For routine culture and sensitivity testing, use the white top sterile universal bottle – this should be sent to the laboratory as soon as possible. Minimum volume required is 1 ml.
- CMV: use a plain sterile universal container and send or take to the laboratory immediately accompanied by a completed blue and white Microbiology request form.
- Legionella and pneumococcal antigen: use a plain universal
- TB: boric acid container. If TB culture is indicated, 3x 250ml containers will be issued.
Contaminating bacteria from the external genitalia may give rise to misleading results. Therefore we can only accept the following specimens for routine culture:
- Catheter or cystoscopy specimens
- Mid-stream urine specimens
- Supra-pubic aspirates
Please note that urinary catheter tips will not be processed as they do not provide helpful microbiological information.
Mid-stream specimens are collected as follows:
If the patient is able to collect urine without assistance from the nursing staff they should be instructed as follows:
- Separate the labia and with cotton wool or a sponge moistened with water, wipe the vulva from the front to the back. Disinfectant MUST NOT be used.
- With the labia still separated allow some urine to pass into the toilet, then, without stopping, allow urine to pass into a sterile borate container and fill to the line.
- Pass the remaining urine into the toilet.
- Clean the glans penis with soap and water. Commence micturition, and when a few millilitres of urine have been passed introduce a sterile borate container into the stream and fill the container to the line.
- In elderly or very ill patients nursing assistance may be required.
- Send to the laboratory. The specimen can be preserved in a refrigerator at 4°C prior to transport.
- Specimens showing signs of contamination, e.g. with faecal material, are of no value and will not be cultured.
- Investigation for Chlamydia from male urine specimens (see under examination for chlamydia).
- The majority of urine results will be available the following day.
Collection of Catheter Specimens of Urines (CSUs)
The specimen should not be collected from the drainage bag, only from the sampling port. Clean the sampling port with an alcoholic 2% chlorhexidine swab. Insert the syringe into the sampling port and aspirate urine. Transfer 15ml urine to a red topped sterile boric acid bottle.
Urine for culture for Mycobacterium tuberculosis (TB)
Culture for Mycobacterium tuberculosis is only performed when white cells are present in the urine. Submit a MSU specimen in a red-topped boric acid container (GPs) or plain, white topped container (hospital users), indicating that Mycobacterium tuberculosis culture is required. This will be examined as a normal MSU. If white cells are present, 3 x 250ml urine containers should be ordered (using the Pathology Supplies order Form) so that three consecutive early morning specimens can be collected for examination for TB. If there are no white cells present in the MSU, Mycobacterium tuberculosis culture is not indicated.
Urine for microscopy for Schistosomiasis
Collect a urine specimen in a plain (non-boric acid) container. This should be collected between 10:00 and 14:00 hrs, as this is when the highest concentration of eggs is found.
In patients with haematuria, eggs may be found trapped in the blood and mucus in the terminal portion of the urine specimen. It is therefore preferable to obtain a complete urine sample collected between 10am – 2pm. Alternatively, submit terminal stream urines collected over a whole 24 hour period. (24hr urine containers (brown container/yellow top) are available from Pathology stores.
If the urine cannot be examined within an hour of collection, it is advisable to add 1ml of undiluted formalin to preserve any eggs that may be present.