Culture, Urine, Routine (REFLEX)

The Culture, Urine, Routine (REFLEX) test contains 1 test with 3 biomarkers.

Brief Description: A urine culture test is a laboratory test that helps identify and diagnose urinary tract infections (UTIs) caused by bacteria or other pathogens. It involves analyzing a urine sample to detect the presence of microorganisms and determine their type and quantity. The test is crucial in guiding appropriate treatment for UTIs.

Also Known As: Urine Culture Test, Urine Culture and Sensitivity, Urine C and S, UTI test

Collection Method: Urine Collection

Specimen Type: Urine

Test Preparation: No preparation required

IMPORTANT - Culture, Urine, Routine #395 can Reflex to additional testing and charges, detailed below, if Culture is positive.

If culture is positive, CPT code(s): 87088 (each isolate) will be added with an additional charge.  Identification will be performed at an additional charge (CPT code(s): 87077 or 87140 or 87143 or 87147 or 87149).

Antibiotic susceptibilities are only performed when appropriate (CPT code(s): 87181 or 87184 or 87185 or 87186).

• ORG ID 1. $ 12.45

• ORG ID 2. $ 23.95

• PRESUMPTIVE ID 1. $ 12.45

• PRESUMPTIVE ID 2. $ 23.95

• SUSC-1  $14.95

• SUSC-2  $30.90

When is a Urine Culture test ordered?

A urine culture test may be ordered in the following situations:

1. Suspected Urinary Tract Infection: When a patient presents with symptoms suggestive of a UTI, such as frequent urination, painful urination, cloudy urine, or urinary urgency, a urine culture is ordered to confirm the presence of an infection and identify the causative bacteria.

2. Recurrent or Persistent Infections: In cases where a patient experiences recurrent UTIs or persistent symptoms despite previous treatment, a urine culture helps identify the specific bacteria causing the infection and determine their susceptibility to antibiotics.

3. Preoperative Evaluation: Prior to certain surgical procedures, especially those involving the urinary tract, a urine culture may be ordered as part of routine preoperative testing to ensure the absence of an active infection.

What does a Urine Culture test check for?

Urine is a fluid generated by the kidneys that contains both water and waste. It passes from the kidneys to the bladder through tubes called ureters before being expelled from the body through the urethra. Urine culture is a test that detects and identifies bacteria and yeast in the urine that could be the source of a urinary tract infection.

A small amount of urine is placed on one or more agar plates and incubated at body temperature for a urine culture. Any bacteria or yeast present in the urine sample will grow into little circular colonies during the next 24 to 48 hours. The number of colonies and the size, shape, and color of these colonies assist identify which bacteria are present in the urine sample, and the number of colonies shows the amount of bacteria that were initially present in the urine sample. A laboratory technician counts the total number of colonies on the agar plate and determines how many types have grown. If a good, clean catch sample was taken for the test, the only bacteria found should be from an infection. Typically, there will be only one variety of bacterium present in relatively significant quantities. More than one type of bacteria may be present at any given time. This could be the result of a multi-pathogen infection, although it's more likely owing to contamination from the skin picked up during the urine collection.

A gram stain will be performed on a colony from each type by the laboratory technician. The bacteria are examined under a microscope by the laboratory technician. Different species of bacteria will have distinct colors and forms. Under a microscope, the bacterium Escherichia coli, which is responsible for the majority of urinary tract infections, will appear as gram-negative rods. Lactobacillus, a frequent vaginal contaminant found in women's urine, will show up as gram-positive rods. Some bacteria, such as Lactobacillus, are easy to detect by a skilled lab technician, are nonpathogenic, and do not require additional research. Others, such as gram-negative rods, represent clusters of identical bacteria that will necessitate extra testing to determine which bacteria are present.

After 24 to 48 hours of incubation, if there is no or little growth on the agar, the urine culture is declared negative for pathogens and the culture is complete. If one or more pathogens are found, more testing is done. Testing is performed to determine which bacteria are present, as well as susceptibility testing to determine which antibiotics are most likely to cure the infection.

