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HelpOrder Code URNS Bacterial Culture, Aerobic, with Antimicrobial Susceptibilities, Urine
Shipping Instructions
Specimen must arrive within 72 hours of collection.
Necessary Information
Specimen source is required.
Specimen Required
Supplies: Boric Acid Urine Preservative Tube, 4 mL (T996)
Collection Container/Tube: Clean, plastic urine collection container
Submission Container/Tube: Commercially available transport system intended for the collection and transport of urine samples for culture and sensitivity testing of bacteria (4 mL of lyophilized maintenance formula; BD Vacutainer C and S Preservative and BD Vacutainer C and S Boric Acid Sodium Borate/Formate)
Specimen Volume: 4 mL
Collection Instructions:
1. Collect a random urine specimen.
2. Transfer 4 mL into the boric acid transport tube.
3. Send ambient in transport tube. Do not aliquot from transport tube.
Additional Information: Aliquots from transport tube and frozen specimens are not acceptable.
Specimen Stability Information: Ambient 72 hours
Useful For
Diagnosing urinary tract infections
May be helpful in discriminating contamination, colonization, and infection
Determining the in vitro antimicrobial susceptibility of potentially pathogenic aerobic bacteria, if appropriate
This test is not intended for medicolegal use.
Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| COMM | Identification Commercial Kit | No, (Bill Only) | No |
| RMALD | Ident by MALDI-TOF mass spec | No, (Bill Only) | No |
| GID | Bacteria Identification | No, (Bill Only) | No |
| REFID | Additional Identification Procedure | No, (Bill Only) | No |
| STAP | Identification Staphylococcus | No, (Bill Only) | No |
| STRP | Identification Streptococcus | No, (Bill Only) | No |
| SALS | Serologic Agglut Method 1 Ident | No, (Bill Only) | No |
| EC | Serologic Agglut Method 2 Ident | No, (Bill Only) | No |
| SHIG | Serologic Agglut Method 3 Ident | No, (Bill Only) | No |
| SIDC | Ident Serologic Agglut Method 4 | No, (Bill Only) | No |
| ISAE | Aerobe Ident by Sequencing | No, (Bill Only) | No |
| PCRID | Identification by PCR | No, (Bill Only) | No |
| BLA | Beta Lactamase | No, (Bill Only) | No |
| MIC | Susceptibility, MIC | No, (Bill Only) | No |
| SUS | Susceptibility | No, (Bill Only) | No |
| MECAB | mecA PCR Test, Bill Only | No, (Bill Only) | No |
Testing Algorithm
When this test is ordered, the reflex tests may be performed at an additional charge. Antimicrobial agents appropriate to the organism and specimen source will be tested according to Mayo Clinic's practice and the laboratory's standard operating procedures.
The following tables list the antimicrobials routinely tested in the laboratory as well as antimicrobials that may be tested upon request. These tables are organized by isolate groups and are not all inclusive. Call 800-533-1710 and ask to speak to the Bacteriology Antimicrobial Susceptibility Testing Laboratory if the organism or antimicrobial of interest are not listed in these tables.
-Aerobic Gram-Negative Bacilli Antimicrobials
-Additional Gram-Negative Bacteria Antimicrobials
-Staphylococcus, Enterococcus, Bacillus, and Related Genera Antimicrobials
Special Instructions
Method Name
Conventional Quantitative Culture Technique/Identification of Pathogens with Minimal Inhibitory Concentration (MIC) (Agar Dilution or Broth Microdilution or Gradient Diffusion) or Disk Diffusion, (if appropriate)
Reporting Name
Bacterial Culture, Aerobic + SuscSpecimen Type
UrineSpecimen Minimum Volume
See Specimen Required
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Urine | Varies | |
Reject Due To
| Frozen specimens | Reject |
| Aliquots from transport tubes | Reject |
Reference Values
No growth, Organism present less than 10,000 cfu/mL or urogenital microbiota.
Identification of probable pathogens with colony count ranges.
Susceptibility results are reported as minimal inhibitory concentration (MIC) in mcg/mL. Breakpoints (also known as clinical breakpoints) are used to categorize an organism as susceptible, susceptible-dose dependent, intermediate, resistant, or nonsusceptible according to breakpoint setting organizations, either the Clinical and Laboratory Standards Institute (CLSI) or the European Committee on Antimicrobial Susceptibility Testing (EUCAST), as applicable.
