Urine Culture


Abbrev Code:URCX   
Order Code:LAB239Order Name:Urine Culture
Synonyms:URC
CPT Codes: 87086 x1, 87088 x1, 87186 x8
Test Includes:Culture of aerobic flora for 1,000 to >100,000 organisms/mL and susceptibility testing. Gram stain if requested.
Turnaround Time:Performed daily; results are reported within 2 days.
Special Instructions:Specimens must be delivered to the laboratory within 30 minutes of collection if not refrigerated or collected in vacutainer urine C&S transport kit.


Collection Instructions

Specimen:Urine
Optimal Volume:5-10 mL
Minimum\Peds Volume:0.2 mL (4.0 mL if using vacutainer C&S)
Container:Urine culture tubes
Collection Instructions:Obtain first morning specimen for best results (overnight incubation in bladder yields highest bacterial counts). Refrigerate specimen if not delivered to laboratory within 30 minutes.

Female
  1. Wash hands with soap and water, dry with disposable paper towel.
  2. With one hand, patient or personnel should spread the labia and keep them apart for remainder of procedure.
  3. Using povidone-iodine swab, wipe down one side from front to back; with fresh swab,wipe other side from front to back. With fresh swab, wipe center from front to back. Repeat as necessary to clean thoroughly.
  4. Wipe and dry area with sterile gauze.
  5. Void small amount of urine into toilet or bedpan. Stop flow for a minute then continue flow into sterile container. Be careful not to touch inner part of container or lid as container is being capped.

Male
  1. Wash hands with soap and watr; dry with disposable paper towel.
  2. Retract foreskin if necessary.
  3. Using povidone/iodine swabs, clean glans and urethral opening thoroughly.
  4. Wipe and dry area with sterile gauze.
  5. Void small amount of urine into toilet or bedpan. Stop flow for a minute then continue flow into sterile container. Be careful not to touch inner part of container or lid as container is being capped.

Infants and Small Children:
  1. After cleaning appropriately, as above, place sterile urine bag over labia or penis.
  2. After 30 minutes, observe for presence of urine. If no urine is present, re-clean patient and attach new bag.
  3. If impossible to obtain urine or if culture results yield mixture of organisms, a suprapubic aspiration is recommended.


Catheter Collection - Clean catheter with alcohol sponge; puncture with sterile needle and collect urine in sterile syringe. (Note: This technique is unsatisfactory for certain silicone catheters which may then leak.)

Straight Catheter - To obtain urine directly from bladder, trained care worker should use asceptic technique to insert catheter. Discard initial 10-30 mL; collect next flowof urine in sterile container and remove catheter.

Suprapubic Tap - Expose area above pubis. Scrub area with povidone-iodine. Cover area with povidone-iodone solution and allow to dry. Using sterile syringe and needle, aspirate urine from bladder and inject into a sterile container. If anaerobic culture is desired, expel air bubble and inject sample into anaerobic vial.
Contraindications:Do not culture urine collected from bed pan, urinal, or container brought from patient's home.


Processing and Shipping

Specimen Processing:Urine: Specimens must be transferred into preservative or refrigerated within 2 hours of collection. Store in refrigerator. Specimen must arrive refrigerated within 24 hours.
Vacutainer: Store at room temperature. Must arrive within 48 hours.
Shipping Instructions:Ship at refrigerated temperature. Must arrive within 24 hours.
Vacutainer: Ship at room temperature. Must arrive within 48 hours.
Test Performed at or Referral Lab Infectious Diseases Diagnostic Laboratory  (Grand Itasca, Range, UMMC East Bank)


Interpretive

Reference Range:No growth; normal urogenital flora.
Use:Isolate and identify potentially pathogenic organisms causing urinary tract infection.


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