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Test Code U Dip UA Reflex Culture

Aliases

Urinalysis Reflex Microscopic and Culture

Useful For

Urinalysis testing is a set of screening tests that can be used to detect and/or help manage some common diseases or conditions.

Collection Method

  1. Urine specimen must be collectd in a clean, dry container. The container must be sterile if a culture and sensitivity is needed on the same specimen.
  2. Specimen must be properly labeled. Hospital policy states the label must be on the specimen container and not the lid and must include the following:
    • Patient’s name
    • Patient’s Medical Record Number
    • Date and time of collection
    • Time of refrigeration if testing will occur over 2 hours after collection
    • Initials of person responsible for the collection
    • Patient’s location
    • Note: Unlabeled specimens are not acceptable and must be recollected.
  3. Urine collected for pregnancy testing is acceptable for 72 hours after collection if refrigerated.
  4. Only urines that are received in sterile containers and/or syringes (NICU specimens) will retained. Urines received in KOVA tubes will be discarded after testing is complete.
  5. Urines are stored for 2 days after testing.

Minimum Volume

  • NICU Patients: 1 mL
  • All Others: 3 mL

Container

Sterile Cup

Preferred Specimen

Urine in Sterile container

Reference or Target Ranges

  iRIS Clinitek Status Manual Microscope
Color Yellow    
Clarity Clear    
Specific Gravity 1.006 – 1.035 1.005 – 1.030  
pH 4.5 – 8.0 4.5 – 9.0  
Bilirubin Negative Negative  
Ketones Negative mg/dL Negative mg/dL  
Glucose Negative mg/dL Negative mg/dL  
Protein Negative mg/dL Negative mg/dL to trace  
Urobilinogen 0.2 – 1.0 Eu 0.2 – 1.0 Eu  
Blood Negative Negative  
Leukocytes Negative Negative  
Microscopic      
RBCs 0 – 2 / HPF   0 – 2 / HPF
WBCs 0 – 3 / HPF   0 – 3 / HPF
Squamous Epithelial None Seen (Neg) to Few   None Seen (Neg) to Few
Hyaline Cast 0 – 2 / HPF   0 – 2 / HPF
Bacteria Negative   Negative
All other microscopics None Seen (Negative)   None Seen (Negative)

Reportable Units

Varies

Critical Value

  • Glucose >500
  • Ketones >80

Reasons for Rejection

Hemolysis Threshold N/A
Icterus Threshold N/A
Lipemia Threshold N/A
Other QNS, Labeled incorrectly, Color interferences (e.g. AZO, Pyridium), improper container

Specimen Stability

Ambient 2 hours
Refrigerated (2°C to 8°C) 24 hours
Frozen(-70°C to 0°C) N/A

Performance Information

Days and Time Performed 24/7
Expected Turn Around Time STAT: Within 1 hour of arrival in lab
Routine: Within 4 hours of arrival in lab
Stat Availabilty Yes
Performing Bench UH UA,  Clinics
Methodology/Method Description  
UH iRIS
Bilirubin This test is based on the coupling of bilirubin and diazonium salt in an acidic medium. A pinkish
tan color proportional to bilirubin concentration is generated.
Urobilinogen This test is based on the coupling reaction of urobilinogen with a stable diazonium slat in buffer.
A pink to red color proportional to the urobilinogen concentration is generated.
Ketone This test is based on Legal’s method in which the test pad contains sodium nitroprusside and
glycine in an alkaline medium. A violet color proportional to methylketone is generated.
Glucose This two-step enzymatic reaction uses glucose oxidase, peroxidase and a chromogen. Glucose
oxidase catalyzes the formation of gluconic acid and hydrogen peroxide via the oxidation of
glucose. Peroxidase then catalyzes the reaction of hydrogen peroxide with a chromogen via the
oxidation of chromogen to colors ranging between green and gray-blue.
Protein This test is based on the “protein error of pH indicators” on the green color developed from the
presence of protein. This dye-binding is particularly strong with albumin.
Blood This pseudo-enzymatic test contains organic peroxide and a chromogen. The peroxidase effect of
hemoglobin and myoglobin causes a color change to green.
pH This test contains a mixed indicator which assures a marked change in color between pH5 and
pH9. Colors range from orange through yellow and green to cyan.
Nitrite This test is based on modified Griess reaction in which nitrite in the urine reacts with amide to
form a diazonium compound. The subsequent coupling reaction yields a pink color in the
presence of nitrite. Some Gram positive and non-nitrite-forming bacteria are not detected in this
test.
Leukocytes This enzymatic test pad contains an indoxyl ester and a diazonium salt. Granulocyte esterases
react with indoxyl ester and diazonium salt to generate a violet color.


Microscopy is performed on iQ200 Analyzer or manually by microscope when indicated

Additional Information/Important Notes

  • <3 mL of sample may result in QNS for microscopic testing.
  • Reflex cultures indicated for WBCs >10, yeast present, culture not already ordered on the same visit and designated patient admission locations.
  • All urine cultures must be performed within 24 hours of specimen collection.

CPT Codes

UA/Micro: 81001
UA w/o Micro: 81003

Panel Components

Color, Clarity, Specific Gravity, pH, Bilirubin, Ketones, Glucose, Protein, Urobilinogen, Blood, Leukocytes, RBCs, WBCs, Squamous Epithelial, Hyaline Cast, Bacteria, and all other microscopics.

Reflex Testing

Urine Culture