CPT Codes

81000 (Nonautomated, with microscopy)
81001 (Automated, with microscopy). If reflex testing is performed, an additional charge will be added: 87086

Synonyms

  • Reflex Urine Culture, Bacterial
  • UA with Reflex
  • UA with Reflex to Culture
  • Urinalysis with Reflex

Test Includes

Includes Urinalysis (UA). Specimen will reflex to a bacterial urine culture if there has been no urine culture collected in the past 24 hours and if any one of the following criteria is met on UA:
1. Leukocyte esterase is 1+, 2+, or 3+
2. Nitrite is positive, 1+, or 2+
3. WBC is >52 /μL (>9 WBC/HPF)

Performing Laboratory / Facility

Ronald Reagan UCLA Medical Center Clinical Laboratory
Santa Monica UCLA Medical Center and Orthopaedic Hospital
UCLA Outreach Clinical Laboratory - Panorama City (BURL)

Performing Section

Urinalysis

Availability

Urinalysis:
Ronald Reagan UCLA Medical Center Clinical Laboratory and Santa Monica UCLA Medical Center and Orthopaedic Hospital: Daily, 24 hours (including holidays)
Outreach Clinical Laboratory - Panorama City (BURL):Monday-Friday 0600-0230, Saturday 1200-2030 (excluding holidays)

Urine Culture:
UCLA Healthcare Clinical Laboratory - Brentwood: Daily (including holidays)

Turnaround Time

Urinalysis:
Ronald Reagan UCLA Medical Center Clinical Laboratory and Santa Monica UCLA Medical Center and Orthopaedic Hospital: Routine 4 hours from receipt in the Laboratory; STAT 1 hour from receipt in the Laboratory.
Outreach Clinical Laboratory - Panorama City (BURL): Routine 24 hours; Stat 4 hours from receipt in the laboratory

Urine Culture:
UCLA Healthcare Clinical Laboratory - Brentwood: Preliminary report available within 24 hours of receipt of specimen in microbiology; Final report in 48 hours.

Methodology

iQ200/Arkray and culture

Use

Detect urinary tract infection, including isolation and identification of potentially pathogenic organisms causing urinary tract infection.

See Also

Urinalysis, Dipstick LAB2543
Urinalysis, Microscropic LAB348
Urinalysis, Routine LAB347
Bacterial Culture, Urine LAB239

Patient Preparation

Clean catch specimen: Thoroughly instruct patient for proper collection of "clean catch" specimen. Patient must be instructed to thoroughly cleanse skin and collect midstream specimen. Do not collect urine from a drainage bag when an indwelling catheter is in place, as growth of bacteria can occur in the bag itself.

Limitations

Urinalysis: Insufficient volume, <3 mL, may limit the extent of procedures performed. Metabolite of Pyridium® may interfere with the dipstick reactions by producing color interference. High vitamin C intake may cause an underestimate of glucosuria, or a false-negative nitrate test. Survival of WBCs is decreased by low osmolality, alkalinity, and lack of refrigeration. Formed elements in the urine, including casts, disintegrate rapidly
Therefore, the specimen should be analyzed as soon as possible after collection. Specific gravity is affected by glucosuria, mannitol infusion, or prior administration of iodinated contrast material for radiologic studies (IVP dye). False-positive tests for protein can also be due to contamination of the urine by an ammonium-containing cleansing solution. Bence Jones proteins may not be detected by dipstick method.
Urine Culture: Bacteria present in numbers <1000 organisms/mL are not detected by this method. Bacteria present in urine obtained by sterile collection (eg, suprapubic aspirates), nephrostomy, and urological reconstructions will be detected at >=100 organisms/mL.

