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Test Code 115 Urinalysis (UA), Do Culture if Indicated

Epic Code

LAB348

Test Name Alias

Urinalysis, Culture if Indicated | UA |Urine C&amp |S | UA do if | 115

Ordering Instructions

Please indicate source, i.e. ccms, nephrostomy, straight catheter. Please do not order UA do if and Urine culture together. UA do if will reflex to Urine Culture if necessary.

Collection Instructions

Specimen Collection: Urine (Clean Catch Mid-Stream/CCMS or Straight Catheter)

 

Container(s): 2 Pale Yellow Top Urine Tubes (UA No Additive) AND 1 Gray top urine C&S tube (contains boric acid)

Acceptable container: Sterile Cup AND 1 Gray top Urine C&S tube (contains boric acid)

Preferred Volume to Collect: 24 mL (2 × 10 mL Yellow and 1 × 4 mL Gray)

Minimum Volume to Collect: 4.0 mL

Neonate Volume to Collect: 3.0 mL

 

Collection Instructions:

  • Clean Catch Mid-Stream or Straight Catheter Collection.
  • If a short specimen, fill the gray tube only 1/4 full, (1.0 mL).
  • Ambient specimen must be received in the Lab within 2 hours.
  • If delay, keep the specimen refrigerated and send to laboratory as soon as possible.
  • Specimen must be received in laboratory for analysis within 24 hours of collection.
  • Gray vacutainer is to be used for Culture and Sensitivity (C&S).

Unacceptable

Specimens with 10 or more squamous epithelial cells are not appropriate for culture, a CCMS or catheterized may be indicated if culture is requested.

Processing Instructions (Laboratory, Outpatient or Off-site collection)

Transport Temperature: Refrigerate

Specimen Requirements

Preferred:

Specimen Type: Urine (Clean Catch Mid-Stream/CCMS or Straight Catheter)
Container/Tube: 2 Pale Yellow Top Urine Tubes (no preservative) AND 1 Gray top urine C&S tube (contains boric acid)
Volume: 24 mL (2, 10 mL Yellow and 1, 4 mL Gray)

Minimum Volume: 4 mL
Collection Instructions: Refrigerate specimen as soon as possible after collection. Specimen must be received in laboratory for analysis within 24 hours of collection. If a short specimen, fill the gray tube only 1/4 full, (1.0 mL).

 

Acceptable

Specimen Type: Urine (Clean Catch Mid-Stream/CCMS or Straight Catheter)
Container/Tube: Sterile Cup AND 1 Gray top urine C&S tube (contains boric acid)
Volume: 24 mL

Minimum Volume: 4 mL
Collection Instructions: Refrigerate specimen as soon as possible after collection. Specimen must be received in laboratory for analysis within 24 hours of collection. If a short specimen, fill the gray tube only 1/4 full, (1.0 mL).

Specimen Transport Temperature

Refrigerate

Special Instructions

Gray vacutainer is unacceptable for urinalysis, this is to be used for Culture and Sensitivity (C&S). If a short specimen, fill the gray tube only 1/4 full.

 

Please indicate source, i.e. ccms, nephrostomy, straight catheter.

Rejection Criteria

Specimens that do not meet Spectrum Health Laboratory standards may be rejected (cancelled) due to:

  • Request a repeat specimen when there is no evidence of refrigeration for a sterile cup collection and the specimen is greater than 2 hours old.
  • Foley catheter tips/bags
  • Catheter bags
  • Leaky containers

Reflex Information

  • Culture and Sensitivity (C&S) will be performed with 2 or more of the following abnormal findings, provided there are less than 10 squamous epithelial cells per HPF:
    • Greater than or equal to 10 WBC
    • Positive leukocyte esterase
    • Positive nitrite
    • OR if the specimen is:
    • Grossly bloody
  • Specimens with 10 or more squamous epithelial cells, culture will not be performed
  • Culture and Sensitivity (C&S) will be performed if volume is inadequate for microscopic exam and Urinalysis (UA) with one or more of the following abnormal findings:
    • Positive leukocyte esterase
    • Positive nitrate
  • If urinalysis is negative, culture will not be performed.

 

Specimen Stability

2 Yellow top tubes and Urine Cup:

Ambient: 2 hours

Refrigerate: 24 hours

Laboratory Retention: 3 days

 

Gray top tube:

Ambient: 48 hours

Refrigerate: 48 hours

Laboratory Retention: 3 days

 

Test Frequency

Available 24 hours, usual TAT 1 day

Reference Range

Urinalysis (UA) is always performed first

Color Yellow/Straw
Clarity Clear
Glucose Negative
Bilirubin Negative
Ketone Negative
Sp Gravity 1.010-1.030
Blood Negative
pH

5.0-9.0

Protein Negative
Urobilinogen Normal (0.2-1.0mg/dL)
Nitrite(reductase) Negative
Leukocyte (esterase) Negative
Ictotest Negative
Mucus None to Moderate
Epithelial Cells 0-9/HPF
RBC’s 0-3/HPF
WBC’s 0-5/HPF
Bacteria/Yeast None
Amorphous

None to Heavy

Casts

None (Few Hyaline may be normal)

Parasites None
Trichomonas None
Urine Fat None
Crystals

None (Some may be normal others pathogenic)

 

Laboratory Critical Values Table

Performing Department

Multiple Departments:
Chemistry (UA)
Microbiology (Culture)

Performing Department Laboratory Location

Spectrum Health Regional Laboratory (SHRL), Grand Rapids, MI
Blodgett Hospital Laboratory (BIRL), Grand Rapids, MI
Big Rapids Hospital Laboratory (SHBR), Big Rapids, MI
Gerber Memorial Laboratory (SHGM), Fremont, MI
Kelsey Hospital Laboratory (SHKH), Lakeview, MI

Pennock Laboratory (SHP), Hastings, MI
Reed City Hospital Laboratory (SHRC), Reed City, MI
United Hospital Laboratory (SHUH), Greenville, MI
Zeeland Community Hospital Laboratory (SHZCH), Zeeland, MI

Clinical Information

Refrigeration of urine inhibits bacteria growth but does not prevent the lytic effects of low specific gravity or alkaline pH. Urine crystal formation may be induced by refrigeration.

Methodology

Methodology is available on request.

Please call the Laboratory Customer Service Call Center 616.774.7721 or send an email to LaboratoryServices@spectrumhealth.org

CPT

81001

 

This test is not limited to the CPT code(s) listed.  Others may be added if culture and sensitivity is performed and if more testing is necessary depending on the pathogens isolated (such as MIC’s and ID’s).

CDM Code

4128715

Interface Order Alias

10540

Reviewed Date

7/1/2017