Laboratory: Clinical Microbiology
Test Name:
Test Code: UCM
Clinical Information:
Test Indications:
A nephrostomy tube urine sample for aerobic bacterial culture should be obtained from patients with evidence of infection at the time of tube placement (i.e., when a nephrostomy tube is being placed to relieve obstruction in the setting of a urinary infection).  Collection of urine for aerobic bacterial culture from a nephrostomy tube is also indicated for patients that already have a nephrostomy tube and are presenting with symptoms and/or signs compatible with a nephrostomy tube infection.  A properly obtained nephrostomy urine sample for aerobic bacterial culture can assist the clinician in determining the pathogen responsible for a urinary infection and guide selection of appropriate antimicrobial therapy.

A nephrostomy tube urine specimen for aerobic bacterial culture is indicated at the time of tube placement for patients with evidence of infection, and for patients who already have a nephrostomy tube in place that are presenting with symptoms/signs of a urinary infection.
Clearly indicate on the microbiology requisition the specimen site, the specimen type, and the test(s) requested (e.g., bacterial culture - aerobic).  If other tests (e.g., bacterial culture - anaerobic, fungal culture) are also required based on the clinical presentation of the patient,  these may be requested using the same requisition.  Refer to the LIM entries on anaerobe culture and fungal culture for further details pertaining to these tests.
Indicate the current antimicrobial therapy the patient is receiving on the requisition.

Patient Preparation Instructions:
For nephrostomy tube urine samples obtained at the time of tube insertion, the specimen should be collected in a sterile manner following protocols outlined by your healthcare facility for this sample type.
For nephrostomy tube urine samples obtained from patients that already have a nephrostomy tube in place, follow local nursing protocols for this specimen type. One first follows the procedure for drainage bag change. Once the new bag is in place, facilitate gravity flow of urine collection into bag by ensuring bag is held below level of kidneys.  When sufficient volume of urine has collected (5-10 mL), open drainage bag valve and drain urine into sterile collection container without allowing tip of bag to touch inside of sterile container.  Close drainage bag valve.
The urine sample should be submitted in a BD Vacutainer Plus C&S preservative tube. Follow the manufacturer’s recommendations on how to fill the tube.
Accurate patient identification must be made prior to sample collection.  Patient identification should be done in accordance with site policy.
Samples and requisitions must be labeled/completed in accordance with the Shared Health Specimen Acceptance Policy.
Collection Devices:
BD Vacutainer Plus C&S preservative tube
Specimen Required: BD Vacutainer Plus C&S preservative tube: Minimum 3 mL as indicated by minimum draw line on tube (Adult and Pediatric)

Ensure samples that are being sent to a referral laboratory are packaged in accordance with Transport of Dangerous Goods recommendations for diagnostic samples.
Reference Values:
A descriptive report will be sent.  Significant uropathogens recovered at a quantity of ≥10^5 cfu/L will be identified and susceptibility testing for these isolates will be performed.
If no bacteria are recovered at ≥10^5 cfu/L a report of "No growth at 10^5 cfu/L." will be issued by the microbiology laboratory.
The anticipated turn-around-time is two to three days from receipt of the specimen in the Microbiology laboratory.
See Also:
More Information:
Specimen Handling:
Transport specimen in a BD Vacutainer Plus C&S preservative tube to the microbiology laboratory at 4°C or room temperature within 48 hours of specimen collection.