Additional Information

COLOR
Colorless urine may be normal or secondary to diuretic use, high fluid intake, diabetes insipidus, or diabetes mellitus. Cloudy or hazy urine may reflect the presence of phosphates, pyuria, or bacteriuria. On oxidation, development of a black color is evidence for alkaptonuria. Increased indican may cause the urine to blacken on standing. Dark urine is the second most common sign of acute intermittent porphyria. Very rarely, dark urine may indicate the presence of malignant melanoma. Green urine may be produced by indigo carmine, methylene blue, phenol, and in some cases of iodochlorhydroxyquin (clioquinol)-induced subacute myelo-opticoneuropathy. Other causes of green urine are reported as Pseudomonas bacteremia, urinary bile pigments amitriptyline hydrochloride or methocarbamol ingestion, and breath freshener abuse. Red plasma and red urine indicate hemoglobin. Clear plasma with red urine may indicate myoglobin, but may occur as well in congenital erythropoietic porphyria and cutanea tarda porphyria. Purple urine, after standing, may also be due to porphyrins. Yellow to orange urine may contain bile. Other causes of darker yellow to orange urine include increased concentration of urine or the presence of riboflavin, quinacrine (Atabrine®), rifampin (Rifadin®, Rimactane®), phenazopyridine (Pyridium®), or salicylazosulfapyridine (Azulfidine®). The plastic urine bag may discolor purple in the presence of the indican produced by Providencia or Klebsiella species.

SPECIFIC GRAVITY
Indicates the relative proportions of dissolved solid components to the total volume of the specimen. It reflects the relative degree of concentration or dilution of the specimen.

DIPSTICK
Blood in the urine is used to detect myoglobin, hemoglobin, or RBCs in the urine. Hematuria and hemoglobinuria may represent a variety of conditions.
Glucose in the urine usually indicates significant hyperglycemia. A positive screening test for urine glucose is a significant sign and indicates a substantial likelihood of diabetes mellitus.
pH is a crude measure of the acid-base balance of the body. It may be helpful in determining subtle presence of distal renal tubular disease or pyelonephritis. Urine pH is useful for identifying crystals in urine and determining predisposition to form a given type of stone.
Protein in the urine is a screen for nephrotic syndromes, including complications of diabetes mellitus, glomerulonephritis, amyloidosis, and other diseases. Proteinuria is probably the single most important indicator of renal disease.
Ketone in the urine is used to detect acetoacetic acid. Ketonuria can occur in infants and children with febrile illnesses or toxic states with marked vomiting or diarrhea. It may be noted in normal pregnancy, starvation, high protein diet, eclampsia thyrotoxicosis, and isopropanol ingestion.
Bilirubin in the urine is used to detect the presence of conjugated bilirubin. It can be a sign of liver disease or intra- or extrahepatic biliary obstruction.
Leukocyte esterase is used to detect the presence of white blood cells in the urine. The presence of WBCs can be an indication of inflammation.
Nitrite in the urine is used to detect for the presence of gram negative bacteria.
Reducing substances is performed on patients <1 year of age. It helps to detect galactosemia.

