Culture & Sensitivity, Aerobic bacteria Urine(Vitek 2 Compact)

Bacterial/ Viral

Report in 72Hrs

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No Fasting Required

Details

Identifies bacteria & antibiotic susceptibility.

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Culture & Sensitivity, Aerobic bacteria Urine (Vitek 2 Compact)

Why is it done?
- Identifies specific aerobic bacteria causing urinary tract infections (UTIs), including both upper and lower urinary tract infections
- Determines antimicrobial susceptibility patterns to guide appropriate antibiotic therapy selection
- Performed when patients present with symptoms suggestive of UTI such as dysuria, frequency, urgency, or suprapubic pain
- Used to diagnose asymptomatic bacteriuria in pregnant women and other high-risk populations
- Helps monitor treatment efficacy in recurrent UTIs or complicated urinary tract infections
- Utilized in patients with indwelling catheters, urinary obstruction, or immunocompromised states
Normal Range
- Negative/No Growth: Less than 10³ colony-forming units per milliliter (CFU/mL) or <100,000 CFU/mL in a single void specimen
- Questionable Significance: 10² to 10³ CFU/mL (100 to 1,000 CFU/mL) - may represent contamination, colonization, or early infection
- Positive/Significant Bacteriuria: ≥10⁵ CFU/mL (≥100,000 CFU/mL) in a midstream clean-catch specimen from symptomatic patients
- Catheterized Specimens: ≥10² CFU/mL (≥100 CFU/mL) may be considered significant
- Units of Measurement: Colony-forming units per milliliter (CFU/mL)
Interpretation
- No Growth or Negative Results:
  - Indicates absence of significant bacterial infection in the urinary tract
  - Rules out bacterial UTI as the cause of symptoms
  - Suggests symptoms may be due to viral infection, irritation, or non-infectious causes
- Positive Cultures with Single Organism:
  - Highly suggestive of true infection, particularly with E. coli, Klebsiella, Proteus, or Pseudomonas species
  - Sensitivity results guide selection of appropriate antibiotics for targeted therapy
- Positive Cultures with Multiple Organisms:
  - Likely represents contamination from skin flora or perineal region during collection
  - May indicate specimen collection impropriety or inadequate cleaning
  - Recollection with proper technique usually recommended
- Sensitivity Pattern Interpretation:
  - Susceptible (S): Organism is likely to respond to antibiotic therapy; therapeutic drug concentration achievable in urine
  - Intermediate (I): Organism may respond to therapy at higher antibiotic doses; clinical response uncertain
  - Resistant (R): Organism is unlikely to respond to therapy; alternative antibiotic selection required
- Factors Affecting Results:
  - Improper specimen collection technique causing contamination with skin or perineal flora
  - Delayed specimen processing or transport at room temperature may allow bacterial overgrowth
  - Recent or concurrent antibiotic therapy may inhibit bacterial growth
  - Specimen dilution from excessive fluid intake or frequent voiding may decrease bacterial recovery
  - Vitek 2 Compact automated system provides rapid and accurate identification using biochemical testing
Associated Organs
- Primary Organ System:
  - Urinary tract system including urethra, bladder, ureters, and kidneys
- Common Infections Detected:
  - Acute Cystitis: Infection of the bladder causing dysuria, frequency, and urgency
  - Acute Pyelonephritis: Infection of the kidneys potentially causing flank pain, fever, and systemic symptoms
  - Chronic Recurrent UTI: Repeated bacterial infections requiring long-term monitoring and management
  - Asymptomatic Bacteriuria: Bacterial infection without symptoms, especially significant in pregnancy
  - Catheter-Associated UTI (CAUTI): Infection associated with indwelling urinary catheters
- Associated Conditions and Risk Factors:
  - Urinary obstruction from stones, tumors, or prostatic hyperplasia
  - Neurogenic bladder with incomplete emptying
  - Diabetes mellitus increasing susceptibility to infection
  - Immunocompromised states including HIV/AIDS and chemotherapy patients
  - Pregnancy-related changes in urinary anatomy and immune function
  - Vesicoureteral reflux allowing bacteria to ascend to kidneys
- Potential Complications of Untreated Infections:
  - Progression to urosepsis and systemic septic shock, particularly in immunocompromised patients
  - Permanent kidney damage and renal scarring if pyelonephritis left untreated
  - Adverse pregnancy outcomes including preterm labor and low birth weight
  - Chronic kidney disease from repeated renal infections
Follow-up Tests
- Additional Tests Based on Positive Culture Results:
  - Repeat Urine Culture: Performed 3-5 days after initiating therapy to confirm treatment efficacy
  - Test of Cure: Performed 1-2 weeks after completing therapy to verify bacterial eradication
  - Urinalysis: May accompany culture to assess for pyuria, hematuria, and proteinuria
- Imaging Studies for Recurrent or Complicated UTI:
  - Renal Ultrasound: Non-invasive assessment for hydronephrosis, stones, and anatomic abnormalities
  - CT Abdomen/Pelvis: Detailed imaging to exclude obstructing pathology, pyelonephritis, or abscess
  - Voiding Cystourethrography (VCUG): Fluoroscopic study to assess for vesicoureteral reflux, particularly in children
- Laboratory Tests for Systemic Involvement:
  - Complete Blood Count (CBC): Evaluates for leukocytosis suggesting systemic infection
  - Metabolic Panel and Renal Function: Assesses renal function and excludes electrolyte abnormalities
  - Blood Cultures: Obtained if patient presents with fever and suspected urosepsis
- Monitoring Frequency for Chronic or Recurrent Infections:
  - Pregnant women: Monthly screening after initial UTI or continuous with asymptomatic bacteriuria
  - Recurrent UTI patients: Culture with each symptomatic episode or as clinically indicated
  - Catheterized patients: Culture only when symptomatic or prior to catheter removal
Fasting Required?
- Fasting Requirement: No
- Fasting is not required for urine culture collection
Special Patient Preparation:
- Specimen Collection Technique:
  - Obtain midstream clean-catch urine specimen by thoroughly cleaning perineal area with sterile wipes
  - Initiate voiding, discard first portion, collect 20-30 mL of midstream urine in sterile container
  - Straight catheterization or suprapubic aspiration performed for patients unable to void
  - First-morning urine specimen preferred due to higher bacterial concentration
- Specimen Handling:
  - Transport immediately to laboratory or refrigerate at 4°C if delay in processing >2 hours
  - Use sterile, leakproof container without additives or preservatives
  - Minimum specimen volume typically 20-30 mL for culture
- Medications to Avoid or Disclose:
  - Recent antibiotic therapy should be reported as it may inhibit bacterial growth and produce false-negative results
  - Ideally, obtain culture before initiating antibiotic treatment when possible
- Additional Preparation Notes:
  - Maintain normal hydration status and void normally as forced hydration may dilute urine
  - Avoid vaginal douches, deodorants, or other topical agents 24 hours prior to collection in females
  - Females should not collect specimen during menstrual cycle when possible due to potential contamination

How our test process works!