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Epic Code LAB239 Urine Culture

Test Name Alias

Culture Urine | C&S | Urine Culture and Sensitivity | 8888

Interface Order Alias

50016

Ordering Instructions

Effective 11/17/2021: When an order for Urine Culture [LAB239] and Urinalysis, do Culture if indicated [LAB348] is placed in the same encounter, these labs will update at the time of collection to an order for Urine Culture [LAB239] and Urinalysis [LAB2111180] to decrease duplicate urine cultures. 

Icons & Photos

 

Urine Gray Tube with Boric Acid

(Urine C&S Kit includes gray tube and transfer straw)

ITM-1066841

PREFERRED

or Sterile Container with screw-on lid

Collection Instructions

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

 

Container(s): Collect into a sterile specimen cup and transfer 4.0 mL into a Gray Top Urine C&S tube (contains boric acid preservative, gray top and urine transfer straw part of Urine C&S Kit)

Preferred Volume to Collect: 4.0 mL

Minimum Volume to Collect: 3.0 mL

Neonate Minimum Volume to Collect: 1.0 mL

If only a small volume of urine is available (less than 3.0 mL) submit in a sterile specimen container at refrigerated temperature.

Collection Instructions:

  • Please indicate CCMS or catheter specimen.  If CCMS please use first morning void.
  • Patient collection instructions are located in the left side menu.
  1. Clean & rinse the urethral area
  2. Urinate into toilet, stop and urinate about 10 – 20 mL into a sterile cup.
  3. Transfer urine immediately to gray top tube preservative using the transfer straw. Do not pour over or use a syringe.
  4. Using the C&S Transfer Straw Kit, submerge the tip of the transfer straw in the specimen.
  5. Push C&S Preservative tube (gray top) into the top of the transfer straw all the way.
  6. Hold in position until flow stops, making sure to reach the minimum volume line.
  7. Remove tube, leaving transfer straw in specimen container.
  8. Label gray top with at least 2 patient identifiers and source.
  9. Dispose of urine down drain; transfer straw in sharps container.

*If sending specimen in sterile cup, refrigerate specimen immediately and use a purple priority bag to notify Lab that the specimen needs to be processed immediately. Tighten lid of cup, making sure the specimen does not leak. Leaky specimens will be discarded. 

 

Unacceptable

Specimens with 10 or more squamous epithelial cells per high powered field are not appropriate for culture.

 

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

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

 

Container(s): Gray top Urine C&S tube (boric acid preservative) 

Preferred Volume to Collect: 4.0 mL

Minimum Volume to Collect: 3.0 mL

 

Processing Instructions:

  • Using the C&S Transfer Straw Kit, submerge the tip of the transfer straw in the specimen
  • Push C&S Preservative tube (gray top) into the transfer straw all the way .
  • Hold in position until flow stops
  • Remove tube, leaving transfer straw in specimen container
  • Label Gray top with at least 2 patient identifiers and source.

Transport Temperature:

Ambient: Gray top tube, Yellow Tube

Refrigerate: Sterile cup

Rejection Criteria

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

  • Urine specimen cup will be rejected if it is not received in a bag labeled refrigerated or in a purple priority bag.
  • Foley catheter tips/bags
  • Catheter bags
  • Leaky containers
  • Non-sterile container (example: pill bottles or household containers)

Specimen Stability

Ambient:

Gray top: 48 hours (refrigeration for preserved specimens will not extend stability of the sample)

Sterile cup: Transfer to a gray top tube within 30 minutes after collection

Refrigerate:

Sterile cup: 24 hours

Laboratory Retention: 2 days

Reflex Information

  • Identification and sensitivity from culture will be performed, when appropriate, at an additional charge.

Urine culture may be performed if Urinalysis (UA), Do Culture if Indicated is ordered:

  • 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.

Test Frequency

Available daily, usual TAT is 24 hours after receipt of the specimen (48 hours for catheterized specimens).

 

Cultures are read at appropriate intervals to detect early bacterial growth. STAT culture requests are not applicable.

Reference Range

Negative culture: No bacteria isolated

Positive culture: Identification with susceptibility on urinary pathogens with colony counts of greater than 10,000 CFU/mL

Performing Department

MICROBIOLOGY

Performing Department Laboratory Location

Spectrum Health Regional Laboratory, Grand Rapids, MI

Methodology

Manual

CPT

87086

 

This test is not limited to the CPT code(s) listed.  Others may be added for identification and susceptibility testing.

CDM Code

4048888

Epic Test ID

1230100571

Beaker LOINC

BACTERIAL CULTURE, URINE: 630-4

Mayo Access Code

SHO50016

Additional Information

Reference material:

  1. BD Vacutainer® Urine Collection kit for urine collection
  2. Clinical Microbiology Procedures handbook, Third Edition, 2010 ASM Press (American Society of Microbiology). 3.12.4 to 3.12.5

Reviewed Date

7/31/2021

Beaker Names

Beaker Procedure Name: URINE CULTURE
Beaker Display Name: Urine Culture
BEAKER TEST NAME: URINE CULTURE
BEAKER TEST REPORT NAME: Urine Culture

Beaker Synonyms

No synonym on file

Beaker Location, Container and Temperature

BW MICROBIOLOGY: 4 ML URINE GREY R (Preferred)-Refrigerated
BW MICROBIOLOGY: UR CUP/GREY (Acceptable)-Refrigerated
BW MICROBIOLOGY: UR YELLOW/GREY (Acceptable)-Refrigerated
BW MICROBIOLOGY: URINE CUP R (Acceptable)-Refrigerated