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HelpTest Code LAB6002 Culture, Urine, Bacterial—Aerobic Only
Additional Codes
| Test Name in EPIC | EPIC Test Code | Mnemonic |
|---|---|---|
| CULTURE, URINE | LAB6002 | Urine Cx |
Useful For/Utility
Diagnosis of urinary tract infections. Quantitative culture results may be helpful in discriminating contamination, colonization, and infection. Identification and susceptibilities will be performed on all microbiology isolates considered by the laboratory to be significant.
Methodology
Direct smear not performed.
Clinical Information
Urinary tract infection (UTI) encompasses a broad range of clinical entities that vary in their clinical presentation, degree of tissue invasion, epidemiologic setting, and antibiotic therapy requirements. There are 4 major types of UTIs: urethritis, cystitis, acute urethral syndrome, and pyelonephritis. UTIs may also be classified as uncomplicated or complicated. Escherichia coli the leading cause of uncomplicated community-acquired UTI. Risk factors that predispose one to complicated UTIs include: underlying diseases that are associated with kidney infection (e.g., diabetes), kidney stones, structural or functional urinary tract abnormalities, and indwelling urinary catheters. Another classification of UTIs is upper UTI (related to the kidney, renal pelvis or ureter) or lower UTI (urinary bladder and urethra). The classic symptoms of upper UTI are fever (often with chills) and flank pain; frequent painful urination, urgency and dysuria are more often associated with lower UTI.
Specimen Requirements
Whenever possible, culture specimens should be obtained before antibiotics or antimicrobial agents have been administered.
Specimen source is required.
Submit only 1 of the following specimens:
Specimen Type: Catheterized, indwelling catheter, straight catheter, or suprapubic indwelling catheter
Container/Tube: Sterile container
Specimen Volume: Entire collection
Collection Instructions:
1. No preservative.
2. Collect urine specimen per Nursing Standard Operation Procedures (S.O.P.).
3. Collection type must be indicated.
Additional Information:
1. Label container with patient’s name (first and last), date and actual time of collection, and type of specimen.
2. If there is a delay in transport of > 24 hours, the site laboratory will process specimen as follows:
a. Inoculate and streak 1 TSAII 5% SB and 1 selective agar (MAC) plate using a calibrated loop (.001 mL).
b. Deliver a loop of well mixed urine onto the TSA agar plate by streaking a straight line from the top of the plate to the bottom of the plate.
c. Streak at right angles several times top to bottom over the initial streak.
d. Repeat with the selective agar plate.
e. Incubate per laboratory procedure.
f. Transport to the laboratory as soon as possible.
Specimen Type: Clean-voided midstream (CVMS)
Container/Tube: Sterile container
Specimen Volume: Entire collection
Collection Instructions:
1. No preservative.
2. Collect urine specimen per Nursing Standard Operation Procedures (S.O.P.).
3. See Urine Collection in Special Instructions for clean-catch, midstream specimen collection instructions.
4. Collection type must be indicated.
Additional Information:
1. Label container with patient’s name (first and last), date and actual time of collection, and type of specimen.
2. If there is a delay in transport of > 24 hours, the site laboratory will process specimen as follows:
a. Inoculate and streak 1 TSAII 5% SB and 1 selective agar (MAC) plate using a calibrated loop (.001 mL).
b. Deliver a loop of well mixed urine onto the TSA agar plate by streaking a straight line from the top of the plate to the bottom of the plate.
c. Streak at right angles several times top to bottom over the initial streak.
d. Repeat with the selective agar plate.
e. Incubate per laboratory procedure.
f. Transport to the laboratory as soon as possible.
Specimen Type: Suprapubic aspirate (SPA)
Container/Tube: Sterile container
Specimen Volume: Entire collection
Collection Instructions:
1. No preservative.
2. Clean suprapubic skin and collect urine per Nursing Standard Operation Procedures (S.O.P.).
3. Collection type must be indicated.
Additional Information:
1. Label container with patient’s name (first and last), date and actual time of collection, and type of specimen.
2. If there is a delay in transport of > 24 hours, the site laboratory will process specimen as follows:
a. Inoculate and streak 1 TSAII 5% SB and 1 selective agar (MAC) plate using a calibrated loop (.001 mL).
b. Deliver a loop of well mixed urine onto the TSA agar plate by streaking a straight line from the top of the plate to the bottom of the plate.
c. Streak at right angles several times top to bottom over the initial streak.
d. Repeat with the selective agar plate.
e. Incubate per laboratory procedure.
f. Transport to the laboratory as soon as possible.
Specimen Type: Pediatric Bagged Urine
Container/Tube: Sterile container
Specimen Volume: Entire collection
Collection Instructions:
1. No preservative.
2. Collect urine specimen per Nursing Standard Operation Procedures (S.O.P.).
3. Collection type must be indicated.
Additional Information:
1. Label container with patient’s name (first and last), date and actual time of collection, and type of specimen.
2. If there is a delay in transport of > 24 hours, the site laboratory will process specimen as follows:
a. Inoculate and streak 1 TSAII 5% SB and 1 selective agar (MAC) plate using a calibrated loop (.001 mL).
b. Deliver a loop of well mixed urine onto the TSA agar plate by streaking a straight line from the top of the plate to the bottom of the plate.
c. Streak at right angles several times top to bottom over the initial streak.
d. Repeat with the selective agar plate.
e. Incubate per laboratory procedure.
f. Transport to the laboratory as soon as possible.
