be significant. When more than two organisms are recovered, the likelihood of contamination is high; thus, the significance of definitive identification of the organisms and susceptibility testing in this situation is severely limited. A repeat culture with proper specimen collection, including patient preparation, is often indicated. Cultures of specimens from Foley catheters yielding multiple organisms with high colony counts usually represents colonization of the catheter and not true significant bacteriuria. Most laboratories limit to two the number of organisms that will be identified when recovered from urine. Similarly, most do not routinely perform susceptibility tests on isolates from presumably contaminated specimens. Failure to recover aerobic organisms from patients with pyuria or positive Gram stains of urinary sediment may indicate the presence of mycobacteria or anaerobes.

Specimen Requirements

Specimen

Urine

Volume

To fill line on Vacutainer® gray-top urine culture transport tube

Patient Preparation

See Urine Culture, Comprehensive [008086].

Storage Instructions

Maintain specimen at room temperature.

Causes for Rejection

Unrefrigerated specimen older than two hours may be subject to overgrowth and may not yield valid results; unlabeled specimen or name discrepancy between specimen and request label; specimen in expired transport container; specimen received after prolonged delay (usually >36 hours for urine); specimen collected via Foley catheter; unpreserved specimen

Clinical Information

Special Instructions

Specimens from other sources, such as genital, stool, urine, upper and lower respiratory specimens, cannot be cultured under the aerobic bacterial culture test number. 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 test request form. The client will not be telephoned to approve this change, but the change will be indicated on the report.

Footnotes

1. Verani JR, McGee L, Schrag SJ, et al. Prevention of perinatal group B streptococcal disease—revised guidelines from CDC, 2010. MMWR. 2010 Nov 19; 59(RR-10):1-32. 21088663
2. Stamm WE, Hooton TM, Johnson JR, et al. Urinary tract infections: From pathogenesis to treatment. J Infect Dis. 1989 Mar; 159(3):400-406 (review). 2644378

References

Cavagnolo R. Evaluation of incubation times for urine cultures. J Clin Microbiol. 1995 Jul; 33(7):1954-1956. 7665682
Clarridge JE, Pezzlo MT, Vosti KL. Laboratory diagnosis of urinary tract infections. In: Weissfeld AS, ed. Cumitech 2A. Washington, DC: American Society for Microbiology; March 1987.
Joho KL, Soliman H, Weinstein MP. Comparison of one-day versus two-day incubation of urine cultures. Diagn Microbiol Infect Dis. 1995 Jan; 21(1):55-56. 7789098
Ronald AR, Nicolle LE, Harding GK. Standards of therapy for urinary tract infections in adults. Infection. 1992; 20(Suppl 3):S164-S170,S175-180. 1490743
Stamm WE. Criteria for the diagnosis of urinary tract infection and for the assessment of therapeutic effectiveness. Infection. 1992; 20(Suppl 3):S151-S159. 1490740

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
008851 Urine Culture,Prenatal, w/GBS 630-4 008851 Urine Culture,Prenatal, w/GBS 630-4
Reflex Table for Urine Culture,Prenatal, w/GBS
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 008852 Result 997877 Result 1 630-4
Reflex Table for Urine Culture,Prenatal, w/GBS
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 008852 Result 997879 Result 2 630-4
Reflex Table for Urine Culture,Prenatal, w/GBS
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 008852 Result 997881 Result 3 630-4
Reflex Table for Urine Culture,Prenatal, w/GBS
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 008852 Result 997883 Result 4 630-4
Reflex Table for Urine Culture,Prenatal, w/GBS
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 008852 Result 997885 Antimicrobial Susceptibility 23658-8

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