Appendix 3: Guidance for the interpretation of urine culture Note: This is intended for guidance only - supplementation with local reporting policies may be necessary. No. isolates Specimen Clinical details/microscopy Laboratory interpretation Susceptibility Comments to consider Growth cfu/L type influencing report* testing recommended 1 Any None Probable UTI Yes If old specimen or no pyuria consider 108 repeat to confirm Consider SPA or CCU if bag specimen 2 MSU, CCU, WBC present Possible UTI colonisation, faulty Yes Consider repeat to confirm Each org 108 or – SCU, Symptomatic collection or transport and 108 107 BAG CSU, (IL) Indwelling catheter Probable colonisation No Consider keeping Consider discuss if patient systemically – Neurogenic bladder plates 5d in case unwell and therapy required ≤ patient becomes septic 2 1 organism Any None Possible UTI ?colonisation, faulty Yes, predominant organism If old specimen or no pyuria consider – collection or transport predominant at 108 repeat to confirm or 107 Consider SPA or CCU if bag specimen 3 Mixed growth - Any None Faulty collection or transport No Heavy mixed growth probable ≥ – 3 none predominant contamination. Consider repeat if symptomatic Consider repeat to confirm 107 108 1 Any WBC present Possible UTI patient evaluation Yes – – Symptomatic necessary 2 1 predominant at Any WBC present Probable UTI with predominant Yes, predominant organism Consider repeat or SPA/CCU Symptomatic species but suppress results Sensitivities are available if required 107 Children 2nd isolate probable contamination 1 at < 107 or None Probable contamination No Mixed growth probable contamination – 107 108 but not – predominant 1 organism Any WBC present Possible UTI with predominant No keep plates 5d if Mixed growth consider repeat if ≥ – ≤ – 3 predominant at Symptomatic species. Others probable catheter specimen in symptomatic contamination case patient becomes 107 septic Any combination CSU Indwelling catheter Colonisation No keep plates 5d in Please discuss if therapy indicated – ≤ Neurogenic bladder case patient becomes septic
Appendix 3: Guidance for the interpretation of urine culture Note: This 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 108 1 Any None Probable UTI Yes If old specimen or no pyuria consider repeat to confirm Consider SPA or CCU if bag specimen 2 Each org 108 or 108 and 107 MSU, CCU, SCU, BAG WBC present Symptomatic Possible UTI – colonisation, faulty collection or transport Yes Consider repeat to confirm CSU, (IL) Indwelling catheter Neurogenic bladder Probable colonisation No – Consider keeping plates ≤ 5d in case patient becomes septic Consider discuss if patient systemically unwell and therapy required 2 3 1 organism predominant at 108 or 107 Any None Possible UTI – ?colonisation, faulty collection or transport Yes, predominant organism If old specimen or no pyuria consider repeat to confirm Consider SPA or CCU if bag specimen ≥ 3 Mixed growth - none predominant Any None Faulty collection or transport No Heavy mixed growth – probable contamination. Consider repeat if symptomatic 107 – 108 1 Any WBC present Symptomatic Possible UTI – patient evaluation necessary Yes Consider repeat to confirm 2 1 predominant at 107 Any WBC present Symptomatic Children Probable UTI with predominant species 2nd isolate probable contamination Yes, predominant organism but suppress results Consider repeat or SPA/CCU Sensitivities are available if required 1 at < 107 or 107 – 108 but not predominant None Probable contamination No Mixed growth – probable contamination ≥ 3 1 organism predominant at 107 Any WBC present Symptomatic Possible UTI with predominant species. Others probable contamination No – keep plates ≤ 5d if catheter specimen in case patient becomes septic Mixed growth – consider repeat if symptomatic Any combination CSU Indwelling catheter Neurogenic bladder Colonisation No – keep plates ≤ 5d in case patient becomes septic Please discuss if therapy indicated
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