Urinary Tract Infection CULTURE, URINE, ROUTINE

"Clinical Significance
Culture, Urine, Routine - This culture is designed to quantitate the growth of significant bacteria when collected by the Clean Catch Guidelines or from indwelling catheters.  Quantitative culturing of urine is an established tool to differentiate significant bacteruria from contamination introduced during voiding. This test has a reference range of less than 1,000 bacteria per mL. More than 95% of Urinary Tract Infections (UTI) are attributed to a single organism. Infecting organisms are usually present at greater that 100,000 per mL, but a lower density may be clinically important. In cases of UTI where more than one organism is present, the predominant organism is usually significant and others are probably urethral or collection contaminants. When multiple organisms are isolated from patients with indwelling catheters, UTI is doubtful and colonization likely.

Preferred Specimen(s)
4 mL random, clean catch, midstream urine collection in gray-top urine transport tube

Alternative Specimen(s)
Indwelling catheter collected urine, unpreserved specimens less than 3 mL or from pediatric or from patients with renal abnormalities are acceptable when placed in a sterile, leak-proof container.
(Specimens from long term care and/or pediatric difficult collections only)

Minimum Volume
Preserved: Transport tube must be filled to minimum line printed on tube
Unpreserved: 0.5 mL urine

Collection Instructions
Fill to the fill-line (4 mL) indicated on the tube label

Transport Container
4 mL gray-top urine transport tube

Sterile container: Only for specimens less than 3 mL from pediatric specimens or from patients with renal abnormalities.

Transport Temperature
Preserved: Room temperature or refrigerated (cold packs)
Unpreserved: Refrigerated (cold packs) only

Specimen Stability
Preserved urine
Room temperature: 48 hours
Refrigerated: 48 hours
Frozen: Unacceptable
 
Unpreserved urine
Room temperature: Unacceptable
Regrigerated: 24 hours
Frozen: Unacceptable

Reject Criteria
Preserved urine >48 hours old • Unpreserved urine >3 mL with exception of pediatric specimens or from patients with renal abnormalities • Unpreserved refrigerated urine >24 hours old • Unpreserved, not refrigerated urines • Urine tube not filled to minimum fill-line • Foley tips • Received frozen • Specimens from catheter bag • Urine in urinalysis transport tube • Requests for anaerobic culture • Expired transport devices • 24-hour urine collections • Leaking samples • Swabs • Uricult devices

Setup Schedule"

Includes
If culture is positive, CPT code(s): 87088 (each isolate) will be added with an additional charge.  Identification will be performed at an additional charge (CPT code(s): 87077 or 87140 or 87143 or 87147 or 87149).

Antibiotic susceptibilities are only performed when appropriate (CPT code(s): 87181 or 87184 or 87185 or 87186).

Methodology
Culture

Alternative Name(s)
Urine, Routine Culture