Specimen Type: Urostomy
Container/Tube: Sterile container
Specimen Volume: Entire collection
Collection Instructions:
1. No preservative.
2. Collect urine specimen per Nursing Standard Operation Procedures (S.O.P.).
3. Collection type must be indicated.
Additional Information:
1. Label container with patient’s name (first and last), date and actual time of collection, and type of specimen.
2. If there is a delay in transport of > 24 hours, the site laboratory will process specimen as follows:
a. Inoculate and streak 1 TSAII 5% SB and 1 selective agar (MAC) plate using a calibrated loop (.001 mL).
b. Deliver a loop of well mixed urine onto the TSA agar plate by streaking a straight line from the top of the plate to the bottom of the plate.
c. Streak at right angles several times top to bottom over the initial streak.
d. Repeat with the selective agar plate.
e. Incubate per laboratory procedure.
f. Transport to the laboratory as soon as possible.
Specimen Type: Nephrostomy Urine
Container/Tube: Sterile container
Specimen Volume: Entire collection
Collection Instructions:
1. No preservative.
2. Collect urine specimen per Nursing Standard Operation Procedures (S.O.P.).
3. Collection type must be indicated.
Additional Information:
1. Label container with patient’s name (first and last), date and actual time of collection, and type of specimen.
2. If there is a delay in transport of > 24 hours, the site laboratory will process specimen as follows:
a. Inoculate and streak 1 TSAII 5% SB and 1 selective agar (MAC) plate using a calibrated loop (.001 mL).
b. Deliver a loop of well mixed urine onto the TSA agar plate by streaking a straight line from the top of the plate to the bottom of the plate.
c. Streak at right angles several times top to bottom over the initial streak.
d. Repeat with the selective agar plate.
e. Incubate per laboratory procedure.
f. Transport to the laboratory as soon as possible.
Specimen Type: Kidney Aspirate
Container/Tube: Sterile container
Specimen Volume: Entire collection
Collection Instructions:
1. No preservative.
2. Collect urine specimen per Nursing Standard Operation Procedures (S.O.P.).
3. Collection type must be indicated.
Additional Information:
1. Label container with patient’s name (first and last), date and actual time of collection, and type of specimen.
2. If there is a delay in transport of > 24 hours, the site laboratory will process specimen as follows:
a. Inoculate and streak 1 TSAII 5% SB and 1 selective agar (MAC) plate using a calibrated loop (.001 mL).
b. Deliver a loop of well mixed urine onto the TSA agar plate by streaking a straight line from the top of the plate to the bottom of the plate.
c. Streak at right angles several times top to bottom over the initial streak.
d. Repeat with the selective agar plate.
e. Incubate per laboratory procedure.
f. Transport to the laboratory as soon as possible.
Specimen Type: Post Prostate Massage
Container/Tube: Sterile container
Specimen Volume: Entire collection
Collection Instructions:
1. No preservative.
2. Collect urine specimen per Nursing Standard Operation Procedures (S.O.P.).
3. Collection type must be indicated.
Additional Information:
1. Label container with patient’s name (first and last), date and actual time of collection, and type of specimen.
2. If there is a delay in transport of > 24 hours, the site laboratory will process specimen as follows:
a. Inoculate and streak 1 TSAII 5% SB and 1 selective agar (MAC) plate using a calibrated loop (.001 mL).
b. Deliver a loop of well mixed urine onto the TSA agar plate by streaking a straight line from the top of the plate to the bottom of the plate.
c. Streak at right angles several times top to bottom over the initial streak.
d. Repeat with the selective agar plate.
e. Incubate per laboratory procedure.
f. Transport to the laboratory as soon as possible.
Specimen Type: Flow
Container/Tube: Sterile container
Specimen Volume: Entire collection
Collection Instructions:
1. No preservative.
2. Collect urine specimen per Nursing Standard Operation Procedures (S.O.P.).
3. Collection type must be indicated.
Additional Information:
1. Label container with patient’s name (first and last), date and actual time of collection, and type of specimen.
2. If there is a delay in transport of > 24 hours, the site laboratory will process specimen as follows:
a. Inoculate and streak 1 TSAII 5% SB and 1 selective agar (MAC) plate using a calibrated loop (.001 mL).
b. Deliver a loop of well mixed urine onto the TSA agar plate by streaking a straight line from the top of the plate to the bottom of the plate.
c. Streak at right angles several times top to bottom over the initial streak.
d. Repeat with the selective agar plate.
e. Incubate per laboratory procedure.
f. Transport to the laboratory as soon as possible.
Specimen Transport Temperature
Container -(No Preservative) Refrigerate 24 hours/Ambient 2 hours OK/Frozen NO
Container- (C&S Preservative Plus Urine Tube): Ambient 48 Hours OK/Refrigerated NO/Frozen NO
Plates-Ambient/Refrigerate NO/Frozen NO
Day(s) Test Set Up
Monday through Sunday
Performing Laboratory
Microbiology -
Central Region: St. Joseph's Medical Center Lab
East Region: SMDC Clinical Lab, Virginia Hospital Lab
West Region: Fargo Hospital Lab, Fosston Hospital Lab, St. Mary's - Detroit Lakes Hospital Lab
Test Classification and CPT Coding
87088
Additional CPT codes will be billed when appropriate.
Reference Values
Approximately 2 days to final report
Special Instructions
Cautions
Although urine is normally sterile, contamination by organisms normally present in the urethra or on periurethral surfaces can allow a proliferation of these organisms yielding misleading urine culture results. Urine obtained from catheter bags at the beside and Foley catheter tips are unacceptable for culture.