As of today, December 16, 2014, a new reflex urine order will be available for providers interested in obtaining a urine culture only if urinalysis is positive.  A positive urinalysis in this order is defined as any level of positivity in leukocyte esterase or nitrite.  Microscopic findings do not trigger a reflex culture.  Negative urinalysis will result in cancellation of the urine culture order.  This reflex order set is associated with a new set of collection and transport requirements that are summarized below.

Key points are:

• The gray top tube should be sent to Microbiology.  Send the yellow top tube to Specimen Control.


• The new collection and transfer devices are for convenience.  Gray top C&S tubes must be filled completely to ensure that culture growth is not inhibited.  If samples are short, a urine cup or second yellow top tube are acceptable for culture.


• Urinalysis must be done from yellow top tubes.  Other urine chemistries, such as toxicology testing and pregnancy testing, have other tube requirements.  Consult the Pathology Handbook for specific specimen requirements.


• Because no reflex order has existed previously, it is up to individual providers to request that it be added to their preference lists.


• Epic Order Panels:
  Inpatient Order Panel - URINALYSIS WITH REFLEXED CULTURE AND MICROSCOPIC EXAM, #O111523
  Ambulatory Order Panel - URINALYSIS WITH REFLEXED CULTURE AND MICROSCOPIC EXAM, #O111649

Questions concerning testing can be directed to Bradley Ford, MD, PhD, Medical Director of Microbiology (ext. 6-2990, pager 8290).