Department

Microbiology

Preferred Sample Type

Urine Microscopy, Culture and Susceptibility

Turnaround Time

2 days for negative results; 3 days for confirmed positive results

Sample Stability

Urines kept for 2 days

Urine Microscopy, Culture and Susceptibility

General Information

Transport and Storage

Please send to the lab as soon as possible (within 4 hours) if sample not in boric acid and not refrigerated. Store in a refrigerator at 4°C if there is a delay in transporting. It can be stored up to 48 hours.

Sample Container

 Preferred: 10ml Red Top Urine Microbiology Tubes - Sterile with boric acid.

Min Volume = 10ml. Please do not perform urine dip analysis on urine in a boric acid tube.

Alternative 10ml White Top Sterile Urine Microbiology Tubes are ONLY to be used when 10ml for normal boric red top cannot be obtained i.e. paediatricss, renal failure, critically ill oliguric patients.

 

 

  

Patient Preparation

Please ensure MSU samples are mid-stream and CSUs are from catheter sample port (not collection bag).

For instructions on how to collect urine samples for M,C&S please see the following guides:

GP PATIENTS - HOW TO COLLECT A MID-STREAM URINE SAMPLE

HOSPITAL PATIENT - HOW TO COLLECT A MID-STREAM URINE SAMPLE

Tests performed

1) Quantification of cells in urine by automated cell counter or microscopy.
2) Bacterial culture and sensitivities. 

 

 Specific groups/information

Paediatrics

For urgent testing of urine in neonates please call the laboratory on ext 43256 up until 7pm and after that contact on call BMS technician through switchboard. Please give the patient’s details, where the sample is coming from and who to contact with the results.

For all children 3 years and under

All microscopy reports will be sent out as interim with culture results to follow. If an organism is identified, this will also be reported at an interim stage followed by the final result with antimicrobial sensitivity testing information.

Please be aware that ALL urines are cultured regardless of the urinary white cell count. If a child is empirically started on antimicrobials based on symptoms, signs or dipstick testing in accordance with the CG 54 NICE guidelines, please continue until the culture result is reviewed.

Pregnancy

In pregnancy – all samples sent will be cultured as this is important for identifying asymptomatic bacteriuria and UTIs which may adversely affect a pregnancy. To assist in this please either tick pregnancy on ICE form or clearly document ‘PREGNANT’ in clinical details.

Urology

If a patient has a nephrostomy please document on ICE or paper request form the date when it was last changed. This will help indicate how significant the culture results are. Please do not send nephrostomy or urosotomy bag urine. Fresh urine should be collected.

Sensitivity reporting

Some common UTI pathogens are inherently resistant to common oral antimicrobials and therefore are NOT tested or reported. Please be aware so that these antibiotics are not used.

Examples:

Klebsiella species: amoxicillin not tested
Proteus species: nitrofurantoin not tested

Enterobacterales ( Coliforms) that are reported as ESBL/Amp C : Do not use penicillins, penicillin/ beta-lactamase inhibitors ( e.g co – amoxiclav) or cephalosporins

Notes

Please also check:

  • Lids are secure
  • Two matching patient identifiers on form AND container
  • Sample type and test required stated on form
  • Brief, relevant clinical history stated on form

Reference Range

WBC 0-80

RBC 0-140

Casts 0-1

Epithelial Cells 0-5 males : 0-50 females

Specifications

  • EQA Scheme?: Yes
  • EQA Status: NEQAS

The laboratories at Heartlands Hospital, Good Hope Hospital and Solihull Hospital form part of the services provided by University Hospitals Birmingham and are UKAS (United Kingdom Accreditation Service) accredited to the ISO 15189:2012 standard. For a list of accredited tests and other information please visit the UKAS website using the following link: https://www.ukas.com/find-an-organisation/

  • Heartlands, Good Hope and Solihull Hospital pathology laboratories are a UKAS accredited medical laboratory No.8217
  • United Kingdom Health Security Agency laboratory is a UKAS accredited medical laboratory No.8213

Tests not appearing on the UKAS Schedule of Accreditation currently remain outside of our scope of accreditation. However, these tests have been validated to the same high standard as accredited tests and are performed by the same trained and competent staff.

For further test information, please visit the test database: http://www.heftpathology.com/frontpage/test-database.html.

Protection of personal information - Laboratory Medicine comply with the Trust Data Protection policy and have procedures in place to allow the Directorate and its employees to comply with the Data Protection act  1998 and associated best practice and guidance.

For further information contact Louise Fallon, Quality Manager, 0121 424 1235

UKAS HEFT