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Lab Manual for UCSF Clinical Laboratories

Lab Manual for SFGH

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BACTERIA CULTURE, URINE, ROUTINE CLEAN CATCH

Item Value
Available Stat? No
Test code UNO, URC
Performed by? Microbiology (Bacteriology)
Sendout? no
Price range $$-$$$
In House Availability 7 days
Principle Specimens are inoculated onto plate media which is incubated and observed daily. Negative culture final reports are issued after 18 hours incubation. When growth is present, the approximate total number of bacterial colonies/mL urine is counted. Counts of 10,000 col/mL or greater of one or two organisms will be identified and antimicrobial susceptibilities done when appropriate. If acute urethra syndrome is suspected, then 102 to 103 gram negative bacteria/mL may be significant. Contact Microbiology (206-8576) about pursuing identification.

When three or more species are isolated, no further workup on the culture will be done. Bacteria isolated are saved five days, and identification and susceptibility testing can be done during this period.
Patient Preparation Males: Cleanse the glans penis with sponges soaked in surgical soap. Do not use Phisohex or any other hexachlorophrene or quaternary ammonium containing disinfectant, (e.g., Zephiran). It is difficult to wash these agents away, and a small quantity entering the specimen may kill any bacteria present. Thoroughly cleanse the meatus. Rinse the glans penis thoroughly with successive sponges soaked in water. Discard the first portion of the specimen; collect the midstream urine in a sterile container;/ discard the last portion of the urine.

Females: Using a similar cleansing process, hold the labia apart, wash the vulva from front to back four times and rinse with water. While the labia are separated, discard the first portion of the specimen; collect the midstream urine in a sterile container; discard the last portion of urine.
Collection Instructions 1. Collection: Take great care in obtaining a well-collected specimen. Your patient will benefit by meaningful laboratory results. Do not delegate specimen collection to your least trained personnel or to the patient. Indicate on the requisition that the specimen is a clean catch.

2. Males: Cleanse the glans penis with sponges soaked in surgical soap. Do not use Phisohex or any other hexachlorophrene or quaternary ammonium containing disinfectant, (e.g., Zephiran). It is difficult to wash these agents away, and a small quantity entering the specimen may kill any bacteria present. Thoroughly cleanse the meatus. Rinse the glans penis thoroughly with successive sponges soaked in water. Discard the first portion of the specimen; collect the midstream urine in a sterile container;/ discard the last portion of the urine.

3. Females: Using a similar cleansing process, hold the labia apart, wash the vulva from front to back four times and rinse with water. While the labia are separated, discard the first portion of the specimen; collect the midstream urine in a sterile container; discard the last portion of urine.
Special instructions In acute urinary tract infections, either a single specimen may be obtained for culture prior to treatment or empirical therapy may be started with clinical observation. For culture, obtain a clean-catch midstream specimen and culture immediately, or refrigerate until it can be plated. In chronic urinary infections, culture and antibiotic susceptibility testing should be performed at appropriate intervals before and during treatment, 1 month later, and thereafter at 1-2 month intervals. Please request a Gram stained smear when appropriate.
Synonyms Urine Culture;
Stability The urine, in a labeled sterile container, should be refrigerated until cold prior to transport or placed in an insulated carrier or carton with blue ice, and sent immediately to the laboratory.
Additional information GRAM STAINS: No Gram stains are done routinely by the laboratory on clean-catch midstream specimens or if type of collection is not indicated. If a Gram stain on a clean-catch specimen is desired, check the "Gram stain only (no cultures)" box on the Bacterial Test Requested portion of the Microbiology Requisition, and cross out "no culture."
References 1. Forbes BA, et al. Bailey and Scott's Diagnostic Microbiology, 11th Ed., Mosby, St. Louis MO, 2002.

2. Murray PR, et al. Manual of Clinical Microbiology, 9th Ed., ASM Press, Washington, DC, 2007.
CPT coding 87070
Last Updated 8/19/2009 1:19:24 PM
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