Urine Culture, Comprehensive w/Reflex to ID and Susceptibility*

A single culture is about 80% accurate in the female; two containing the same organism with count of 100,000 cfu/mL or more represent a 95% chance of true bacteriuria; three such specimens mean virtual certainty of true bacteriuria. A single clean voided specimen from an adult male may be considered diagnostic with proper preparation and care in specimen collection. If the patient is receiving antimicrobial therapy at the time the specimen is collected, any level of bacteriuria may be significant. When more than two organisms are recovered, the likelihood of contamination is high; thus, the significance of definitive identification of the organisms and susceptibility testing in this situation is severely limited. A repeat culture with proper specimen collection including patient preparation is often indicated. Cultures of specimens from Foley catheters yielding multiple organisms with high colony counts usually represents colonization of the catheter and not true significant bacteriuria. Failure to recover aerobic organisms from patients with pyuria or positive Gram stains of urinary sediment may indicate the presence of mycobacteria or anaerobes. Few clinical studies have been performed to support the identification of more than two organisms or implicate usual site flora (eg, diphtheroids, α- or γ-streptococci, and coagulase-negative staphylococci other than S saprophyticus).