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Test Code Urinalysis, Reflex to Culture Urinalysis with Reflex to Culture

Performing Laboratory

NRL-Urinalysis/Barnes Jewish Hospital

Methodology

#UA Urinalysis is performed first.
Testing Algorithm:

If urinalysis result indicates any 1 of the following abnormalities (WBC: >5/hpf; LE dipstick: positive; nitrites: positive; or yeast: positive), culture will be performed, at an additional charge.

If  #UA Urinalysis is negative, no culture will be ordered.

Specimen Requirements

Specimen source is required.

 

Specimen must arrive within 24 hours of collection.

 

Preferred specimen is from a first-morning void. When antibiotics are to be started immediately, a first-morning specimen is still preferred.

 

Submit only 1 of the following specimens:
 

Specimen Type: Urine, catheter

Container/Tube: Sterile syringe

Specimen Volume: 10 mL

Collection Instructions:

1. Clean catheter with an alcohol sponge, puncture with a sterile needle, and collect in sterile syringe. Do not collect urine from drainage bag.
2. Transfer 10 mL of urine into a boric acid urine preservative tube within 1 hour of collection. Mix well. If boric acid preservative tube is not available, refrigerate specimen immediately after collection.
3. Label tube with patient’s name (first and last), date and actual time of collection, and source of specimen.

 

Specimen Type: Urine, clean-catch

Container/Tube: Sterile container

Specimen Volume: 10 mL

Collection Instructions:

1. Clean-catch urine for culture should be collected in a sterile container.
2. Unscrew cap of urine container. Place cap on counter, top down. Do not contaminate interior of cap or container.
3. Cleanse patient yourself or instruct patient to collect a clean-catch, mid-stream specimen as follows:

 

Males
A. Wipe head of penis in a single motion with first Towelette.
B. Repeat with second Towelette.
C. If not circumcised, hold foreskin back before cleansing.
D. Urinate a small amount into toilet or bedpan and proceed to step #4.


Females
A. Separate labia.
B. Wipe inner folds front to back in a single motion with first Towelette.
C. Wipe down through center of labial folds with second Towelette.
D. Keep labia separated, urinate a small amount into toilet or bedpan, and proceed to step #4.


4. Place container under stream and continue to urinate into container to collect specimen.
5. Finish voiding into toilet or bedpan.
6. Place cap on container and tighten securely. Give specimen to nurse.
7. Transfer 10 mL of urine into a boric acid urine preservative tube within 1 hour of collection. Mix well. If boric acid preservative tube is not available, refrigerate specimen immediately after collection. Specimen collected in a urine transport container with preservative may be sent at ambient temperature.

8. Label tube/container with patient’s name (first and last), date and actual time of collection, and source of specimen.

Reference Values

Urinalysis


Specific gravity: 1.001-1.033
pH: 5.0-8.0
Protein: negative
Glucose: negative
Ketones: negative

Leukocyte esterase: negative

Nitrite: negative
Bile: negative
Blood: negative
Urobilinogen: 0.2 mg/dL
 

Microscopic

 

Bacteria: negative
WBC: 0-5/hpf
RBC: 0-3/hpf

Yeast: negative

 

CULTURE

No growth

Day(s) Test Set Up

Monday through Sunday

Turnaround Time:

Culture-48 hours

Urinalysis-1 hour

Specimen Transport Temperature

Refrigerate

Test Classification and CPT Coding

81001-Urinalysis
87077-Aerobic identification, each bacterium (if appropriate)
87086-Culture (if appropriate)
87088-Isolation and presumptive identification of isolates from urine (if appropriate)
87106-Yeast identification (if appropriate)

87147-Agglutination grouping, per antisera (if appropriate)

87181-Sensitivity, gradient (if appropriate)
87184-Sensitivity, Kirby-Bauer (if appropriate)
87186-Sensitivity, MIC (if appropriate)