MICROSCOPY
Crystalluria is uncommon despite maximal concentrations in warm, fresh urine because of the normal presence of crystal inhibitors, the lack of available nidus, and the time factor. When properly observed in fresh urine, crystals are diagnostically useful for a physician evaluating microhematuria, nephrolithiasis, or toxin ingestion.
In abundance, calcium oxalate and/or hippurate crystals may suggest ethylene glycol ingestion (if accompanied by neurological abnormalities, appearance of drunkenness, hypertension, and a high anion gap acidosis).
Calcium magnesium ammonium phosphate may be present in massive quantities in alkaline urine. They usually are associated with urine infected by urea splitting bacteria which cause infection or triple phosphate stones.
Cystine crystals can be associated with cystinuria (failure of renal tubular reabsorption) and cystinosis (an inherited metabolic defect). In either disorder, calculi can be formed.
Tyrosine and leucine crystals are found in acid urine, indicating abnormal metabolism. These crystals occur together in acute yellow atrophy and in other destructive diseases of the liver.
Crystals may also provide a clue to the composition of renal stones not yet passed.
Leukocyturia may indicate inflammatory disease in the genitourinary tract, including bacterial infection, glomerulonephritis, chemical injury, autoimmune diseases, or inflammatory disease adjacent to the urinary tract such as appendicitis or diverticulitis.
White cell casts indicate the renal origin of leukocytes, and are most frequently found in acute pyelonephritis. White cell casts are also found in glomerulonephritis, such as lupus nephritis, and in acute interstitial nephritis.
Red cell casts indicate renal origin of hematuria and suggest glomerulonephritis, including lupus nephritis. Red cell casts may also be found in subacute bacterial endocarditis, renal infarct, vasculitis, Goodpasture's syndrome, sickling, and in malignant hypertension.
Dark brown or smoky urine suggests a renal source of hematuria.
Pink or red urine suggests an extrarenal source.
Hyaline casts occur in physiologic states (eg, after exercise) and many types of renal diseases.
Renal tubular (epithelial) casts are most suggestive of tubular injury, as in acute tubular necrosis. They are also found in other disorders, including eclampsia, heavy metal poisoning, ethylene glycol intoxication, and acute allograft rejection.
Granular casts are very finely granulated casts which may be found after exercise
Coarse granular casts are abnormal and are present in a wide variety of renal diseases.
Dirty brown granular casts are typical of acute tubular necrosis.
Waxy casts are found especially in chronic renal diseases, and are associated with chronic renal failure
They occur in diabetic nephropathy, malignant hypertension, and glomerulonephritis.
Fatty casts are generally found in the nephrotic syndromes diabetic nephropathy, other forms of chronic renal diseases, and glomerulonephritis. The fat droplets originate in renal tubular cells when they exceed their capacity to reabsorb protein of glomerular origin.
Broad casts originate from dilated, chronically damaged tubules or the collecting ducts. Broad waxy casts are called renal failure casts.
Spermatozoa may be seen in male urine related to recent or retrograde ejaculation. In female urine, the presence of spermatozoa may provide evidence of vaginal contamination following recent intercourse.

URINE CULTURE
A single culture is approximately 80% accurate in the female
Two containing the same organism with a count of 104 or more represents 95% chance of true bacteriuria. A single clean voided specimen from an adult male may be considered diagnostic with proper preparation and care in specimen collection. If the patient is receiving antimicrobial therapy at the time the specimen is collected, any level of bacteriuria may be significant. When more than two organisms are recovered, the likelihood of contamination is high
Thus, the significance of definitive identification of the organisms and susceptibility testing in this situation is severely limited. A repeat culture with proper specimen collection and patient preparation is often indicated. Cultures of specimens from Foley catheters yielding multiple organisms with high colony counts may represent colonization of the catheter and not true significant bacteriuria.

Specimen Type

Random urine

Container

Urine Container, Clean Catch
Sterile Urine Container
BD Vacutainer UA Preservative Tube
BD Vacutainer Urine C&S Preservative Tube (Boric Acid)

Collection Instructions

Freshly voided random urine, a clean catch specimen is preferred. First morning specimen preferred.

Volume

15 mL and one gray top (boric acid) tube filled to line

Minimum Volume

6 mL (UA) and 3 mL (culture)

Stability

Inpatient: 6 hours
Outpatient:72 hours

Special Instructions

The following information will assist the Laboratory in the proper processing of the specimen: Specific site of specimen (catheter, bladder, kidney, nephrostomy), collection date and time, age and sex of patient, current antimicrobial therapy, and clinical diagnosis. Both plastic urine container and gray top (boric acid) tube are required for outpatients.

Shipping and Handling Instructions

Transport to the laboratory as soon as possible after collection. For urine in the plastic container (not in the gray top tube with boric acid), refrigerate specimen if it cannot be processed within 2 hours. Refrigeration preserves formed elements in the urine, but many precipitate crystals not originally present.

