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Urine Culture

Urine Culture. Urine Gram Stain. Urine Culture Quantitation. Clean catch or catheterized urine Plate = 1000 organisms/ml Clean catch: >10 5 orgs/ml Suprapubic urine Any colony is significiant. Urine Cultures. 1. Plates initially read at 18-24 hr

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Urine Culture

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  1. Urine Culture

  2. Urine Gram Stain

  3. Urine Culture Quantitation Clean catch or catheterized urine Plate = 1000 organisms/ml Clean catch: >105 orgs/ml Suprapubic urine Any colony is significiant

  4. Urine Cultures 1. Plates initially read at 18-24 hr 2. All specimens plated after NOON of the previous day, hold another overnight 3. Gram positives take longer to grow

  5. Most Common Pathogens of Human Urinary Tract • Community acquired • E. coli is most frequent pathogen isolated • Klebsiella sp and other Enterobacteriaceae • Staphylococcus saprophyticus • Hospital acquired • E. coli, Klebsiella, otherEnterobacteriaceae • Pseudomonas aeruginosa • Enterococci and Staphylococci

  6. Abbreviated Identification • E. coli • Non-swarming, spot indole pos, oxidaseneg • Lactose positive (MacConkey or eosin methylene blue), PYR (pyrrolidonylarylamidase) test positive 2. API

  7. Abbreviated Identification • Proteus spp. • Swarming growth • Indole • Negative: P. mirabilis/penneri • P. mirabilis: maltose neg, ornithine pos • P. penneri: maltose pos, ornithineneg • Positive: P. vulgaris

  8. Abbreviated Identification • P. aeruginosa • Oxidase-positive bacillus • Typical smell (grapes) • Colony morphology P. aeruginosa: metallic/pearlescent, rough, pigmented, mucoid • Indole-negative

  9. Abbreviated Identification • CHROMagar Orientation • Presumptive ID for some UTI pathogens • E. coli (dark rose to pink) • Enterococci (turquoise blue) • S. saprophyticus(light pink to rose) • S. agalactiae(light blue-green to light blue) • Proteus-Morganella-Providencia group (brown) • Klebsiella-Enterobacter-Serratia group (dark blue) • Issues and challenges • All except E. coli and enterococci require further ID • Small E. coli colonies require spot indole • Poor growth of some gram-positive bacteria • Nonselective– other pathogens may or may not produce color change

  10. Abbreviated Identification • Enterococcus spp. • Cocci or coccobacilli in pairs and chains • >1 mm colonies • Non-hemolytic on SBA • Catalase-negative • PYR-positive (pyrrolidonyl-a-naphthylamide hydrolysis)

  11. Abbreviated Identification • S. agalactiae (GBS) • Cocci in pairs and chains • Catalase-negative • Narrow zone of beta-hemolysis on SBA • Rapid hippurate hydrolysis test (beta strep only) OR • Test for CAMP factor (spot or O/N) OR • Typing by particle agglutination • R/O beta hemolytic Enterococcus (PYR+) b-hem Enterococcus

  12. Abbreviated Identification • Yeast • Candida albicans • Microscopy required: oval, budding yeast • Colonies <48 h old on blood-containing medium with “feet” or mycelial projections *CHROMagar

  13. Abbreviated Identification • Candida CHROMagar

  14. Why females has higher incidence of UTI?? • Short urethra • Anus nearby urethra • contraceptives

  15. Now to the lab…

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