Investigation of urine

Microbiology

Urinary tract infection (UTI) results from the presence and multiplication of microorganisms in one or more structures of the urinary tract with associated tissue invasion. This can give rise to a wide variety of clinical syndromes. These include acute and chronic pyelonephritis (kidney and renal pelvis), cystitis (bladder), urethritis (urethra), epididymitis (epididymis) and prostatitis (prostate gland). Infection may spread to surrounding tissues (eg perinephric abscess) or to the bloodstream.

PLEASE NOTE: Samples and accompanying relevant patient/ isolate data maybe referred for confirmatory or further laboratory testing to Reference laboratories. Relevant Public Health departments may also be notified IF a notifiable disease is identified under the Infectious Diseases Regulations https://www.hpsc.ie/notifiablediseases/listofnotifiablediseases/

Sample Type:

MSU, CSU or Bag urine. In an appropriate sterile leak proof container. Minimum volume: 1mL

Temperature: 2-8°C

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Turnaround Time:

24h for a negative result.

48h for a positive result.

*Excludes Sundays and Bank Holidays

Sample Stability:

48 hours @ 2-8°C

Where there is a delay >48 hours the use of sterile urine containers with boric acid preservative may be beneficial this will increase the sample stability to 96hours.

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Instrument / Procedure:

Automated method Sysmex UF-5000 analyser.

Manual Microscopy & Culture for specimens that cannot be processed using the automated method & for the confirmation of presence of yeast cells and examination of the morphology of casts & crystals if present.

Units:

Reference Range:

Precautions:

Preparation of patient: Collect specimens before antimicrobial therapy where possible.

Precautions: Rapid transport and culture, or measures to preserve the sample aid reliable laboratory diagnosis. Delays and storage at room temperature allow organisms to multiply which generates results that do not reflect the true clinical situation. Where delays in processing are unavoidable, refrigeration is recommended or the use of a boric acid preservative may be beneficial. Boric acid increases the maximum permissible time for transport to the laboratory to up to 96hr.

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Accreditation Status:

Accredited

Non-Accredited

SAMPLE REQUIREMENTS FOR COAGULATION TESTS

PROCEDURE

Sample Requirements and Collection

Patients should be relaxed pre-venepuncture. Excessive stress and exercise will increase FVIII, vWF antigen and fibrinolysis. Venous occlusion should be avoided.
Difficult venepuncture with trauma may lead to platelet activation with release of PF4 from alpha granules.
Venous blood should be collected into coagulation tubes containing Sodium Citrate 3.2%, 0.105M.
Specimens must be mixed immediately post venepuncture to avoid clot activation, by GENTLY inverting the tubes 5 to 10 times.
The ratio of whole blood to anticoagulant is crucial to clotting times. A target blood to anticoagulant ratio of 9:1 is optimal. Under- or over- filled specimens will not be processed this can adversely affect results.
Any warfarin treatment should be mentioned on the request form.
Sample rejection Criteria: Clotted sample, grossly hemolyzed sample, underfilled/overfilled specimen, unlabeled sample, mismatched patient ID, aged samples, wrong sample tube (citrate tube only).

Transportation and Storage

PT/INR specimens should be transported to the laboratory at room temperature.
Coagulation specimens should ideally be analysed within 4 hours of collection. Where this is not possible, centrifuge specimens at room temperature (RT) @ 1500RCF for at least 15 minutes, and then carefully remove the plasma from the cells, transfer to a fresh plastic plain tube and freeze at -20oC.
Non-frozen coagulation specimens should be transported at RT ASAP to avoid deterioration of labile factors V and VIII.
Collection of blood through intravenous lines that have been previously flushed with heparin should be avoided. In the event blood is drawn from an indwelling catheter, the line should be flushed with 5ml of saline, and the first 5ml of blood or 6 times the line volume be drawn off and discarded before coagulation tube is filled.
Effect of freezing on Coagulation Specimens.
A 14days in-house study on the effect of freezing, on coagulation specimens at -20oC, showed that there was negligible and clinically non-significant effect of freezing on coagulation specimen results. Therefore frozen citrated coagulation samples are stable for 14 days at -20oC, post centrifugation. This study is available in-house for reference.

ESR Ref Ranges

Units of Measurement

MALE

FEMALE

>50 Years

mm/hr

0 - ≤12

0 - ≤15

<50 Years

mm/hr

0 - ≤8

0 - ≤10

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Analyte

Units of Measurement

MALE

FEMALE

WBC

10^9/L

4.0–10.0

4.0 - 10.0

RBC

10^12/L

5.0 ± 0.5

4.3 ± 0.5

g/dL

15.0 ± 2.0

13.5 ± 1.5

HCT

L/L

0.45 ± 0.05

0.41 ± 0.05

MCV

92 ± 9

MCH

29.5 ± 2.5

MCHC

g/dL

33.0 ± 1.5

PLT

10^9/L

280 ± 130

MPV

N/A

RDW

11.6 - 14.0

#Neut

10^9/L

2.0 – 7.0 (40 - 80%)

#Lymph

10^9/L

1.0 – 3.0 (20 - 40%)

#Mono

10^9/L

0.2 – 1.0 (2 - 10%)

#Eos

10^9/L

0.02 – 0.5 (1 - 6%)

#Baso

10^9/L

0.02 – 0.1 (<1 - 2%)

Analyte

Units of Measurement

MALE & FEMALE

WBC

10^9/L

Birth: 18 ± 8
Day 3: 15 ± 8
Day 7: 14 ± 8
Day 14: 14 ± 8
1 Month: 12 ± 7
2 Months: 10 ± 5
3–6 Months: 12 ± 6
1 Year: 11 ± 5
2–6 Years: 10 ± 5
6–12 Years: 9 ± 4

