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Urine Culture
MessageOther urine-related culture types:
Urine for AFB Culture refer to C AFB
Urine for Fungus Culture refer to C F
Suprapubic ONLY for anaerobic culture refer to C ANA
Urine for AFB Culture refer to C AFB
Urine for Fungus Culture refer to C F
Suprapubic ONLY for anaerobic culture refer to C ANA
Test Code
C U
Preferred Specimen
Acceptable Specimens Include for Culture:
Clean catch
Midstream
Minicath
Foley cath (NOT considered a catheter urine; will be treated as a clean catch/ midstream urine)
Peds bag
Single cath
Suprapubic
Cytoscopic
Nephrostomy
Kidney or bladder tap
Ileal loop
Indwelling catheter
Describe the TYPE OF URINE collection, such as:
Clean catch
Indwelling catheter
Nephrostomy
Straight catheter
Suprapubic catheter
Suprapubic needle aspirate
Acceptable Specimens for AFB Culture:
Entire first morning specimen (40-50 mL urine)
NOTE: Do not use preserved urine for AFB culture.
Ileal Loop/ Indwelling Catheter:
1-2 mL aspirate in a sterile tube of small sterile container.
The urine specimens should not be from the drainage bag. The only proper method of collection is by needle puncture of the catheter and aspiration of the urine into a sterile syringe; the catheter site of collection must be properly cleansed prior to performing the procedure.
NOT suitable for anaerobic culture.
Clean catch
Midstream
Minicath
Foley cath (NOT considered a catheter urine; will be treated as a clean catch/ midstream urine)
Peds bag
Single cath
Suprapubic
Cytoscopic
Nephrostomy
Kidney or bladder tap
Ileal loop
Indwelling catheter
Describe the TYPE OF URINE collection, such as:
Clean catch
Indwelling catheter
Nephrostomy
Straight catheter
Suprapubic catheter
Suprapubic needle aspirate
Acceptable Specimens for AFB Culture:
Entire first morning specimen (40-50 mL urine)
NOTE: Do not use preserved urine for AFB culture.
Ileal Loop/ Indwelling Catheter:
1-2 mL aspirate in a sterile tube of small sterile container.
The urine specimens should not be from the drainage bag. The only proper method of collection is by needle puncture of the catheter and aspiration of the urine into a sterile syringe; the catheter site of collection must be properly cleansed prior to performing the procedure.
NOT suitable for anaerobic culture.
Patient Preparation
For Ileal Loop/ Indwelling Catheter:
Aseptically cleanse the distal end with alcohol at the junction of the catheter and the drainage tube.
Insert the needle (approximate size 25) into the catheter at an angle to ensure self-sealing.
Aspirate 1-2mL of urine and aseptically transfer to a sterile tube or small container. Label & transport.
Not suitable for anaerobic culture.
Minimum Volume
- Clean Catch/ Voided Midstream Urine: Full 2-8 mL urine collection kit (grey top vacutainer- PREFERRED) or 2-5mL in a sterile screw-capped container
- Single Caths/ Suprapubic Aspirates: 2-3 mL urine in a sterile container or grey top vacutainer tube (PREFERRED)
- Urine Specimens for AFB/ Fungus (DO NOT use preserved urine):
- Clean Catch/ Voided Midstream Urine: 10-100 mL for AFB and Fungal cultures.
-
Single Caths/ Suprapubic Aspirates: 5-30 mL for AFB and Fungal cultures.
Other Acceptable Specimens
Urines collected in surgery by an invasive method are the ONLY urine specimen acceptable for anaerobic culture (suprapubic aspirate).
Instructions
Bacteria can contaminate the urine from the urethral/paraurethral meatus as well as from the perineum. The amount of contamination increases significantly with inappropriate cleansing and collection techniques. These contaminating bacteria can proliferate well in urine, many species having generation times as short as 2-80 minutes. Thus, proper collection, storage, and transport of urine specimens is paramount to the significance and interpretation of their culture.
Collection: It is desirable but not absolutely necessary (except for AFB) to obtain early morning specimens. This assures the highest bacterial counts after overnight incubation in the bladder. Forced fluid administration to patients may dilute the bacterial count and compromise interpretation of the culture.
Suprapubic aspiration (tap) is performed by direct needle puncture of the bladder. Urines collected in surgery by an invasive method are the ONLY urine specimen acceptable for anaerobic culture.
Collection: It is desirable but not absolutely necessary (except for AFB) to obtain early morning specimens. This assures the highest bacterial counts after overnight incubation in the bladder. Forced fluid administration to patients may dilute the bacterial count and compromise interpretation of the culture.
Suprapubic aspiration (tap) is performed by direct needle puncture of the bladder. Urines collected in surgery by an invasive method are the ONLY urine specimen acceptable for anaerobic culture.
Transport Temperature
Ambient/ Room Temperature
Unpreserved urine specimens may be transported refrigerated.
Unpreserved urine specimens may be transported refrigerated.
Specimen Stability
Unpreserved urine
Room temperature: Less than 2 hours
Refrigerated: Less than 24 hours
Preserved urine (grey top vacutainer - boric acid)
Room temperature: Less than 48 hours
Room temperature: Less than 2 hours
Refrigerated: Less than 24 hours
Preserved urine (grey top vacutainer - boric acid)
Room temperature: Less than 48 hours
Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Unacceptable specimens:
- Unpreserved specimens:
- at room temperature greater than 2 hours old.
- refrigerated greater than 24 hours old.
- Preserved specimens greater than 48 hours old.
- Underfilled grey top vacutainer (GU) specimens
- Urine from a foley catheter drainage bag.
- Urines that have been pooled or collected over a 12-24 hour period
- Preserved urine for AFB cultures
- Ileal loop or indwelling catheter for anaerobic culture.
- ANY urine collected that is NOT a suprapubic aspirate collected in surgery with anaerobic culture orders.
- More than 1 urine is received per patient, per day unless patient is a urology patient, or the urine specimens are from different sources.
- ANY specimen that meets ANY of the above criteria will be rejected and test will be cancelled.
Clinical Significance
This culture is designed to quantitate the growth of significant bacteria. 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 than 100,000 bacteria per mL, but a lower density may be clinically important. In cases of UTI .
