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Urine colony counts.



Q Could you give me the "pros and cons pros and cons
Noun, pl

the advantages and disadvantages of a situation [Latin pro for + con(tra) against]
" of doing a total colony count Colony count
A measurement of the growth of bacteria in a urine sample that has been cultured for 24 to 48 hours.

Mentioned in: Urinalysis
 on a urine culture Urine Culture Definition

A urine culture is a diagnostic laboratory test performed to detect the presence of bacteria in the urine (bacteriuria).
 vs. doing individual colony counts on pathogens in a urine culture. We are in the process of standardizing several labs in our system, and this is an issue for which we cannot find much information to reference.

A Urine colony counts should always be done per isolate and not as a total colony count of all organisms. For example, if a clean-catch urine clean-catch urine Lab medicine A specimen of 'midstream' urine for bacterial culture that is obtained from ♂ easily, and from ♀ after cleansing the perineum and meatus with povidone-iodine wipes  culture grew greater than 100,000 cfu/mL of E coli E COLI Escherichia Coli (bacteria)  and 5,000 cfu/mL of a coagulase-negative staphylococci staph·y·lo·coc·cus  
n. pl. staph·y·lo·coc·ci
A spherical gram-positive parasitic bacterium of the genus Staphylococcus, usually occurring in grapelike clusters and causing boils, septicemia, and other infections.
 (CNS See Continuous net settlement.

CNS

See continuous net settlement (CNS).
), you would want to report as in Example A, not as in Example B.

Example A) APPROPRIATE

>100,000 cfu/ml E coli

5,000 cfu/mL CNS (or insignificant growth)

Example B) NOT APPROPRIATE

>100,000 cfu/mL E coli and CNS

Example A appropriately confers the culture results, where Example B could lead a clinician clinician /cli·ni·cian/ (kli-nish´in) an expert clinical physician and teacher.

cli·ni·cian
n.
 to treat for both E coli and the coagulase-negative Staphylococcus staphylococcus (stăf'ələkŏk`əs), any of the pathogenic bacteria, parasitic to humans, that belong to the genus Staphylococcus. The spherical bacterial cells (cocci) typically occur in irregular clusters [Gr. , when only treatment of the E coli would be appropriate as the 5,000 cfu/mL of the CNS most likely represents contamination.

Table 1 below lists general guidelines for urine culture interpretation and work up for one or more potential pathogens from urine cultures. Often, we do not receive patient history with our urine specimens for culture. In this case, Table 2 gives general guidelines that might be used.

--Susan E. Sharp, PhD, D(ABMM ABMM American Board of Medical Microbiology
ABMM American Board of Medical Management
ABMM Anti-Ballistic Missile Missile
ABMM American Board of Medical Malpractice
)

Director of Microbiology, Kaiser Permanente Kaiser Permanente is an integrated managed care organization, based in Oakland, California, founded in 1945 by industrialist Henry J. Kaiser and physician Sidney R. Garfield.  Pathology

Regional Laboratory; Associate Professor, Oregon Health and Science University

Portland, OR

Resources

1. Forbes BA, Sahm DF, Weissfeld AS, eds. Bailey and Scott's Diagnostic Microbiology. 10th ed. St. Louis, MO: Mosby; 1998.

2. Mandell GL, Bennett JE, Dolin R, eds. Principles and Practices of Infectious Diseases infectious diseases: see communicable diseases. . 5th ed. New York New York, state, United States
New York, Middle Atlantic state of the United States. It is bordered by Vermont, Massachusetts, Connecticut, and the Atlantic Ocean (E), New Jersey and Pennsylvania (S), Lakes Erie and Ontario and the Canadian province of
, NY: Churchill Livingston; 2000.

Edited by Daniel M. Baer, MD

MLO's "Tips from the Clinical Experts" provides practical, up-to-date solutions to readers' technical and clinical issues from a panel of experts in various fields. Readers may send questions to Dan Baer by e-mail at tips@mlo-online.com.
Table 1

                            Specimen type and/or
Result                      patient history              Work-up

>[10.sup.4] cfu/mL of a     CC/MS, IDC from patients     Work up the one
  single PP or for each     with pyelonephritis,         or both PP with
  of 2 PP                   acute cystitis, or           ID/AST
                            asymptomatic bacteruria,
                            OR SC
>[10.sup.3] cfu/mL of a     CC/MS, IDC from symptomatic  Work up PP with
  single pp                 male patients, OR SC, OR     ID/AST
                            acute urethral syndrome
>3 PP                       CC/MS, IDC, SC               No work up
1 PP at >[10.sup.5] cfu/mL  CC/MS, IDC                   Work up the one
  with 1 to 2 PP at                                      PP at
  <[10.sup.4] cfu/mL                                     >[10.sup.5]
                                                         cfu/ml with ID/
                                                         AST
1 PP at >[10.sup.4] cfu/mL  SC                           Work up the one
  with 1 to 2 PP at                                      PP at
  <[10.sup.3] cfu/mL                                     >[10.sup.4]
                                                         cfu/ml with ID/
                                                         AST
>[10.sup.2] cfu/mL of any   SB                           Work up all PP
  PP                                                     with ID/AST

Table 2

Specimen type and result                   Work-up

CC/MS: [greater than or equal to]          Work up the one or both PP
  [10.sup.4] cfu/mL of a single PP or for  with ID/AST
  each of 2 PP
SC: [greater than or equal to]             Work up the one or both PP
  [10.sup.3] cfu/mL of a single PP or for  with ID/AST
  each of 2 PP
CC/MS, SC: [greater than or equal to]3 PP  No work up
CC/MS: 1 PP at [greater than or equal to]  Work up the one PP at
  [10.sup.5] cfu/mL with 1 to 2 PP at      [greater than or equal to]
  <[10.sup.4] cfu/mL                       [10.sup.5] cfu/mL with ID/AST
SC: 1 PP at [greater than or equal to]     Work up the one PP at
  [10.sup.4] cfu/ml with 1 to 2 PP at      [greater than or equal to]
  <[10.sup.3] cfu/mL                       [10.sup.4] cfu/mL with ID/AST
SB: [greater than or equal to][10.sup.2]   Work up PP (up to three) with
  cfu/mL of up to 3 PP                     ID/AST

Key to tables:

CC/MS = clean catch and/or midstream
IDC = indwelling catheter
SC = straight catheter
ID/AST = identification and antimicrobial susceptibility testing (if
appropriate)
PP = potential pathogen
SB = suprapubic urine aspirates or other surgical obtained urine
specimens
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Title Annotation:Answering your questions
Author:Baer, Daniel M.
Publication:Medical Laboratory Observer
Geographic Code:1USA
Date:Mar 1, 2008
Words:756
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