Lab tests often ordered with a Urine Culture test:

When a Urine Culture test is ordered, it's often part of a broader evaluation of urinary symptoms or suspected infection. Here are some tests commonly ordered alongside it:

1. Urinalysis:

   • Purpose: A preliminary test that examines the physical and chemical properties of urine.
   • Why Is It Ordered: To detect signs of infection (like the presence of white blood cells, red blood cells, or nitrites) and other urinary disorders. It can help guide the need for further testing, such as a urine culture.

2. Complete Blood Count (CBC):

   • Purpose: Provides a broad picture of overall blood health.
   • Why Is It Ordered: To detect signs of infection or inflammation, such as an elevated white blood cell count, which can accompany a UTI.

3. Blood Urea Nitrogen (BUN) and Creatinine:

   • Purpose: To assess kidney function.
   • Why Is It Ordered: To evaluate if the UTI has affected the kidneys or if there's a pre-existing kidney condition that might complicate the infection.

4. C-Reactive Protein (CRP) or Erythrocyte Sedimentation Rate (ESR):

   • Purpose: Non-specific markers of inflammation.
   • Why Is It Ordered: To assess the severity of infection or inflammation, particularly in complicated or recurrent UTIs.

5. STD Testing (such as Chlamydia and Gonorrhea):

   • Purpose: To test for sexually transmitted infections.
   • Why Is It Ordered: In sexually active individuals, especially if they have symptoms like urinary discomfort or discharge, as some STDs can cause symptoms similar to a UTI.

These tests, when ordered alongside a Urine Culture test, provide a comprehensive view of urinary health, infection status, and kidney function. They are critical in diagnosing and managing UTIs and identifying any underlying or concurrent conditions that may affect treatment and prognosis. The specific combination of tests will depend on the individual’s symptoms, medical history, and the severity of the urinary symptoms.

Conditions where a Urine Culture test is recommended:

A urine culture test may be necessary for various conditions or diseases, including:

1. Urinary Tract Infections: Suspected or confirmed UTIs, including bladder infections (cystitis), kidney infections (pyelonephritis), or urethral infections (urethritis).

2. Recurrent UTIs: In individuals who experience multiple episodes of UTIs, a urine culture is valuable in identifying the underlying cause and guiding appropriate treatment strategies.

How does my health care provider use a Urine Culture test?

The urine culture is often used to diagnose a urinary tract infection and to identify the bacteria or yeast that is causing it. It can be used in conjunction with susceptibility testing to discover which drugs will stop the infection-causing bacterium from growing. The findings will aid a doctor in determining which treatments are most likely to be beneficial in treating a patient's infection.

The kidneys, a pair of bean-shaped organs positioned near the bottom of the ribcage on the right and left sides of the back, produce urine. To transport wastes out of the body, the kidneys filter waste from the blood and generate urine, a yellow fluid. Urine goes from the kidneys to the bladder, where it is briefly stored, and then via the urethra to be emptied. Urine is normally sterile, but bacteria or, more rarely, yeast can migrate up the urinary tract from the skin outside the urethra and produce a urinary tract infection.

The majority of UTIs are considered simple and treatable. The infection may spread up through the ureters and into the kidneys if they are not treated. A kidney infection is more hazardous and can result in renal damage that is irreversible. In some situations, a urinary tract infection can escalate to a life-threatening infection in the bloodstream.

People with renal disease or other illnesses that impact the kidneys, such as diabetes or kidney stones, as well as people with compromised immune systems, may be more susceptible to UTIs.

What do my Urine Culture test results mean?

Urine culture results are frequently interpreted in conjunction with urinalysis results, as well as how the sample was taken and whether symptoms are present. Because certain urine samples may contain bacteria that are ordinarily found on the skin, some culture results must be interpreted with caution.