RBC

10^12/L

Birth: 6.0 ± 1.0
Day 3: 5.3 ± 1.3
Day 7: 5.1 ± 1.2
Day 14: 4.9 ± 1.3
1 Month: 4.2 ± 1.2
2 Months: 3.7 ± 0.6
3–6 Months: 4.7 ± 0.6
1 Year: 4.5 ± 0.6
2–6 Years: 4.6 ± 0.6
6–12 Years: 4.6 ± 0.6

g/dL

Birth: 18.0 ± 4.0
Day 3: 18.0 ± 3.0
Day 7: 17.5 ± 4.0
Day 14: 16.5 ± 4.0
1 Month: 14.0 ± 2.5
2 Months: 11.2± 1.8
3–6 Months: 12.6 ± 1.5
1 Year: 12.6 ± 1.5
2–6 Years: 12.5 ± 1.5
6–12 Years: 13.5 ± 2.0

HCT

L/L

Birth: 0.60 ± 0.15
Day 3: 0.56 ± 0.11
Day 7: 0.54 ± 0.12
Day 14: 0.51 ± 0.12
1 Month: 0.43 ± 0.10
2 Months: 0.35 ± 0.07
3–6 Months: 0.35 ± 0.05
1 Year: 0.34 ± 0.04
2–6 Years: 0.37 ± 0.03
6–12 Years: 0.40 ± 0.05

MCV

Birth: 110 ± 10
Day 3: 105 ± 13
Day 7: 107 ± 19
Day 14: 105 ± 19
1 Month: 104 ± 12
2 Months: 95 ± 8
3–6 Months: 76 ± 8
1 Year: 78 ± 6
2–6 Years: 81 ± 6
6–12 Years: 86 ± 9

MCH

Birth: 34 ± 3
Day 3: 34 ± 3
Day 7: 34 ± 3
Day 14: 34 ± 3
1 Month: 33 ± 3
2 Months: 30 ± 3
3–6 Months: 27 ± 3
1 Year: 27 ± 2
2–6 Years: 27 ± 3
6–12 Years: 29 ± 4

MCHC

g/dL

Birth: 33.0 ± 3.0
Day 3: 33.0 ± 4.0
Day 7: 33.0 ± 5.0
Day 14: 33.0 ± 5.0
1 Month: 33.0 ± 4.0
2 Months: 32.0 ± 3.5
3–6 Months: 33.0 ± 3.0
1 Year: 34.0 ± 2.0
2–6 Years: 34.0 ± 3.0
6–12 Years: 34.0 ± 3.0

PLT

10^9/L

Birth: 100 – 450
Day 3: 210 – 500
Day 7: 160 – 500
Day 14: 170 – 500
1 Month: 200 – 500
2 Months: 210 – 650
3–6 Months: 200 – 550
1 Year: 200 – 550
2–6 Years: 200 – 490
6–12 Years: 170 – 450

Reticulocytes

10^9/L

Birth: 120 – 400
Day 3: 50 – 350
Day 7: 50 – 100
Day 14: 50 - 100
1 Month: 20 – 60
2 Months: 30 – 50
3–6 Months: 40 – 100
1 Year: 30 – 100
2–6 Years: 30 – 100
6–12 Years: 30 – 100

#Neut

10^9/L

Birth: 4 – 14
Day 3: 3 – 5
Day 7: 3 – 6
Day 14: 3 – 7
1 Month: 3 – 9
2 Months: 1.0 – 5
3–6 Months: 1 – 6
1 Year: 1 – 7
2–6 Years: 1.5 – 8
6–12 Years: 2 – 8

#Lymph

10^9/L

Birth: 3 – 8
Day 3: 2 – 8
Day 7: 3 – 9
Day 14: 3 – 9
1 Month: 3 – 16
2 Months: 4 – 10
3–6 Months: 4 – 12
1 Year: 3.5 – 11
2–6 Years: 6 - 9
6–12 Years: 1 - 5

#Mono

10^9/L

Birth: 0.5 – 2.0
Day 3: 0.5 – 1.0
Day 7: 0.1 – 1.7
Day 14: 0.1 – 1.7
1 Month: 0.3 – 1.0
2 Months: 0.4 – 1.2
3–6 Months: 0.2 – 1.2
1 Year: 0.2 – 1.0
2–6 Years: 0.2 – 1.0
6–12 Years: 0.2 – 1.0

#Eos

10^9/L

Birth: 0.1 – 1.0
Day 3: 0.1 – 2.0
Day 7: 0.1 – 0.8
Day 14: 0.1 – 0.9
1 Month: 0.2 – 1.0
2 Months: 0.1 – 1.0
3–6 Months: 0.1 – 1.0
1 Year: 0.1 – 1.0
2–6 Years: 0.1 – 1.0
6–12 Years: 0.1 – 1.0

Reference Ranges:

Age

Absolute Reference Range

Age

% Reference Range

0 - 1 day

324 - 617 x10⁹/L

0 - 1 day

1.72 - 8.62%

1 - 5 days

85 - 400 x10⁹/L

1 - 5 days

1.9 - 9.1%

5 days - 1 mth

34.2 - 724 x10⁹/L

5 days - 1 mth

0.1 - 6.9%

1 - 3 mths

21.3 - 205 x10⁹/L

1 - 3 mths

0.1 - 6.27%

3 - 12 mths

8.0 - 171 x10⁹/L

3 - 12 mths

0.1 - 4.7%

1 - 3 yrs

55.6 - 120 x10⁹/L

1 - 3 yrs

0.35 - 2.95%

3 - 7yrs

16.4 - 120.7 x10⁹/L

3 - 7yrs

0.25 - 2.57%

Adult

35.2 - 122.8 x10⁹/L

Adult

0.75 - 2.7%

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