Urine Culture & Sensitivity

A. Clean-voided midstream urine collection

1. Before starting the procedure, wash hands thoroughly with soap and water.
2. Cleanse the genital area using the following procedure:

• Female

1. Squat over the toilet or bed pan, use the fingers of one hand to separate and hold the folds of the skin of the genital area.
2. Clean the urinary opening and surrounding area with a cleansing towelette, moving from front to back. Repeat cleaning using a second towelette.

• Male

1. Circumcised males: no preparation for midstream specimen.
2. Uncircumcised males: The foreskin should be withdrawn to expose the urethral meatus. With a cleansing towelette or equivalent, the glans should be cleansed, beginning at the tip and moving toward the base. Repeat the cleansing process using a second towelette.
3. Discard towelettes in trash cans.
4. Open the lid of the sterile container taking extra care not to touch the inside.
5. Have the patient collect voided urine. The first portion should be passed into the toilet bowl or bed pan. Collect the mid portion (“midstream clean catch”) directly into a sterile leak proof container without contaminating container. Do not halt and restart urinating for a midstream collection but preferably move the container into the path of the already voiding urine.
6. Tightly screw the cap on the specimen container.
7. Wash hands thoroughly with soap and water.
8. Label the container properly with your full name along with the date and time of collection and submit to the laboratory for processing.

B. Catheter urine

Using a needle or syringe, collect through the catheter port, after cleaning with alcohol.

NOTE:

• Recommended time for collection: Early morning
• Never collect urine from a bedpan or urinal.
• Collection of midstream urine specimens should be avoided during menstruation.
• Do not send urine obtained from a catheter bag.
• Submission of urine on pedibag is discouraged. In-and-out catheterization is the recommended method for neonates, infants and young toddlers. But if the urine on pedibag is the only sample that can be obtained, sample can be analyzed provided that proper handling is observed.
• Pedibag must be properly sealed and submitted inside a sterile leak-proof container.
• No specific patient preparation is necessary. However, specimen collection is ideally performed prior to initiation of antibiotic therapy.
• If the patient is currently taking antibiotics, this information must be indicated on the request form or should be communicated to the laboratory.
• Medications should not be discontinued unless instructed by the physician.

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