Bacteria - Culture & Sensitivities – Urine

Alternative Names/Synonyms	Culture-based detection and identification of bacteria causing urinary tract infections
Laboratory	Microbiology
Sub-section	Bacteriology
Specimen Type	Voided: ○ Midstream urine ○ Bagged urine (neonate only) ○ Indwelling catheter (Foley catheter) urine ○ Ileal conduit urine ○ Suprapubic catheter urine Catheterized: ○ In and out catheter/catheter insertion urine Aseptically collected: ○ Nephrostomy urin

Other Information

○ The majority of positive urine cultures from inpatients without an indwelling catheter represent asymptomatic bacteriuria. If a urinary tract infection is suspected and the patient is from Mount Sinai on 11S, 11N, 14N, 14S, 14 Step Down, please call the Microbiology laboratory within 48h to have a specimen processed if it has been sent. If a phone call is not received the specimen will not be processed

○ If anaerobic culture required, transport urine immediately after collection. The appropriate specimen is a subrapubic aspirate.
○ For prostate specimens, more clinically relevant results may be obtained by collecting the urine specimens pre- and post-prostate massage as described above to indicate urethral and bladder organisms.

Specimen Requirements (Tube Type)

○ Sterile container
○ BD Grey Top Urine Vacutainer tube

Collection Requirements

○ Collect urine into a clean, sterile container, then transfer it to a BD grey top urine vacutainer tube. A sterile container is also acceptable. Transport to the microbiology laboratory ASAP after collection.

Midstream urine (MSU):
○ Clean urethral meatus. Void and discard the first 10 - 20 mL of urine in order to clear the urethra. Collect the subsequent urine into a clean, sterile container.

Neonatal bagged urine:
○ Place a clean collection bag over the external genitalia. Transfer the urine from the bag into a clean, sterile container.

Indwelling catheter (Foley catheter) urine:
○ Puncture catheter tubing aseptically and transfer the urine into a clean, sterile container.

Ileal conduit urine:
○ Clean the stomal opening with alcohol. Insert a sterile catheter to collect the urine and transfer the urine into a clean, sterile container.

In and Out catheter / catheter insertion urine:
○ Collect urine into a clean, sterile container immediately following the initial insertion of an indwelling catheter into the bladder.

Nephrostomy urine
○ Urine draining from a nephrostomy tube placed in the renal pelvis is collected into a clean, sterile container.

Bladder / Cystoscopy urine
○ Collect urine into a clean, sterile container following temporary insertion of a sterile catheter or cystoscope into the bladder.

Suprapubic urine aspirate
○ Aspirate urine through the bladder using a sterile needle and syringe. Transfer the urine into a clean, sterile container.

Segmented urine
○ Collect these specimens for the diagnosis of chronic bacterial prostatitis. Collect three urines plus prostatic secretions (after massaging prostate through the rectum) and designate them as follows:
VB1 = first voided urine representing the urethra
VB2 = midstream urine representing the bladder
VB3 = first voided urine after prostatic massage representing the prostate
EPS = expressed prostatic secretions

Sample Stability

Refer to section Sample Processing / Delivery

Referral Laboratory

In-house

Routine Turnaround Time

○ Up to 48 hours

Laboratory Contact Information

416-586-4800 extension 4452

Approval Required

Sample Processing / Delivery

○ Label specimen container. Place specimens in biohazard bag and seal.

○ Transfer urine specimen to BD Grey Top Vacutainer tube. Do not fill to rubber stopper to avoid leaks when re-capping tube.

○ Specimens should be stored at refrigeration temperature (2-8C˚) after collection if a delay of more than 2h in transport is anticipated.