To help the Laboratory tremedously A good history on the request would be of great benefit (e.g. "not on antibiotics....urinalysis positive" or "on 3 days of trimethoprim still urinary symptoms") Simply recording dipstick results without other clinical information is NOT acceptable.
Microscopy and Culture.
Urine should be sent in boric acid preservative, filled to the line marked on the container.
Suitable samples for test are: Mid-stream urine, urine collected from urinary catheter port (not bag bladder washout samples), cystoscopy urine, nephrostomy tube urines, bag urine from infants, supra-pubic aspirate.
Test is indicated for investigation of urinary tract infection
e.g. in paediatric patients, 5ml bottles should be used. This prevents the concentration of the preservative affecting the result
Sterile Universal Containers should be sent for:
Early morning urine, samples required from 3 consecutive days for mycobacterial culture.
Pregnancy testing; early morning sample recommended
Antigen detection tests e.g. legionella Virology testing e.g. BK virus, CMV
Urine for Schistosomiasis must be collected between 10am and 2pm after a period of activity. Minimum 10mls Alternatively a 24h collection of terminal samples of urine may be obtained.
How to collect a sample
Collect 20ml of urine if using a red topped universal container, this should fill up to the fill line. If less than 20ml is collected the boric acid in the container may inhibit the growth of some bacteria. Urine can be collected from a variety of sites (Mid-stream specimen of urine - MSSU - , catheter urine, bag urine from young children, nephrostomy tube urine, suprapubic aspirates of urines etc).
MSSU samples are prone to contamination and the patient has to be instructed to cleanse the area of the urethra thoroughly with soap and water before collecting after voiding the initial portion of urine. This reduces the contamination rate greatly.
Indicators of contamination are presence of epithelial cells or absence of white cells or pyuria. The cell count is found on the final report.
If the specimen is not transported immediately for bacterial culture, refrigerate.
Delay in transit can lead to a false positive result.