Causes for Rejection

Specimen not received in boric acid transport and urine cup from outpatient clinics. Excessive delay in transport (more than 24 hours for refrigerated urine container and more than 48 hours for gray top with boric acid for bacterial culture
Fecal contamination, decomposition or bacterial overgrowth, insufficient quantity of urine, specimen received in inappropriate container, leaking specimen, improper storage, 24 hour specimen, urine bag, more than one specimen submitted per day, sample stability exceeded.
If an unacceptable specimen is received, appropriate personnel will be notified.

Reference Range

Chemistry
Color Straw-Yellow
Appearance Clear
Specific gravity 1.005-1.030
pH 5.0-8.0
Protein Negative
Bilirubin Negative
Glucose Negative
Ketones Negative
Blood Negative
Nitrite Negative
Leukocyte esterase Negative
 
Microscopy
RBCs 0-11/μL
RBCs/HPF 0-2/HPF
WBCs 0-22/μL
WBCs/HPF 0-4/HPF
Squamous epithelial cells 0-17/μL
WBC Clumps Absent
Bacteria Absent
Renal Epithelial Cells  None
Transitional Epithelial Cells 0-11 cells/uL
Hyaline Casts 0-2/LPF
Granular Casts Absent
Waxy Casts 0/LPF
Fatty Casts 0/LPF
RBC Casts 0/LPF
WBC Casts 0/LPF
Epithelial Casts 0/LPF
Mixed Casts 0/LPF
Crystal Absent
Calcium Oxalate Crystal Absent
Uric Acid Crystal Absent
Triple Phosphate Crystal Absent
Carbonate Crystal Absent
Calcium Phosphate Crystal Absent
Leucine Crystal Absent
Cystine Crystal Absent
Tyrosine Crystal Absent
Ammonium Biurate Absent
BIlirubin Crystal Absent
Cholesterol Crystal Absent
Hippuric Crystal Absent
Sulfa Crystal Absent
Fat Globules Absent
Oval Fat Bodies Absent
Yeast Absent
Motile Flagellate Absent
 
Urine culture
No growth at 1:1000 dilution

 
Test Information

CPT Codes

81000 (Nonautomated, with microscopy)
81001 (Automated, with microscopy). If reflex testing is performed, an additional charge will be added: 87086

Synonyms

  • Reflex Urine Culture, Bacterial
  • UA with Reflex
  • UA with Reflex to Culture
  • Urinalysis with Reflex

Test Includes

Includes Urinalysis (UA). Specimen will reflex to a bacterial urine culture if there has been no urine culture collected in the past 24 hours and if any one of the following criteria is met on UA:
1. Leukocyte esterase is 1+, 2+, or 3+
2. Nitrite is positive, 1+, or 2+
3. WBC is >52 /μL (>9 WBC/HPF)

Performing Laboratory / Facility

Ronald Reagan UCLA Medical Center Clinical Laboratory
Santa Monica UCLA Medical Center and Orthopaedic Hospital
UCLA Outreach Clinical Laboratory - Panorama City (BURL)

Performing Section

Urinalysis

Availability

Urinalysis:
Ronald Reagan UCLA Medical Center Clinical Laboratory and Santa Monica UCLA Medical Center and Orthopaedic Hospital: Daily, 24 hours (including holidays)
Outreach Clinical Laboratory - Panorama City (BURL):Monday-Friday 0600-0230, Saturday 1200-2030 (excluding holidays)

Urine Culture:
UCLA Healthcare Clinical Laboratory - Brentwood: Daily (including holidays)

Turnaround Time

Urinalysis:
Ronald Reagan UCLA Medical Center Clinical Laboratory and Santa Monica UCLA Medical Center and Orthopaedic Hospital: Routine 4 hours from receipt in the Laboratory; STAT 1 hour from receipt in the Laboratory.
Outreach Clinical Laboratory - Panorama City (BURL): Routine 24 hours; Stat 4 hours from receipt in the laboratory

Urine Culture:
UCLA Healthcare Clinical Laboratory - Brentwood: Preliminary report available within 24 hours of receipt of specimen in microbiology; Final report in 48 hours.

