Urinalysis with Reflexed Culture Order
| Label Mnemonic: | UAR, UARM and URCXR |
| Epic code: | LAB8379 (see Comments for further details) |
| Downtime form: | Doctor/Provider Orders - Pathology Core and Specialty Care Nursery |
Hematology: 6240 RCP Microbiology: BT 6004
Hematology: 356-3527 Microbiology: 356-2591
[1] Transport specimen to the microbiology laboratory as soon as possible. Samples preserved in Gray Top C&S tubes may be stored at room temperature or refrigerated. Refrigerate unpreserved urine. Unpreserved urine stored incorrectly or >24 hours old will be rejected. Preserved specimens stored incorrectly or >3 days old will be rejected.
[2] Gray top C&S tubes are not acceptable for urinalysis and urine chemistries because the preservative interferes with testing. This includes Epic LAB1160, LAB1164 and other urine tests that are incompatible with tube preservatives.
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| Yellow top round bottom tube (no additive) | UA - C&S Collection Kit | Sterile Container |
URINALYSIS:
Collect in Random Urine Yellow Top, round bottom tube (no additive).
URINE CULTURE:
[1] UA - C&S Collection kit is preferred and is available from Hospital Stores (#91900 for clean catch urines and #91901 for Foley catheters). Transfer urine to a Gray Top C&S urine container -- tubes must be filled to 3 mL to prevent inhibition of bacterial growth.
[2] If unable to fill the Gray Top C&S tube, send any volume in the sterile container from the C&S kit or in a sterile specimen container (Hospital Stores #37777).
Deliver to laboratory immediately after collection.1 hour (upon receipt in laboratory) for urinalysis
Urine culture (if performed) turnaround time dependent on bacterial growth, typically 24-48 hours.
Specific gravity: 1.001-1.029; pH: 5.0-9.0, Dipstick negative for protein, blood, bilirubin, urobilinogen, ketones, glucose, leukocyte esterase and nitrite.
Reflectance Spectrophotometry
Microbiology Specimen Collection and Transport
Urine Tests Requiring no Preservatives
Order:
LAB8148 for Urinalysis with Reflex Culture
LAB1164 for Microscopic Exam
LAB8116 for Urine Culture Reflex
NOTE:
[1] Culture cannot be performed as an add-on test to urinalysis. Send separate samples for urinalysis (Random Urine Yellow Top, conical bottom tube (no additive)) and culture (as above).
[2] See "Microbiology Specimen Collection and Transport" and individual test descriptions in the Pathology Lab Handbook.
[3] STAT Microbiology requests are not accepted for this specimen type.
UIHC's reflex culture algorithm is designed to cancel cultures based on nitrite, leukocyte esterase, and the microscopic WBC count per high- power field. Outpatient clinic algorithm is determined by nitrite and leukocyte esterase only. Combinations of test outcomes and whether they generate a reflex urine culture are summarized below.
Outpatient cultures:
Nitrite/Leukocyte Esterase
-/- --> reflexively cancel culture
Any/- --> reflex to culture
-/Any --> reflex to culture
Any/Any --> reflex to culture
Urines with source other than Foley or Indwelling Cath:
Nitrite/Leukocyte Esterase/Microscopic WBC
-/-/less than 5 --> reflexively cancel culture
+/-/less than 5 --> reflex to culture
ANY/+/ANY --> reflex to culture
ANY/ANY/>=5 --> reflex to culture
Urines with source Foley Cath or Indwelling Cath:
Nitrite/Leukocyte Esterase/Microscopic WBC
-/-/less than 10 --> reflexively cancel culture
+/-/less than 10 --> reflex to culture
ANY/+/ANY --> reflex to culture
ANY/ANY/>=10 --> reflex to culture
Voiding Trial Protocol PDF
External Catheter Alternatives