Urine Culture, Routine

CPT 87086
Synonyms
  • Culture, Urine, Routine
  • Midstream Urine Culture, Routine
  • Routine Culture, Urine, Clean Catch
  • Urine Culture, Catheter
  • Urine Culture, Routine, Midvoid Specimen

Test Details

Use

Semiquantitative culture to isolate and identify bacterial causes of urinary tract infection. Detect up to two pathogenic bacterial organisms at levels above 10,000 cfu/mL.

Special Instructions

Unrefrigerated, unpreserved urine specimens greater than two hours old may be subject to overgrowth with organisms normally present in the urethra and periurethral areas, and may yield inaccurate or misleading results. If specimens are incorrectly submitted with an order for aerobic bacterial culture, the laboratory will process the specimen for the test based on the source listed on the request form. The client will not be contacted to approve this change, but the change will be indicated on the report.

Test Includes

Culture; quantitation, isolation, identification (additional charges/CPT code[s] may apply), and susceptibility testing of up to two organisms at >10,000 colonies/mL if culture results warrant (additional charges/CPT code[s] may apply). CPT coding for microbiology and virology procedures often cannot be determined before the culture is performed. Requests with only a written order and no test number indicated will be processed according to Default Testing for Routine Microbiology.

Methodology

Culture

Related Documents

For more information, please view the literature below.

Microbiology Specimen Collection and Transport Guide

References

Cavagnolo R. Evaluation of incubation times for urine cultures. J Clin Microbiol. 1995 Jul;33(7):1954-1956.7665682
Joho KL, Soliman H, Weinstein MP. Comparison of one-day versus two-day incubation of urine cultures. Diagn Microbiol Infect Dis. 1995 Jan;21(1):55-56.7789098
McCarter YS, Burd EM, Hall GS, Zervos M. Laboratory diagnosis of urinary tract infections. Sharp SE, ed. Cumitech 2C, Washington, DC: ASM Press; 2009.
Ronald AR, Nicolle LE, Harding GKM. Standards of therapy for urinary tract infections in adults. Infection. 1992;20(Suppl 3):S164-S170.1490743
Stamm WE. Criteria for the diagnosis of urinary tract infection and for the assessment of therapeutic effectiveness. Infection. 1992;(Suppl 3):S151-S159.1490740

Additional Information

A single culture is about 80% accurate in the female; two containing the same organism with a count of 100,000 cfu/mL or more represent a 95% chance of true bacteriuria; three such specimens mean virtual certainty of true bacteriuria. A single clean voided specimen from an adult male may be considered diagnostic with proper preparation and care in specimen collection. If the patient is receiving antimicrobial therapy at the time the specimen is collected, any level of bacteriuria may be significant. When more than two organisms are recovered, the likelihood of contamination is high; thus, the significance of definitive identification of the organisms and susceptibility testing in this situation is severely limited. A repeat culture with proper specimen collection including patient preparation is often indicated. Cultures of specimens from Foley catheters yielding multiple organisms with high colony counts usually represents colonization of the catheter and not true significant bacteriuria. Failure to recover aerobic organisms from patients with pyuria or positive Gram stains of urinary sediment may indicate the presence of mycobacteria or anaerobes.

Specimen Requirements

Information on collection, storage, and volume

Specimen

Urine

Volume

To minimum fill line (4 mL) on Vacutainer® gray-top urine culture transport tube with preservative (preferred)

Container

Vacutainer® gray-top urine culture transport tube with preservative (preferred). If less than 4 mL of urine is collected, usually from pediatric and geriatric patients or from a catheter, submit refrigerated in a sterile, screw cap container or tube. Do not submit low volume urine specimens in underfilled gray top tubes.

Storage Instructions

Preserved: Room temperature for 48 hours

Unpreserved: Refrigerated for 24 hours

Causes for Rejection

Unrefrigerated, unpreserved specimen greater than two hours old; unlabeled specimen or name discrepancy between specimen and request label; specimen in expired transport container; specimen received after prolonged delay (usually more than 48 hours for urine); specimen collected from a Foley catheter bag; specimen in nonsterile or leaking container

Collection

Clean catch mid-stream collection. First morning specimens yield highest bacterial counts from overnight incubation in the bladder, and are the best specimens. Read Patient Preparation.