A positive urine culture is usually defined as the presence of a single kind of bacteria growing at high colony counts. Cultures containing more than 100,000 CFU/mL of one species of bacteria in clean catch samples that have been correctly collected usually indicate infection. Even if an infection is present, there may not be a large number of germs present in some circumstances. Lower levels can sometimes suggest infection, particularly if symptoms are present. Similarly, values of 1,000 to 100,000 CFU/mL may be deemed significant for samples acquired using a technique that reduces contamination, such as a sample collected with a catheter.

Although UTIs can be caused by a variety of bacteria, the majority are caused by Escherichia coli, a kind of bacteria that is widespread in the digestive tract and frequently detected in stool. Proteus, Klebsiella, Enterococcus, and Staphylococcus are among the bacteria that can cause UTIs. A yeast infection, such as Candida albicans, can cause a UTI, but urethritis is more commonly caused by a sexually transmitted illness, such as herpes, chlamydia, or gonorrhea.

When a culture says "no growth in 24 or 48 hours," it usually means there isn't an infection. If the symptoms persist, a urine culture on a new sample may be performed to test for bacteria with reduced colony numbers or other microorganisms that could be causing the symptoms. Acute urethral syndrome is defined as the presence of white blood cells and low quantities of bacteria in a sick person's urine.

If multiple different species of bacteria thrive in a culture, the growth is almost certainly due to contamination. This is notably true in urine samples containing Lactobacillus and/or other prevalent nonpathogenic vaginal bacteria in women. If the symptoms persist, the healthcare provider may order a second culture on a more thoroughly collected sample. However, if one species of bacteria has considerably larger colony counts than the others, such as 100,000 CFUs/mL versus 1,000 CFUs/mL, further testing to determine the dominating bacterium may be required.

Susceptibility testing may be used to guide treatment if a culture is positive. Any bacterial infection can be dangerous and, if left untreated, can spread to other parts of the body. Pain is frequently the first sign of infection. Treatment as soon as possible, generally with antibiotics, will help to relieve the pain.

Most Common Questions About the Urine Culture test:

Understanding the Urine Culture Test

What is a Urine Culture test?

A Urine Culture test is a laboratory test that is performed to detect and identify bacteria or yeasts in the urine that can cause a urinary tract infection (UTI).

Why would a Urine Culture test be performed?

A Urine Culture test is typically performed when a person has symptoms of a UTI, such as pain during urination, frequent urge to urinate, lower abdominal pain, or cloudy or strong-smelling urine. It might also be performed in individuals with recurrent UTIs to understand the nature of the infecting organism.

Interpreting Urine Culture Test Results

What does a positive Urine Culture test result mean?

A positive Urine Culture test result indicates the presence of bacteria or yeast in the urine, suggesting a urinary tract infection. The test also identifies the specific type of bacteria or yeast, which can guide the appropriate treatment.

What does a negative Urine Culture test result mean?

A negative result means no growth of bacteria or yeast was observed in the urine sample, suggesting there's no urinary tract infection.

Can a Urine Culture test determine the severity of a urinary tract infection?

No, the Urine Culture test doesn't provide direct information about the severity of the infection. However, it identifies the type of organism causing the infection and its antibiotic sensitivity, which helps in selecting effective treatment.

Urine Culture Test and Specific Populations

Why might pregnant women need a Urine Culture test?

Pregnant women may be screened for bacteria in their urine, even without symptoms, because untreated urinary infections can increase the risk of kidney infections, premature labor, and low birth weight in babies.

Can the Urine Culture test be used in children with urinary symptoms?

Yes, Urine Culture tests can be used in children who exhibit symptoms of a UTI. This helps in the diagnosis and treatment of the infection, which is important as untreated UTIs can sometimes lead to kidney damage in children.

Why might elderly individuals need a Urine Culture test?

In older adults, UTI symptoms might be vague or non-specific, or UTIs might lead to more serious complications. As such, Urine Culture tests can help identify UTIs in this population for prompt treatment.

