Specimen Requirements

Alternate Specimen Requirements

Minimum Specimen Requirements

Stability

Days Performed

Sun - Sat

Turnaround Time

6 days

Methodology

Reference Range

Special Info

Voided midstream clean catch method: Patients should be instructed to wash hands prior to collection and offered exam gloves. Female patients - sit on toilet with legs apart and spread labia with one hand. First void in toilet and then, continuing to void, hold specimen container in “midstream” to collect sample. Male patients - retract foreskin if uncircumcised. First void in toilet and then, continuing to void, hold specimen container in “midstream” to collect sample. Indwelling (foley) catheter or suprapubic tube (SPT): Perform hand hygiene. Clamp drainage tubing a minimum of 12 inches below the sampling port. Allow 30 min for urine to fill the tubing to slightly above sampling port. After performing hand hygiene, apply clean gloves. Clean the entry port with alcohol (scrub for 20 s). Wait for port to dry. Perform urine collection from sampling port using the BD Vacutainer Luer-Lok Access Device. Position device over center of sampling port. Push it on and rotate clockwise until it fits securely. Push C&S Preservative Tube over the holder portion of Access Device. Once the tube is completely filled, remove the tube from the holder. Invert the tube 8-10 times. Do not collect urine from collection bag. Straight catheter: Thoroughly cleanse the urethral opening with betadine or chlorasept. Then pass catheter using sterile technique into the bladder. After discarding initial 15 to 30 ml of urine, transfer urine to a C&S Preservative Tube (preferred) or sterile container. Cystoscopy: Label specimens obtained while cystoscope is in bladder “CB” for catheterized bladder. Label specimens of irrigated fluid passing from bladder though ureteral catheters “WB” (washed bladder urine). Label specimens collected with ureteral catheters passed to midureter or renal pelvis LK-1, RK-1, LK-2, and RK-2 (LK for left kidney, RK for right kidney). Stoma (cystostomy, ileal conduit, nephrostomy, ureterostomy): Remove the external device and discard urine within device. Gently cleanse the stoma. Using sterile technique, insert a catheter into the cleansed stoma, and collect the urine by aspirating back on the syringe. After discarding initial 15 to 30 ml of urine, transfer urine to a C&S Preservative Tube (preferred) or sterile container. Prostatic secretions: Multiple samples are cultured. If one specimen grows far more bacteria than others, the infection is localized to the urethra, bladder, or prostate. VB1 (voided bladder 1) - 1st 10cc of urine represents urethra, VB2 - midstream urine represents bladder EPS (expressed prostatic fluid) - Prostate massaged; represents prostate and VB3 - also represents prostate.

Clinical Info

To transfer urine into C&S preservative tube: Submerge the tip of transfer straw into urine specimen. Push the gray top C&S preservative tube into the transfer straw. Hold in position until flow stops. It must be filled to the minimum fill line on the tube (3 ml). Remove tube leaving transfer straw in urine specimen container. Shake tube vigorously to mix sample. If both a UA (red/yellow) and C&S tube (gray top) are being collected, transfer urine to C&S tube first. Urine specimens are processed based on whether the specimen was collected with an invasive (straight catheter, suprapubic aspirate, cystoscopy) or noninvasive (midstream clean catch, indwelling catheter, stoma) method. A low colony count is performed on urine specimens collected via invasive methods. Normal flora from the urethra, vagina and perineum often contaminate urine specimens. Quantitation of bacteria helps to distinguish contaminated specimens from those representing infection. The most common uropathogens are normal intestinal flora organisms such as Escherichia coli, Klebsiella spp. Enterobacter spp., Proteus spp. and Enterococcus spp. The level of work up is based on the specimen type, number of different organisms growing, and the quantity of potential uropathogens in relation to urogenital flora. If culture is positive, identification will be performed on clinically significant organisms at an additional charge. Identification CPT codes that may apply include: 87077, 87088, 87106, 87107, 87153. Antimicrobial susceptibilities are performed when indicated, and the following CPT codes may apply: 87181, 87184, 87185, 87186.