Methodology

iQ200/Arkray and culture

Use

Detect urinary tract infection, including isolation and identification of potentially pathogenic organisms causing urinary tract infection.

See Also

Urinalysis, Dipstick LAB2543
Urinalysis, Microscropic LAB348
Urinalysis, Routine LAB347
Bacterial Culture, Urine LAB239

Patient Preparation

Clean catch specimen: Thoroughly instruct patient for proper collection of "clean catch" specimen. Patient must be instructed to thoroughly cleanse skin and collect midstream specimen. Do not collect urine from a drainage bag when an indwelling catheter is in place, as growth of bacteria can occur in the bag itself.

Limitations

Urinalysis: Insufficient volume, <3 mL, may limit the extent of procedures performed. Metabolite of Pyridium® may interfere with the dipstick reactions by producing color interference. High vitamin C intake may cause an underestimate of glucosuria, or a false-negative nitrate test. Survival of WBCs is decreased by low osmolality, alkalinity, and lack of refrigeration. Formed elements in the urine, including casts, disintegrate rapidly
Therefore, the specimen should be analyzed as soon as possible after collection. Specific gravity is affected by glucosuria, mannitol infusion, or prior administration of iodinated contrast material for radiologic studies (IVP dye). False-positive tests for protein can also be due to contamination of the urine by an ammonium-containing cleansing solution. Bence Jones proteins may not be detected by dipstick method.
Urine Culture: Bacteria present in numbers <1000 organisms/mL are not detected by this method. Bacteria present in urine obtained by sterile collection (eg, suprapubic aspirates), nephrostomy, and urological reconstructions will be detected at >=100 organisms/mL.

Additional Information

COLOR
Colorless urine may be normal or secondary to diuretic use, high fluid intake, diabetes insipidus, or diabetes mellitus. Cloudy or hazy urine may reflect the presence of phosphates, pyuria, or bacteriuria. On oxidation, development of a black color is evidence for alkaptonuria. Increased indican may cause the urine to blacken on standing. Dark urine is the second most common sign of acute intermittent porphyria. Very rarely, dark urine may indicate the presence of malignant melanoma. Green urine may be produced by indigo carmine, methylene blue, phenol, and in some cases of iodochlorhydroxyquin (clioquinol)-induced subacute myelo-opticoneuropathy. Other causes of green urine are reported as Pseudomonas bacteremia, urinary bile pigments amitriptyline hydrochloride or methocarbamol ingestion, and breath freshener abuse. Red plasma and red urine indicate hemoglobin. Clear plasma with red urine may indicate myoglobin, but may occur as well in congenital erythropoietic porphyria and cutanea tarda porphyria. Purple urine, after standing, may also be due to porphyrins. Yellow to orange urine may contain bile. Other causes of darker yellow to orange urine include increased concentration of urine or the presence of riboflavin, quinacrine (Atabrine®), rifampin (Rifadin®, Rimactane®), phenazopyridine (Pyridium®), or salicylazosulfapyridine (Azulfidine®). The plastic urine bag may discolor purple in the presence of the indican produced by Providencia or Klebsiella species.

SPECIFIC GRAVITY
Indicates the relative proportions of dissolved solid components to the total volume of the specimen. It reflects the relative degree of concentration or dilution of the specimen.

