Definition

A urine culture is a diagnostic laboratory test performed to detect the presence of bacteria in the urine (bacteriuria).

  Purpose

Culture of the urine is a method of diagnosis for urinary tract infection that determines the number of microorganisms present in a given quantity of urine.

  Precautions

If delivery of the urine specimen to the laboratory within one hour of collection is not possible, it should be refrigerated. The health care provider should be informed of any antibiotics currently or recently taken.

  Description

There are several different methods for collection of a urine sample. The most common is the midstream clean-catch technique. Hands should be washed before beginning. For females, the external genitalia (sex organs) are washed two or three times with a cleansing agent and rinsed with water. In males, the external head of the penis is similarly cleansed and rinsed. The patient is then instructed to begin to urinate, and the urine is collected midstream into a sterile container. In infants, a urinary collection bag (plastic bag with an adhesive seal on one end) is attached over the labia in girls or a boy's penis to collect the specimen.

Another method is the catheterized urine specimen in which a lubricated catheter (thin rubber tube) is inserted through the urethra (tube-like structure in which urine is expelled from the bladder) into the bladder. This avoids contamination from the urethra or external genitalia. If the patient already has a urinary catheter in place, a urine specimen may be collected by clamping the tubing below the collection port and using a sterile needle and syringe to obtain the urine sample; urine cannot be taken from the drainage bag, as it is not fresh and has had an opportunity to grow bacteria at room temperature. On rare occasions, the health care provider may collect a urine sample by inserting a needle directly into the bladder (suprapubic tap) and draining the urine; this method is used only when a sample is needed quickly.

Negative culture results showing no bacterial growth are available after 24 hours. Positive results require 24-72 hours to complete identification of the number and type of bacteria found.

  Preparation

Drinking a glass of water 15-20 minutes before the test is helpful if there is no urge to urinate. There are no other special preparations or aftercare required for the test.

  Risks

There are no risks associated with the culture test itself. If insertion of a urinary catheter (thin rubber tube) is required to obtain the urine, there is a slight risk of introducing infection from the catheter.

Normal results

No growth of bacteria is considered the normal result, and this indicates absence of infection.

Abnormal results

Abnormal results, or a positive test, where bacteria are found in the specimen, may indicate a urinary tract infection. Contamination of the specimen from hair, external genitalia, or the rectum may cause a false-positive result. Identification of the number and type of bacteria, with consideration of the method used in obtaining the specimen, is significant in diagnosis.

Escherichia coli causes approximately 80% of infections in patients without catheters, abnormalities of the urinary tract, or calculi (stones). Other bacteria that account for a smaller portion of uncomplicated infections include Proteus klebsiella and Enterobacter.

   Key Terms:

Bacteriuria The presence of bacteria in the urine.

   Resources:

Books

• David, Alan K., et al. Family Medicine: Principles and Practice. New York: Springer Verlag, Inc., 1994.
• Malarkey, Louise, and Mary Ellen McMorrow. Nurse's Manual of Laboratory Tests and Diagnostic Procedures. Philadelphia: W. B. Saunders Co., 1996.

Organizations

• American Foundation for Urologic Disease. 300 West Pratt St., Suite 401, Baltimore, MD 21201.

Other

• "Urine culture." HealthAnswers.com 27 Feb. 1998. http://www.healthanswers.com
• Urine Culture." ThriveOnline. 25 Feb. 1998 http://thriveonline.oxygen.com