3. Defination of urine
• Urine (from Latin Urina, ae, f.) is a
typically sterile liquid by-product of the
body secreted by the kidneys through a
called urination and excreted through
(a) wuchereria bancrofti
(b) schistosoma hematobium
(c) trichomonas viginalis
(d) enterobius vermicularis
• Bladder and urinary tract are normally sterile.
• Urethra and perineum has wide variety of
gram positive and negative organisms.
6. Collection of urine specimen
• The first voided morning urine (most
concentrated) - qualitative
• Random urine (routine)
• 24hrs sample- quantitative
• Mid-stream clean catch (most suitable for
• Post prandial sample.
• Need to be examined within 1 hour.
7. Collection and transport
• Give patient sterile,dry,wide necked leak proof container and
request 10-20 ml specimen.(clean catch specimen)
• Cleanse the area around urethral opening with clean water,dry the
area and collect urine with labia held apart.
• Wash hands before collecting specimen
(middle of urine flow)
• Label container with date & name.
• Number of patient & time of collection.
• As soon as possible, deliver specimen
with request form to laboratory.
8. Collection and transport
• Give patient a sterile,dry,leak proof container with
instructions how to collect a clean catch MSU.(mid
• Add measured amount of boric acid powder (0.1g/10ml
of urine) to preserve a specimen.
• Label container and send urine
with request form to reach
microbiology laboratory within
9. Laboratory examination of urine
• Appearance of specimen
Appearance Possible cause
Cloudy (urine has unpleasent smell and
Bacterial urinary infection
Red &cloudy (due to red cells) Urinary schistosomiasis
Brown &cloudy (due to hemoglobin) Black water fever
Yellow brown or green brown
(due to bilirubin)
Acute viral hepatitis
(due to urobillin)
(due to chyle)
11. Microscopical examination of Urine
• Round,10-15 um in diameter.
• Few upto 10 wbcs/HPF
• Many:more than 40
• Definite outline and no
• Reported as
few,moderate,many in number
/HPF (high power field)
12. Microscopical examination of Urine
(a) A hyaline cast with a 'fluffy'
appearance due to the fibrillary
substructure of Tamm–Horsfall
(b) A hyaline–granular cast.
(c) A finely granular cast.
(d) A waxy cast
13. Microscopical examination of Urine
• Oval shape and some yeast
• Show single budding
• Yeast are reported as
few,moderate or many /
HPF(higher power field)
(a) Uric acid crystals
(b)calcium oxalate crystals.
(c) calcium phosphate
(d) Triple phosphate
14. Biochemical test for urine
• Biochemical tests which
are helpful in
investigating UTI (Urinary
tract infection )
• Dipstick method is mostly
used in chemistry labs.
15. CULTURE THE SPECIMEN:
Culture is required when the urine contains
bacteria(as indicated by Gram
smear),cells,casts,proteins and nitrite.
• Normal specimens may be contain small amount
of organisms(less than 10,000/ml of urine)
• In untreated acute infections the number of bacteria
will be more than 100,000/ml.
16. METHODS OF ESTIMATING BACTERIAL
1. Using quarter plates of culture media
3. Simple to perform
4. Provides individual colonies
17. CYSTINE LACTOSE ELECTROLYTE
• Allows the growth of both gram
negative and gram positive
• Electrolyte deficient to prevent
swarming of Proteus species
• Bromothymol blue indicator
• Lactose fermenting colonies
18. • Mix the urine by rotating the container
• Using a sterile wire loop,inoculate a loopful
of urine on plate of CLED ager
• Incubate at 35-37°C overnight
19. CULTURE IDENTIFICATION
(CLED agar culture)
• look for colonies that could be:
• Escherichia coli
• Proteus species
• Pseudomonas aeruginosa
• Klebsiella strains
• Staphylococcus aureus
• Staphylococcus saprophyticus
• Enterococcus faecalis
21. REPORTING BACTERIAL NUMBERS
• Estimate the number of bacteria,i.e colony
forming units(CFU) per ml of urine
• Report the bacterial count as:
Less than 10,000 organisms/ml
More than 100,000/ml
22. INTERPRETATION OF BACTERIAL COUNTS
• Interpret culture count in relation to clinical
=> infection or contamination
• UTIs with low counts in urinary obstruction.
24. TESTING URINE FOR HCG
• First morning specimen.
• Based on detection of rapidly rising levels of
hCG in urine or serum.
• Investigation of suspected ectopic pregnancy,
threatened abortion or trophoblastic tumor.
• IC (immuno chromatographic) card and strip
tests are able to detect 50mlU/ml of hCG.