The lab will be making slight changes to the order “Urinalysis, Culture” if indicated. The following criteria will need to be met for urine to be reflexed to culture:
1. WBC >= to 10 white cells/high power field
or
2. Leukocyte esterase>= +1
or
3. Bacteria “few” and squamos epithelial cells <= 5/high power field.
4. All nitrite positive urine samples will continue to be cultured.
We hope to increase the specificity of the reflex portion of the test. Antibiotic resistance and Clostridium difficile are growing health care concerns. This is one change that we hope will limit treatment of asymptomatic bacteriuria in certain populations and thus unnecessary antibiotic use. This is in accordance with consensus guidelines. Reflex criteria adjustments could potentially decrease the amount of SH urine cultures by 21 percent without adversely affecting required treatment.
For more information please contact:
Renee Gerros, MT, 503-814-1640
Jasmin Chaudhary, MD, 503-540-9999
Danielle Britt, MA, PharmD, 503-814-9981