Special Precautions/Comments:

N.B. Investigation for casts & crystals are NOT performed as part of routine urine microscopy, culture and sensitivity testing. If additional testing is required please create a separate request for urinary casts & crystals in ICE/Meditech (or indicate testing requirement on an official laboratory request card).

Interferences: Boric acid is present as a preservative to prevent multiplication of organisms. However, inadequately diluted boric acid can have an antimicrobial effect and thus affect the recovery of bacteria from the urine sample. Please ensure samples are at least 2ml in volume.

• If the patient is unable to produce an adequate sample (≥2ml), a non-leaking universal container (green or white top) will generally be accepted. Please be aware that the lack of preservative in universal containers means any time delay in testing may see specimen degradation or overgrowth of contaminating bacteria. Therefore, these results must be interpreted with caution. 

Method: Samples will be tested by either automated fluorescence flow cytometry (FFC)(Sysmex UF-5000) or manual light microscopy depending on their constitution. Positive samples will undergo culture and sensitivity testing on specialised agar (Mast Uri® System). Calibration: N/A. EQA scheme: NEQAS & LabQuality. IQC: IQC: Sysmex commercial preparations (positive & negative control).

Interpretation: Samples deemed NEGATIVE (≤100 bacteria, and /or ≤40 WBC) by microscopy/FFC will be reported as such and will not receive further testing (unless otherwise indicated by certain criteria or by microbiology consultant request). POSITIVE specimens (≥100 bacteria, and /or ≥40 WBC) are taken for culture and sensitivity testing. Further testing of positive samples, such as species level identification by MALDI-ToF MS or further sensitivity testing, may be required based on the organism identified. In cases where AmpC/ESBL enzyme producing or highly resistant organisms have been identified, the consultant microbiologist will be notified first. 

Additional Information:

Background information: Urine microscopy, culture and sensitivity testing is primarily used to assess patients with suspected urinary tract infections (UTIs). Left unchecked UTIs can develop into life-threatening urosepsis, if the significant pathogen enters the bloodstream. Along with any significant bacterial presence, other indicators of inflammation are screened for; including a raised white blood cell (WBC) count, raised red blood cell (RBC) count, and the presence of casts. This test may follow on from abnormal findings in point of care testing (POCT), including the use of chemical testing agents such as ‘dipsticks’.