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Laboratory Testing Update – Revision to the Urinalysis with Reflex Culture Criteria

by kswan on December 11, 2012

Effective Monday, December 17, the algorithm used for the urinalysis with reflex culture will be revised based on the results of urine culture testing performance in both 2011 and 2012 and a review of the literature regarding the role of the clinical laboratory in the diagnosis of urinary tract infection.

As a result, the presence of blood and/or protein alone will no longer be used as a trigger for a reflex culture.  Positive results for leukocyte esterase, nitrite and WBC >10 will continue to trigger a reflex culture.  This change is reached with the consensus of infectious disease, clinical pathology and the hospitalists.

The goal is to improve clinical care by reducing the number of contaminated or uninterpretable urine cultures.  In the shift away from the reliance on reflex testing, a urine culture should be ordered if clinically indicated.

Any questions regarding this change may be directed to Mary Clance, MD, hospital epidemiologist, at or Donna Ragan, core lab manager at