In some instances, an interpretive category cannot be provided based on available data; therefore, the following comment will be included in the report: There are no established interpretive guidelines for agents reported without interpretations.
For information regarding CLSI and EUCAST susceptibility interpretations, see Susceptibility Interpretative Category Definitions.
Method Description
The urine specimen is inoculated onto sheep blood agar and eosin methylene blue agar using a calibrated loop. Following 18 to 24 hours of incubation, semiquantitative colony counts are determined and disease-causing organisms or possible disease-causing organisms are identified using one or a combination of the following techniques: commercial identification strips or panels, matrix-assisted laser desorption/ionization-time of flight mass spectrometry, conventional biochemical tests, carbon source utilization, real-time polymerase chain reaction, and nucleic acid sequencing of the 16S ribosomal RNA gene. Cultures with fewer than 10,000 colony-forming unit (cfu)/mL of a single species are reported as "Organism present <10,000 cfu/mL." The presence of commensal microbiota of the urethra (contaminants) and mixed cultures of organisms present in colony counts below 10,000 cfu/mL are reported as "Urogenital microbiota."(Chan WW. Urine cultures. In: Leber AL, ed. Clinical Microbiology Procedures Handbook. Vol 1. 4th ed. ASM Press; 2016:section 3.12)
When antimicrobial susceptibility testing is performed, an agar dilution method is used for routine testing. The agar dilution method employs the use of antimicrobial agents incorporated in agar plates. The antimicrobial is added to agar in various concentrations depending upon levels attainable in serum, urine, or both. A standardized suspension of the organism is applied to the agar plates, which are incubated for a minimum of 16 to 18 hours at 35° C. Complete inhibition of all but one colony or a very fine residual haze represents the endpoint.(Clinical and Laboratory Standards Institute [CLSI]: Methods for Dilution Antimicrobial Susceptibility Tests for Bacteria That Grow Aerobically. 11th ed. CLSI standard M07. CLSI; 2018)
Daptomycin and tigecycline are tested by agar gradient diffusion.(Clinical and Laboratory Standards Institute [CLSI]: Methods for Dilution Antimicrobial Susceptibility Tests for Bacteria That Grow Aerobically. 11th ed. CLSI standard M07. CLSI; 2018; package insert: Etest Biomerieux;15203E-EN-2016/07. Available at www.biomerieux.com/techlib)
Cefiderocol is tested by disk diffusion.(Clinical and Laboratory Standards Institute [CLSI]: Performance Standards for Antimicrobial Disk Susceptibility Tests. 13th ed. CLSI standard M02. CLSI; 2018)
Day(s) Performed
Monday through Sunday
Performing Laboratory
Mayo Clinic Laboratories in Rochester
CPT Code Information
87086-Bacterial Culture, Aerobic, Urine
87077-Identification commercial kit (if appropriate)
87077-Ident by MALDI-TOF mass spec (if appropriate)
87077-Bacteria Identification (if appropriate)
87077-Additional Identification procedure (if appropriate)
87077-Identification Staphylococcus (if appropriate)
87077-Identification Streptococcus (if appropriate)
87147 x 1-3-Serologic agglut method 1 ident (if appropriate)
87147-Serologic agglut method 2 ident (if appropriate)
87147 x 4-Serologic agglut method 3 ident (if appropriate)
87147 x 2-6-Serologic Agglut Method 4 Ident (if appropriate)
87153-Aerobe ident by sequencing (if appropriate)
87150-Identification by PCR (if appropriate)
87185-Beta lactamase (if appropriate)
87186-Antimicrobial Susceptibility, Aerobic Bacteria, MIC-per organism for routine battery (if appropriate)
87181-Susceptibility per drug and per organism for drugs not in routine battery (if appropriate)
87150-mec A PCR (if appropriate)
87150 x 5 Carbapenem resistance genes (if appropriate)
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| URNS | Bacterial Culture, Aerobic + Susc | 630-4 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| URNS | Bacterial Culture, Aerobic + Susc | 630-4 |