DIPSTICK
Blood in the urine is used to detect myoglobin, hemoglobin, or RBCs in the urine. Hematuria and hemoglobinuria may represent a variety of conditions.
Glucose in the urine usually indicates significant hyperglycemia. A positive screening test for urine glucose is a significant sign and indicates a substantial likelihood of diabetes mellitus.
pH is a crude measure of the acid-base balance of the body. It may be helpful in determining subtle presence of distal renal tubular disease or pyelonephritis. Urine pH is useful for identifying crystals in urine and determining predisposition to form a given type of stone.
Protein in the urine is a screen for nephrotic syndromes, including complications of diabetes mellitus, glomerulonephritis, amyloidosis, and other diseases. Proteinuria is probably the single most important indicator of renal disease.
Ketone in the urine is used to detect acetoacetic acid. Ketonuria can occur in infants and children with febrile illnesses or toxic states with marked vomiting or diarrhea. It may be noted in normal pregnancy, starvation, high protein diet, eclampsia thyrotoxicosis, and isopropanol ingestion.
Bilirubin in the urine is used to detect the presence of conjugated bilirubin. It can be a sign of liver disease or intra- or extrahepatic biliary obstruction.
Leukocyte esterase is used to detect the presence of white blood cells in the urine. The presence of WBCs can be an indication of inflammation.
Nitrite in the urine is used to detect for the presence of gram negative bacteria.
Reducing substances is performed on patients <1 year of age. It helps to detect galactosemia.

MICROSCOPY
Crystalluria is uncommon despite maximal concentrations in warm, fresh urine because of the normal presence of crystal inhibitors, the lack of available nidus, and the time factor. When properly observed in fresh urine, crystals are diagnostically useful for a physician evaluating microhematuria, nephrolithiasis, or toxin ingestion.
In abundance, calcium oxalate and/or hippurate crystals may suggest ethylene glycol ingestion (if accompanied by neurological abnormalities, appearance of drunkenness, hypertension, and a high anion gap acidosis).
Calcium magnesium ammonium phosphate may be present in massive quantities in alkaline urine. They usually are associated with urine infected by urea splitting bacteria which cause infection or triple phosphate stones.
Cystine crystals can be associated with cystinuria (failure of renal tubular reabsorption) and cystinosis (an inherited metabolic defect). In either disorder, calculi can be formed.
Tyrosine and leucine crystals are found in acid urine, indicating abnormal metabolism. These crystals occur together in acute yellow atrophy and in other destructive diseases of the liver.
Crystals may also provide a clue to the composition of renal stones not yet passed.
Leukocyturia may indicate inflammatory disease in the genitourinary tract, including bacterial infection, glomerulonephritis, chemical injury, autoimmune diseases, or inflammatory disease adjacent to the urinary tract such as appendicitis or diverticulitis.
White cell casts indicate the renal origin of leukocytes, and are most frequently found in acute pyelonephritis. White cell casts are also found in glomerulonephritis, such as lupus nephritis, and in acute interstitial nephritis.
Red cell casts indicate renal origin of hematuria and suggest glomerulonephritis, including lupus nephritis. Red cell casts may also be found in subacute bacterial endocarditis, renal infarct, vasculitis, Goodpasture's syndrome, sickling, and in malignant hypertension.
Dark brown or smoky urine suggests a renal source of hematuria.
Pink or red urine suggests an extrarenal source.
Hyaline casts occur in physiologic states (eg, after exercise) and many types of renal diseases.
Renal tubular (epithelial) casts are most suggestive of tubular injury, as in acute tubular necrosis. They are also found in other disorders, including eclampsia, heavy metal poisoning, ethylene glycol intoxication, and acute allograft rejection.
Granular casts are very finely granulated casts which may be found after exercise
Coarse granular casts are abnormal and are present in a wide variety of renal diseases.
Dirty brown granular casts are typical of acute tubular necrosis.
Waxy casts are found especially in chronic renal diseases, and are associated with chronic renal failure
They occur in diabetic nephropathy, malignant hypertension, and glomerulonephritis.
Fatty casts are generally found in the nephrotic syndromes diabetic nephropathy, other forms of chronic renal diseases, and glomerulonephritis. The fat droplets originate in renal tubular cells when they exceed their capacity to reabsorb protein of glomerular origin.
Broad casts originate from dilated, chronically damaged tubules or the collecting ducts. Broad waxy casts are called renal failure casts.
Spermatozoa may be seen in male urine related to recent or retrograde ejaculation. In female urine, the presence of spermatozoa may provide evidence of vaginal contamination following recent intercourse.

