Urine Culture

Urine Culture

Laboratory 

UCS - Urine Culture Screening

UCSRM - Urine Culture Screening and Routine and Microscopic 

URINE - to order Urine Culture (Only ordered by laboratory after reflex test)

• Mid stream Urine (MSU)
• Cystoscopic Urine
• Catheter Urine
• Ileal Conduit
• In-Out catheter Urine

Sterile Container

• In core laboratory, if urine is tested and found to be positive for any of the following: blood, leukocytes, protein or nitrites, according to laboratory policy the culture will be ordered by a reflex order rule. 

  • According to the laboratory policy pediatric specimens will be sent for culture.
  • In addition all patients under the age of 13 will be sent for culture regardless of the screening findings.
• Only one sample per day is permitted, all others will be rejected unless approval from the microbiology department is arranged.
• Clean catch or midstream urine-send first morning voided urine. Do not use disinfectants for cleaning.
• Female-Thoroughly clean the urethral opening and vaginal vestibule area with soapy water or clean gauze pads soaked with liquid soap. Rinse the area well with sterile water or wet gauze wipes. Hold the labia apart during voiding. Allow a few milliliters of urine to pass. Do not stop the flow. Collect the midstream portion in a sterile container.
• Male- Cleanse the penis, retract the foreskin (if not circumcised), and wash with soapy water. Rinse the area well with sterile water. Keeping the foreskin retracted, allow a few milliliters of urine to pass. Do not stop the flow. Collect the midstream portion in a sterile container.
• Ileal Conduit Urine- Remove the external urinary appliance, and discard the urine within. Gently swab and clean the stomal opening with 70% alcohol pad and then with an iodine solution. Remove excess iodine with 70% alcohol after procedure. Using sterile technique, insert a double catheter into the stoma. Catheterize the ileal conduit to a depth beyond the fascial level. Collect the urine drained into a sterile container.
• Catheter Urine (In/Out)- Prior to catheterization, the patient should force fluids until the bladder is full. Clean the urethral opening (an in females, the vaginal vestibule), with soap and carefully rinse the area with water. Using sterile technique, pass a catheter into the bladder. Collect the initial 15-30ml of urine and discard it from the mouth of the catheter. Collect the remaining sample into a sterile container.
• Catheter (indwelling)- Clean the catheter collection port with 70% alcohol. Urine sterile technique , puncture the port with a needle attached to a syringe. Aspirate the urine and place it in a sterile container. Do not collect urine from the collection bag.

Daily

As growth is detected and identified the information is made available to the health care provider.

Once specimen arrives in the laboratory, it requires to process as follow :

• Urine is collected in 90mL sterile container. Swirl to mix urine in the 90mL sterile container.
• Place 90mL urine container on clean, flat surface.
• Label BD vacutainer boric acid C&S tube and BD vacutainer urinalysis tube.
• Place tip of transfer straw into the urine specimen. Container may be tipped at an angel if urine volume is low. Do NOT touch the tip of the transfer straw (it must remain sterile).
• Push BD vacutainer boric acid tube (small  yellow culture tube)  into holder of the transfer straw. Hold in position until urine flow stops. Once the tube is filled, removed the tube from the holder. The urine must meet the minimum fill line to be valid. Mix tubes 8-10 times by inversion.
• Push the BD Vacutainer Urinalysis  Tube (big yellow conical tube) into holder of the transfer straw. Hold in position until urine flow stops. Once the tube is filled, remove the tube from the holder. The urine must meet the minimum fill line to be valid. Mix tubes 8-10 times by inversion.
• Discard transfer straw in sharp container.
• Store BD Vacutainer boric acid C&S tube (small yellow tube) at room temperature in Micro specimen processing area.

Specimen (sterile container) should be transported ASAP to the laboratory in biohazard bag after collection.

Specimen in BD Vacutainer boric acid C&S tube should be stored at room temperature  in the laboratory (in Microbiology rack).

On-site, BGH Laboratory