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D.M.M. Lab.
*Staphylococcus aureus
Pure culture regardless to the no. of CFUs.
Staph saprophyticus
Corynebacterium jeikeium
Acinetobacter spp
Pseudomonas spp
* Gardnerella vaginalis Unusual
* yeast
Parasites
Schistosoma haematobium
Trichomonas vaginalis
Suprapubic aspiration
Specimen processing
Initial report
The use of dipstick designed to detect the presence of urine nitrite and to
indirectly estimate the number of segmented neutrophiles through the detection
of leukocyte esterase activity. Rationale for the nitrate test is that most urinary
tract infections are caused by nitrate reducing members of the family
Enterobacteriaceae.
Leukocyte esterase (LE) is produced by segmented nutrophiles; this test when
performed alone correlated with ten or more white blood cells per high power field
in the urine with a sensitivity in the range 88% and specificity 94%.
Screening test
As many as 60% to 80% of all urine specimens received for culture by the
acute care medical Center laboratory may contain no etiological agents of
infection. Procedure developed to identify quickly those urine specimens that
will be negative on culture, thus to circumvent excessive use of media,
technologist time, and the overnight incubation period. The gram stain is the
easiest, least expensive, and probably the most sensitive and reliable
screening method for identifying urine specimens that contain greater than
10^5 CFU/ml.
A drop of well-mixed urine is allowed to air dry.
The smear is stained and examined under oil immersion (1000x).
Presence of at least one organism per oil immersion field.
( examining 20 fields ) corelates with significant bacteriuria (>10^5 CFU/ml).
Specimen processing
Culturing
Culturing Procedure
Mix the urine sample to re-suspend microorganism present.
Dip a 1 l or 10 l calibrated loop in vertical position in the urine and remove
the loop and use the collected fluid to inoculate Nutrient, Blood and MacConkey
agars respectively.
Culturing Procedure
Colony counting
CFU
# colonies counted
in original sample
ml
(dilution) (volume plated, in ml)
A plate count of 100,000 CFU/ml of pure culture should be considered positive
and isolated organism should be identified and sensitivity test will be performed.
A plate count between 10,000 100,000 CFU/ml is considered suspected .
A plate count less than 10,000 CFU/ml is considered negative.
Additional information
A single culture is about 80% accurate in the female; two containing the
same organism with count of 10^5 or more represents 95% chance of true
bacteriuria; three such specimens mean virtual certainty of true bacteriuria.
Single clean voided specimen from an adult male may be considered
diagnostic with proper preparation and care in specimen collection.
Urinary tract infection is significantly higher in women who use diaphragmspermicide contraception, perhaps secondary to increased vaginal pH and
a higher frequency of vaginal colonization with E. coli.
Most laboratories limit the number of organisms which will be identified
when recovered from urine to two.
If the patient is receiving antimicrobial therapy at the time the specimen is
collected, any level of bacteriuria may be significant.
Failure to recover aerobic organisms from patients with pyuria or positive
Gram's stains of urinary sediment may indicate the presence of
mycobacteria or anaerobes.