URINE CULTURE
A single culture is approximately 80% accurate in the female
Two containing the same organism with a count of 104 or more represents 95% chance of true bacteriuria. A single clean voided specimen from an adult male may be considered diagnostic with proper preparation and care in specimen collection. If the patient is receiving antimicrobial therapy at the time the specimen is collected, any level of bacteriuria may be significant. When more than two organisms are recovered, the likelihood of contamination is high
Thus, the significance of definitive identification of the organisms and susceptibility testing in this situation is severely limited. A repeat culture with proper specimen collection and patient preparation is often indicated. Cultures of specimens from Foley catheters yielding multiple organisms with high colony counts may represent colonization of the catheter and not true significant bacteriuria.
Specimen Collection and Handling

Specimen Type

Random urine

Container

Urine Container, Clean Catch
Sterile Urine Container
BD Vacutainer UA Preservative Tube
BD Vacutainer Urine C&S Preservative Tube (Boric Acid)

Collection Instructions

Freshly voided random urine, a clean catch specimen is preferred. First morning specimen preferred.

Volume

15 mL and one gray top (boric acid) tube filled to line

Minimum Volume

6 mL (UA) and 3 mL (culture)

Stability

Inpatient: 6 hours
Outpatient:72 hours

Special Instructions

The following information will assist the Laboratory in the proper processing of the specimen: Specific site of specimen (catheter, bladder, kidney, nephrostomy), collection date and time, age and sex of patient, current antimicrobial therapy, and clinical diagnosis. Both plastic urine container and gray top (boric acid) tube are required for outpatients.

Shipping and Handling Instructions

Transport to the laboratory as soon as possible after collection. For urine in the plastic container (not in the gray top tube with boric acid), refrigerate specimen if it cannot be processed within 2 hours. Refrigeration preserves formed elements in the urine, but many precipitate crystals not originally present.

Causes for Rejection

Specimen not received in boric acid transport and urine cup from outpatient clinics. Excessive delay in transport (more than 24 hours for refrigerated urine container and more than 48 hours for gray top with boric acid for bacterial culture
Fecal contamination, decomposition or bacterial overgrowth, insufficient quantity of urine, specimen received in inappropriate container, leaking specimen, improper storage, 24 hour specimen, urine bag, more than one specimen submitted per day, sample stability exceeded.
If an unacceptable specimen is received, appropriate personnel will be notified.
Result Interpretation

Reference Range

Chemistry
Color Straw-Yellow
Appearance Clear
Specific gravity 1.005-1.030
pH 5.0-8.0
Protein Negative
Bilirubin Negative
Glucose Negative
Ketones Negative
Blood Negative
Nitrite Negative
Leukocyte esterase Negative
 
Microscopy
RBCs 0-11/μL
RBCs/HPF 0-2/HPF
WBCs 0-22/μL
WBCs/HPF 0-4/HPF
Squamous epithelial cells 0-17/μL
WBC Clumps Absent
Bacteria Absent
Renal Epithelial Cells  None
Transitional Epithelial Cells 0-11 cells/uL
Hyaline Casts 0-2/LPF
Granular Casts Absent
Waxy Casts 0/LPF
Fatty Casts 0/LPF
RBC Casts 0/LPF
WBC Casts 0/LPF
Epithelial Casts 0/LPF
Mixed Casts 0/LPF
Crystal Absent
Calcium Oxalate Crystal Absent
Uric Acid Crystal Absent
Triple Phosphate Crystal Absent
Carbonate Crystal Absent
Calcium Phosphate Crystal Absent
Leucine Crystal Absent
Cystine Crystal Absent
Tyrosine Crystal Absent
Ammonium Biurate Absent
BIlirubin Crystal Absent
Cholesterol Crystal Absent
Hippuric Crystal Absent
Sulfa Crystal Absent
Fat Globules Absent
Oval Fat Bodies Absent
Yeast Absent
Motile Flagellate Absent
 
Urine culture
No growth at 1:1000 dilution

 

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