Urine Culture Test and Disease Management

How does the Urine Culture test help in the treatment of a UTI?

By identifying the specific type of bacteria or yeast causing the infection, and their sensitivity to different antibiotics, the Urine Culture test assists physicians in choosing the most effective treatment for a UTI.

Can the Urine Culture test detect a recurring urinary tract infection?

Yes, a Urine Culture can identify a recurring UTI. For people with repeated UTIs, it can help determine if the same type of bacteria or a different one is causing the new infection.

Can a Urine Culture test detect other types of infections?

The primary focus of a Urine Culture is to identify bacteria or yeast in the urine that cause UTIs. While it might incidentally detect organisms associated with other infections, it's not designed or typically used to diagnose infections outside of the urinary tract.

Urine Culture Test and Other Tests

How does the Urine Culture test relate to the Urinalysis test?

A urinalysis is a broader examination of urine for physical, chemical, and microscopic properties. If a urinalysis suggests an infection (for example, by detecting leukocytes or nitrites), a Urine Culture test may be ordered to identify the specific organism.

What other tests might be performed alongside the Urine Culture test?

Depending on the individual's symptoms and health status, additional tests may include a complete blood count (CBC), blood cultures, kidney function tests, or imaging studies of the urinary tract.

General Queries

Can the Urine Culture test results be influenced by medication?

Yes, antibiotics or antifungal medications could potentially decrease the amount of bacteria or yeast in the urine, affecting the test results.

How does the Urine Culture test differentiate between infection and contamination?

The test differentiates based on the type and number of organisms present. A single type of bacteria growing in large numbers often indicates an infection, whereas multiple types of bacteria might suggest contamination from the skin or genital area during sample collection.

Can dehydration affect the results of a Urine Culture test?

Dehydration itself shouldn't affect Urine Culture results, but it can lead to a higher concentration of substances in the urine, which could potentially influence other urine tests.

Does a positive Urine Culture test mean I need antibiotics?

Not always. Treatment depends on your symptoms, overall health, and the type and amount of bacteria present. Some bacteria found in the urine might not be causing disease and might not require treatment.

Can the Urine Culture test identify drug-resistant bacteria?

Yes, part of the test involves determining which antibiotics the bacteria are sensitive to, so it can identify bacteria that are resistant to certain drugs.

Can a Urine Culture test help in diagnosing other urinary tract conditions?

While its primary function is to detect infections, the Urine Culture test can sometimes provide clues to other urinary tract conditions. For example, certain types of bacteria might be associated with urinary stones.

Can a Urine Culture test be performed after treatment to ensure the infection has cleared?

Yes, a follow-up Urine Culture can be done after treatment to confirm that the infection has cleared, particularly in people with recurrent UTIs or complicated infections.

How does the Urine Culture test support diagnosis in people with diabetes?

People with diabetes are more prone to UTIs. Thus, a Urine Culture test helps in the early detection and treatment of UTIs in this population, thereby preventing complications.

How often should a Urine Culture test be done?

There's no standard frequency for a Urine Culture test. It's typically done when symptoms suggest a UTI, or at the doctor's discretion in cases of recurrent UTIs or risk factors like pregnancy.

Does menstruation affect the results of a Urine Culture test?

Menstruation might increase the risk of contamination of the urine sample with bacteria from the skin or vaginal area. It doesn't directly affect the growth of bacteria or yeast in the culture, but a contaminated sample might lead to misleading results.

Can a Urine Culture test be done if I have a urinary catheter?

Yes, if you have a catheter and develop symptoms of a UTI, a sample of urine can be collected directly from the catheter for a Urine Culture.

Can the Urine Culture test identify sexually transmitted infections?

While a Urine Culture test can identify some bacteria that also cause sexually transmitted infections (like E. coli), it's not designed to detect most sexually transmitted infections like gonorrhea, chlamydia, or trichomoniasis. Specific tests are needed to diagnose these infections.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.