Urine Culture, Routine, Clean Catch

CERNER / EPIC MNEMONIC: C URINE; C URINEGS
POE DESCRIPTION: CU URINE (NON-INVASIVE); URINE C&S (NON-INVASIVE); C URINE (NON-INVASIVE)
CPT CODE: 87086
TEST INFORMATION: A direct Gram stain is performed ONLY if specifically requested.
DAYS PERFORMED:

Daily, 24 hours

TURNAROUND TIME:

Gram stain: 2 hours after receipt of the specimen in the laboratory. Preliminary culture reports are available after 24 hours. Cultures with no growth will be issued after 24 hours. Completion of culture reports may take 48-72 hours after receipt of the specimen when more than one isolate is found.

CONTAINER TYPE:

Sealed sterile urine container or boric acid transport tube.

COLLECTION: Early morning specimens yield highest bacterial counts from overnight incubation in the bladder, and thus, may be the best specimen. The patient must be instructed to thoroughly cleanse the skin and collect the midstream urine specimen. Catheterized specimens are to be collected per the Nursing Procedure Manual. Do NOT collect urine from the drainage bag when an indwelling catheter is in place, since growth of bacteria can occur in the bag itself. Rather, clean the catheter with an alcohol sponge, puncture with a sterile needle, and collect in a sterile container. Transfer a portion of the specimen to a boric acid transport tube. Mix the sample well.
SPECIMEN REQUIREMENTS: Urine
REJECTION CRITERIA: Inappropriate specimen container, insufficient specimen volume, Foley catheter, delay of more than 2 hours when submitting a nonrefrigerated specimen in a sterile container, expired boric acid tube.
MINIMUM VOLUME: 2.5 mL (4.5 mL for boric acid urine transport tube)
HANDLING INSTRUCTIONS: Specimens not collected in the boric acid transport tube MUST be transported as soon as possible. When transportation is delayed, refrigerate. The boric acid transport tube may be stored at room temperature for up to 24 hours before specimen delivery.
REFERENCE RANGE: See Additional Information.
LIMITATIONS OF TEST: Bacteria present in numbers <1000 organisms/mL are NOT detected by this method.
METHODOLOGY: Smear: Gram stain. Culture: conventional culture on routine media.
ADDITIONAL INFORMATION: The following guidelines will be used for the isolation and identification of microorganisms from voided and catheterized urine specimens. If one or two microorganisms are isolated in numbers >10,000 (i.e. 104) organisms/mL, the microorganisms are identified and susceptibility testing performed, if appropriate. If three or more organisms are isolated and one organism is clearly predominant and present in numbers >100,000 (i.e. 105) organisms/mL, the predominant organism will be identified and susceptibility testing performed, if appropriate. If three or more organisms are present and no organism is clearly predominant, the comment ''Three or more organisms present, suggestive of contamination. Consider repeating specimen collection.'' will be added to the report. Organism identification will NOT be performed unless the laboratory is notified that further processing is required. Susceptibility testing is NOT routinely performed for coagulase-negative Staphylococcus species or Group B Streptococcus.
LAST UPDATED:

6-3-2014

TEST SYNONYM(S):Midstream Urine Culture, Routine; Urine Culture, Routine