Table X-1.
Laboratory Diagnosis of Cystitis and Pyelonephritis
| Etiologic Agents | Diagnostic Procedures | Optimum Specimens | Transport Issues; Optimal Transport Time |
|---|---|---|---|
| Gram-Negative Bacteria | |||
| Enterobacteriacae: | Routine aerobic culture | Mid-stream, clean catch or straight cath urine | Closed sterile leakproof container; refrigerate (4°C) or use urine transport tube unless delivery to laboratory ≤1 h is certain. |
| Includes Escherichia coli, Klebsiella spp, Proteus spp, others | Gram stain (optional, low sensitivity) | ||
| Pseudomonas spp, other nonfermenting gram-negative rods | |||
| Gram-Positive Bacteria | |||
| Enterococcus spp Staphylococcus aureus | Routine aerobic culture Gram stain (optional, low sensitivity) | Midstream, clean catch, or straight cath urine | Closed sterile leakproof container; refrigerate (4°C) or use urine transport tube unless delivery to laboratory ≤1 h is certain. |
| Staphylococcus saprophyticus | |||
| Corynebacterium ureolyticum | |||
| Streptococcus agalactiae (Group B streptococci) | |||
| Mycobacteria | |||
| Mycobacterium tuberculosis | Mycobacterial culture | First void urine | Prefer >20 mL urine, refrigerate (4°C) during transport |
| Virus | |||
| Adenovirus | Virus Culture | Midstream or clean catch urine | Closed sterile container to laboratory within 1 h |
| NAATa | |||
| BK Polyoma virus | Quantitative NAATa from urine, plasma, or serum | Blood | EDTA or Citrate blood collection tube, RT |
| Serum | Clot tube, RT | ||
Abbreviations: NAAT, nucleic acid amplification test; RT, room temperature.
a No FDA-cleared NAAT tests available