Urine Microscopy, Culture and Susceptibility

Patient Preparation

Please ensure MSU samples are mid-stream and CSUs are from catheter sample port (not collection bag).

For instructions on how to collect urine samples for M,C&S please see the following guides:

GP PATIENTS - HOW TO COLLECT A MID-STREAM URINE SAMPLE

HOSPITAL PATIENT - HOW TO COLLECT A MID-STREAM URINE SAMPLE

Tests performed

1) Quantification of cells in urine by automated cell counter or microscopy.
2) Bacterial culture and sensitivities. 

 Specific groups/information

Paediatrics

For urgent testing of urine in neonates please call the laboratory on ext 43256 up until 7pm and after that contact on call BMS technician through switchboard. Please give the patient’s details, where the sample is coming from and who to contact with the results.

For all children 3 years and under

All microscopy reports will be sent out as interim with culture results to follow. If an organism is identified, this will also be reported at an interim stage followed by the final result with antimicrobial sensitivity testing information.

Please be aware that ALL urines are cultured regardless of the urinary white cell count. If a child is empirically started on antimicrobials based on symptoms, signs or dipstick testing in accordance with the CG 54 NICE guidelines, please continue until the culture result is reviewed.

Pregnancy

In pregnancy – all samples sent will be cultured as this is important for identifying asymptomatic bacteriuria and UTIs which may adversely affect a pregnancy. To assist in this please either tick pregnancy on ICE form or clearly document ‘PREGNANT’ in clinical details.

Urology

If a patient has a nephrostomy please document on ICE or paper request form the date when it was last changed. This will help indicate how significant the culture results are. Please do not send nephrostomy or urosotomy bag urine. Fresh urine should be collected.

Sensitivity reporting

Some common UTI pathogens are inherently resistant to common oral antimicrobials and therefore are NOT tested or reported. Please be aware so that these antibiotics are not used.

Examples:

Klebsiella species: amoxicillin not tested
Proteus species: nitrofurantoin not tested

Enterobacterales ( Coliforms) that are reported as ESBL/Amp C : Do not use penicillins, penicillin/ beta-lactamase inhibitors ( e.g co – amoxiclav) or cephalosporins

Notes

Please also check:

• Lids are secure
• Two matching patient identifiers on form AND container
• Sample type and test required stated on form
• Brief, relevant clinical history stated on form