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Culture, Urine

Clean Catch Urine, Catheterized Urine, Suprapubic Urine, Cystoscopic, CCMS, Mid-stream, Urine Culture

Test Codes

EPIC: LAB5507

Department

Microbiology

Instructions

• If specimen is from a catheter, the type of catheter must be clearly indicated (i.e. indwelling or straight).
• Proper specimen collection is very important because organisms normally present in the urethra and periurethral areas can overgrow the pathogenic organisms, thereby providing inaccurate or misleading results. 
• Urine held at room temperature can support the growth of contaminants as well as pathogenic organisms. Microorganisms can multiply significantly after two hours at room temperature if the urine is not placed into an appropriate transport media.
• For more information, please refer to Specimen Collection Manual: Urine for Culture.

NOTE: The following test should be used for inpatients at all Beaumont Hospitals, who have an indwelling urinary catheter (currently in use or removed within the last 96 hours): Urinary Catheter Urinalysis with Reflex to Culture.

Specimen Collection Criteria

Collect: 15 mL of urine in a screw-capped container (preferred) or other sterile collection cup. Collection may be clean catch, catheter, cystoscopic, random or suprapubic needle aspiration.

• For optimal recovery of pathogenic microorganisms, transfer 4-5 mL of the urine specimen to a Boric Acid urine transport tube immediately after collection.
• For specimens with less than 3 mL of urine (i.e., pediatric, patients with oliguria/anuria, urine specimens obtained during surgical procedures):
  • Do NOT transfer urine to the Boric Acid urine transport tube.
  • Maintain the urine in the collection cup and keep refrigerated (2-8°C or 36-46°F).
  • Send immediately to the Microbiology Laboratory.

Physician Office/Draw Specimen Preparation

All samples greater than 3 mL must be transferred to a Boric Acid tube. Sterile cups containing greater than 3 mL of urine will be rejected if received more than two hours after collection.

Deliver specimens to the Laboratory for processing immediately after collection.

Preparation for Courier Transport

Transport: 

• Optimal: Urine in Boric Acid tube, room temperature (20-26°C or 68-78.8°F) or refrigerated (2-8°C or 36-46°F).
• Alternative: Urine <3 mL in sterile container, refrigerated (2-8°C or 36-46°F).

Rejection Criteria

• Urine collected from the bag attached to the indwelling catheter.
• Foley catheter tips.
• Specimens in non-sterile or leaking containers.
• Multiple specimens (more than one in 24 hours).
• Pooled specimens.
• Original specimens delayed in transport to the Laboratory (greater than 2 hours at room temperature (20-26°C or 68-78.8°F) or greater than 48 hours in Boric Acid tube.
• Specimens greater than 3 mL sent in a sterile cup and received more than 2 hours after collection.

In-Lab Processing

If the specimen is received in a sterile container and is a shared urinalysis specimen, immediately pour into a separate sterile container and send to the Urinalysis Laboratory (within 1 hour of receipt).

Storage

Specimen Stability for Testing:

COLLECTION CONTAINER			CONDITION			VOLUME			STABILITY
			Room Temperature (20-26°C or 68-78.8°F)			4-5 mL Optimal			48 hours
Boric Acid Tube			Refrigerated (2-8°C or 36-46°F)
			Frozen (-20°C/-4°F or below)			Unacceptable
			Room Temperature (20-26°C or 68-78.8°F)			All			<2 hours
Sterile Cup			Refrigerated			>3 mL <3 mL			<2 hours 24 hours
			Frozen (-20°C/-4°F or below)			Unacceptable

Specimen Storage in Department Prior to Disposal:

Refrigerated (2-8°C or 36-46°F): 4 days

Laboratory

Dearborn Microbiology Laboratory
Taylor, Trenton and Wayne sent to Dearborn Microbiology Laboratory for testing.

Royal Oak Microbiology Laboratory
Farmington Hills, Grosse Pointe and Troy sent to Royal Oak Microbiology Laboratory for testing. 

Performed

Sunday – Saturday, 24 hours a day.

• Preliminary results available within 24 hours.
• Cultures on non-invasive specimens (random, clean catch, Foley cath) with no growth will be reported as final in 1 day.
• Cultures on invasive specimens (straight/suprapubic catheter, cystoscopic) with no growth will be reported as final in 2 days.
• Final results for most urine cultures are available within 48 hours.
• Reports on positive specimens may require 2-3 days for final reports due to more extensive testing. 

• Antimicrobial susceptibility testing is not done on every specimen. Clinicians are encouraged to contact the applicable Clinical Microbiology Laboratory for more information and additional requests. See contact information below. 

Reference Range

No growth.

Test Methodology

Aerobic culture and antimicrobial susceptibility testing.

Interpretation

By report.

Clinical Utility

This assay is used to isolate and identify potentially pathogenic organisms causing urinary tract infections.

Reference

1. McCarter, Y.S., E.M. Burd, G.S. Hall, and M. Zervos. 2009. Cumitech 2C, Laboratory diagnosis of urinary tract infections. Coord. ed. S.E. Sharp. ASM Press. Washington, D.C.

CPT Codes

87086, 87088.
LOINC:  630-4

Contacts

Last Updated

6/17/2022