Urinalysis, Microscopic with Reflex to Culture
CPT Code(s):
81001
Turnaround Time:
4 hours
Specimen Requirements
Preferred Specimen:
Urine
Minimum Volume:
5.0 mL
Transport Container:
Yellow Top Tube or Sterile Cup
Transport Temperature:
Room Temperature
Collection Instructions:
Clean catch, mid - stream collection
Rejection Criteria:
Specimen received outside stability requirements; Excessive blood, particulates, viscosity present
Stability Criteria
Room Temperature:
4 hours
Refrigerated:
72 hours
Frozen:
Unacceptable
Clinical Significance
The Urinalysis, Microscopic with Reflex to Culture has specific clinical significance and diagnostic use in evaluating the components of a patient's urine at a microscopic level and determining the presence of bacterial growth. Here are key points regarding its clinical significance:
1. Initial Assessment: The test begins with a standard urinalysis, which includes evaluating physical, chemical, and microscopic characteristics of the urine. This provides valuable information about the urine's appearance, pH, specific gravity, presence of blood, protein, glucose, and other substances. Abnormal findings can indicate various urinary tract abnormalities or systemic conditions.
2. Detection of Infection: If the initial urinalysis reveals the presence of white blood cells, red blood cells, or bacteria, indicating possible infection, the test reflexively proceeds to urine culture. The culture helps identify the specific bacteria causing the infection and guides appropriate treatment with targeted antibiotics.
3. Diagnosis of Urinary Tract Infections (UTIs): The presence of significant bacterial growth in the urine culture, along with clinical symptoms and the patient's history, confirms the diagnosis of a UTI. The results provide information about the type of bacteria causing the infection and their susceptibility to different antibiotics, allowing for tailored treatment.
4. Identification of Pathogenic Bacteria: The urine culture can identify the specific bacteria causing the infection, including common pathogens such as Escherichia coli, Klebsiella pneumoniae, and Staphylococcus saprophyticus. This information is crucial in selecting appropriate antibiotics to effectively treat the infection.
5. Evaluation of Treatment Response: The follow-up urine culture after treatment helps determine whether the infection has been successfully eradicated. If the culture shows no bacterial growth, it indicates a favorable treatment response. Persistent or recurrent growth may suggest treatment failure or the presence of antibiotic-resistant bacteria.
6. Detection of Asymptomatic Bacteriuria: In some cases, urine culture may be performed even without obvious signs or symptoms of infection, such as in pregnant women or individuals with indwelling catheters. This helps identify asymptomatic bacteriuria, which, if left untreated, can lead to complications in certain populations.
7. Management of Complicated Urinary Tract Infections: In complex cases, such as recurrent or persistent UTIs, the urine culture can provide information about the presence of multiple bacterial strains, antibiotic resistance patterns, or underlying structural abnormalities that contribute to the infection.
In summary, the Urinalysis, Microscopic with Reflex to Culture is clinically significant in diagnosing and managing urinary tract infections. It combines the initial evaluation of the urine's physical, chemical, and microscopic characteristics with subsequent urine culture to identify the specific bacteria causing the infection and guide appropriate treatment. The test is essential for diagnosing UTIs, determining antibiotic susceptibility, evaluating treatment response, and managing complicated cases.