Test Code Lab6557 UA Reflex Culture ( Urine Macroscopic with Reflex Microscopic and Culture, if Indicated)

Important Note

Specimen source(ie Clean catch, catheter) must be filled in on ordering.

Performing Laboratory

Barnes-Jewish Hospital Laboratory

Methodology

Testing Algorithm:

If there are abnormal dipstick findings (Protein≥1+, any Blood, Nitrite or Leukocyte esterase), then #3117 Urine Microscopic will be performed at an additional charge. In patients with ANC < 0.5, a microscopic and culture will be performed. If ANC ≥ 0.5 and WBCs > 10/hpf, a #M052 Culture, Routine, Aerobe will be performed at an additional charge.

Method Name:

Dipstick: Spectrophotometric reflectance of light on color reagent pads

Urine color: Spectrophotometry or visual observation

Specific gravity: Refractometry

Clarity: Measurement of the transmission and scatter of light

Includes color, clarity, specific gravity, pH, protein, glucose, ketones, bilirubin, occult blood, urobilinogen, nitrites and leukocyte esterase.

Literature References:

AUTION MAX^TM AX-4030 Operating Manual. ARKRAY, Inc. 5182 W 76^th St., Minneapolis, MN May,2019 PN 84-02160K
Instructions for Use IQ200 Series. Beckman Coulter. Lismeehan O’Callahan’s Mills CO Clare Ireland. July, 2020.PN:300-4320CE
AUTION Sticks 9EB. ARKRAY, Inc. 5182 W 76^th St., Minneapolis, MN May,2019 PN:CP73501-010D
Brunzel, N. A.: Fundamentals of Urine and Body Fluid Analysis, 4^th ed., St. Louis, MO; Elsevier; 2018; pp. 68-210.

Specimen Requirements

Specimen Type: Urine, random

Container/Tube: 1 UA preservative tube(yellow/red-top) and 1 Grey-top C&S Preservative Tube - Both tubes must be sent together.

Specimen Volume: Full tubes

Specimen Minimum Volume:

Urinalysis: 5mL

Urine culture: 3 mL

Collection Instructions:

1. Collect a midstream voided specimen.Urine Collection

2. Using cannula in collection cup lid, fill yellow-top, plastic, conical tube.

Additional information:

1. Label tubes with patient's name and date of birth. (use PPID label)

2. A catheterized specimen is acceptable.

3. Provide collection date and time, and specimen source (method of collection).

4. If storage and transport is >1 hour, refrigerate specimen.

5. Specimen should be received in the laboratory within 2 hours of collection.

Day(s) Test Set Up

Monday through Sunday, 24 hours, 7 days a week

Turnaround Time:

Urinalysis: STAT: 1 hour after receipt in laboratory

Routine: 2-4 hours after receipt in laboratory

Urine culture: see individual test listing

Test Classification and CPT Coding

81003 - Urine macroscopic

81015 - Urine microscopic (if appropriate)

87086 - Culture, urine (if appropriate)

Reference Values

Specific gravity: 1.003 - 1.030

pH:"Urine pH is affected by diet, medications, systemic acid-base disturbances, and renal tubular function. pH may affect urinary stone formation. For example, urine pH below 6.0 may help reduce the tendency for calcium phosphate stones and pH greater than 6.0 may reduce the tendency for uric acid stone formation.
Information obtained from Mayo Medical Laboratories test catalog 2/20/18."

Protein: Negative

Glucose: Negative

Ketones: Negative

Occult blood: Negative

Urobilinogen: <2.0 mg/dL

Nitrites: Negative

Leukocyte esterase: Negative

See individual test listings for other reference values.

Specimen Transport Temperature

Ambient < 1 hour

Refrigerate > 1 hour

Additional Information

For BJH Laboratory Use Only

Alternate Tube(s):

1 Yellow top urine tube in place of urine preservative tube (UA only)

Analyte Stability:

Urinalysis: specimen should be received in the laboratory within 2 hour of collection. However, using a preservative tube extends the stability.

Laboratory Processing Instructions:

If specimen is received in a cup, lab processing personnel will use the cannula in the lid to transfer urine to red/yellow top and grey top tubes before transporting to UA tech.

Test performed in BJH Core Lab on uncentrifuged urine. If there are abnormal dipstick findings (protein≥1+. blood, nitrite or leukocyte esterase) and the ANC, within 3 days, is ≥ 0.5, a urine microscopic exam will be performed. If >10 WBCs are seen, a culture will be ordered and a label printed for 'Culture Urine'.

If the ANC, within 3 days, is < 0.5, a microscopic and culture will be ordered. The grey top tube will be labeled with 'Culture Urine' label and sent to Microbiology for culture. Microbiology will send all grey tops without a 'Culture Urine' label to Hematology.

LOINC Codes

Macroscopic

Name LOINC code

Color	50553-7
Clarity	32167-9
pH Ur	50560-2
Specific Gravity Ur	53326-5
Protein Ur	50561-0
Blood Ur	50559-4
Glucose Ur	53328-1
Ketones Ur	50557-8
Leuk Esterase Ur	60026-2
Nitrite Ur	50558-6
Urobilinogen Ur	50563-6

Microscopic