Appendix 3 (continued): Guidance for the interpretation of culture Note: This table is intended for guidance only supplementation with local reporting policies may be necessary. – Clinical Growth Specimen Susceptibility Comments to consider No. isolates details/microscopy Laboratory interpretation cfu/L type testing recommended influencing report 106 107 1 MSU, CCU, Symptomatic female Possible UTI clinical evaluation Yes Consider repeat to confirm – – CSU, IL Prostatitis necessary WBC present 2 Any Possible UTI clinical evaluation Yes Consider repeat to confirm Each org 106 - – necessary including possible pathogen, eg E. coli or S. saprophyticus 105 108 1 SPA, CYS, None Probable UTI Yes – (SCU) 2 WBC present Probable UTI patient evaluation Yes Each 106 – necessary 1 organism WBC present Probable UTI patient evaluation Yes, predominant Mixed growth: ≥3 – predominant at necessary organism Consider repeat to confirm 106 No growth ie: Any None or No UTI < 106 if 1 loop asymptomatic μL used < 105 if 10 loop μL used Symptomatic Patient on antibiotics? As appropriate • Marked/persistent Consider Chlamydia, AFB etc • pyuria Fastidious organism? • Consider bacteriuria < 105 cfu/L • MSU Midstream specimen; CCU clean catch; SPA Suprapubic aspirate; IL– Ileal conduit; CSU Catheter; SCU Single, intermittent catheter (“in and out”); CYS Cystoscopy –- – – –- – – * - see Introduction for interpretation of culture results
Appendix 3 (continued): Guidance for the interpretation of culture Note: This table is intended for guidance only – supplementation with local reporting policies may be necessary. Growth cfu/L No. isolates Specimen type Clinical details/microscopy influencing report Laboratory interpretation Susceptibility testing recommended Comments to consider 106 – 107 1 MSU, CCU, CSU, IL Symptomatic female Prostatitis WBC present Possible UTI – clinical evaluation necessary Yes Consider repeat to confirm 2 Each org 106 - including possible pathogen, eg E. coli or S. saprophyticus Any Possible UTI – clinical evaluation necessary Yes Consider repeat to confirm 105 – 108 1 SPA, CYS, (SCU) None Probable UTI Yes 2 Each 106 WBC present Probable UTI – patient evaluation necessary Yes ≥3 1 organism predominant at 106 WBC present Probable UTI – patient evaluation necessary Yes, predominant organism Mixed growth: Consider repeat to confirm No growth ie: < 106 if 1 μL loop used < 105 if 10 μL loop used Any None or asymptomatic No UTI Symptomatic Marked/persistent pyuria • Patient on antibiotics? • Consider Chlamydia, AFB etc • Fastidious organism? • Consider bacteriuria < 105 cfu/L As appropriate MSU –- Midstream specimen; CCU – clean catch; SPA – Suprapubic aspirate; IL– Ileal conduit; CSU –- Catheter; SCU – Single, intermittent catheter (“in and out”); CYS – Cystoscopy * - see Introduction for interpretation of culture results
B_41dl_.docx