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)