Toxins

Cadmium is a naturally occurring element that is mined and used in industrial production because of its durability. Excessive cadmium exposure can damage lungs, kidneys, and the digestive tract.

Cadmium is a naturally occurring element that is mined and used in industrial production because of its durability. Excessive cadmium exposure can damage lungs, kidneys, and the digestive tract.

Clinical Significance
Micronutrient, Cadmium, Blood - Cadmium is a naturally occurring element that is mined and used in industrial production because of its durability. Excessive cadmium exposure can damage lungs, kidneys, and the digestive tract.

Patients must be 18 years of age or greater.

Reference Range(s)

Adults, Non-Smokers	1.7 mcg/L or less
Adults, Smokers	5.0 mcg/L or less
OSHA Reference Range	5.0 mcg/L
Toxic Concentration	Early signs of toxicity have been observed at 30 mcg/L

Reference range not available for individuals <18 years for this micronutrient test.

Cadmium is a naturally occurring element that is mined and used in industrial production because of its durability. Excessive cadmium exposure can damage lungs, kidneys, and the digestive tract.

Cobalt is part of our diet. Approximately 85% of absorbed cobalt is excreted in the urine and the remainder eliminated in stool. Toxicity may occur in select industrial

Clinical Significance
Micronutrient, Cobalt, Blood - Cobalt is part of our diet. Approximately 85% of absorbed cobalt is excreted in the urine and the remainder eliminated in stool. Toxicity may occur in select industrial environments. Cobalt is not mined in the United States so primary supplies are imported.

Patients must be 18 years of age or greater.

Patient Preparation
Patient should refrain from taking mineral supplements, vitamin B-12 or vitamin B complex three days before specimen collection.

Reference Range(s)
≥18 years    ≤1.8 mcg/L
Reference range not available for individuals <18 years for this micronutrient test.

Elevated urinary lead concentration is indicative of chronic lead toxicity. Urinary lead concentrations may be used to monitor detoxification therapy.

Description: Lead is a chemical that is poisonous in large amounts. This lead test will determine the level of lead in the blood. If the lead level comes back high and out of range it is important to work with a licensed healthcare provider to treat the excess amount along with identifying the source and doing what you can to eliminate exposure.

Also Known As: Blood Lead Test, Blood Lead Level Test, BLL Test

Collection Method: Blood Draw

Specimen Type: Whole Blood

Test Preparation: No preparation required

When is a Lead test ordered?

When lead exposure is a concern, blood lead tests may be required to check individuals in the workplace. Because lead can be taken home on clothing, family members may also be checked. This testing complies with federal and state occupational exposure regulations.

Adult blood lead screening does not yet have a nationwide standard like it does for children. Clinical cut-off values for increased blood lead differ by state at the moment. A national health goal for 2015, according to the CDC's Adult Blood Lead Surveillance program, is to reduce all blood lead levels in adults to less than or equal to 5 mcg/dL.

Adults who work in industries that are known to expose people to lead, such as smelters, lead plating, auto repair, and construction, should be tested for lead exposure. Adults who use lead-based paints, ceramics, or gasoline in their hobbies should also be evaluated. See the article on Lead Poisoning for a list of hobbies that could expose someone to high levels of lead.

The Occupational Safety and Health Administration has established guidelines for workplace lead monitoring. Employee blood monitoring programs must be triggered by the findings of an initial air monitoring program, according to OSHA. If a worker's initial blood lead test result is greater than 40 mcg/dL, testing should be done every two months until two consecutive lead tests reveal a blood lead level of less than 40 mcg/dL. Higher amounts necessitate more careful monitoring.

When a person's symptoms imply possible lead poisoning, lead testing may be done for both children and adults. Fatigue, changes in mood, nausea, extended stomach trouble, headache, tremors, weight loss, peripheral neuropathy, anemia, reproductive failure, encephalopathy, memory loss, seizures, and coma are examples of non-specific symptoms. Although many youngsters show no outward signs at the time of exposure, lasting damage might nonetheless occur. Children with growth failure, anemia, sleep issues, hearing loss, or speech, language, or attention deficits should be tested for lead exposure.

What does a Lead blood test check for?

Lead is a soft metal that is found in nature. Lead can harm the brain, organs, and nervous system when it is inhaled or swallowed. This test determines the current blood lead level.

Lead can cause irreparable damage even at low levels without creating physical symptoms. Lead poisoning in children can result in long-term cognitive impairment, behavioral problems, and developmental delays. Lead poisoning can result in weariness, anemia, nausea, weight loss, fatigue, headaches, stomach discomfort, renal, neurological system, and reproductive system problems. Lead poisoning can be passed down from mothers to their unborn children, resulting in miscarriages and early deliveries.

Lead was once used in paints, gasoline, water pipes, and other home products, including canned food solder. Lead is still utilized in many products and industrial processes in the United States and around the world, despite its limited use in the United States. Lead-based paint and lead-contaminated household dust may be found in homes built before 1978. The soil around these homes could be contaminated with lead as well.

Children under the age of six are the most vulnerable to lead poisoning because they frequently put their hands in their mouths, ingesting lead dust or paint chips. They can also breathe lead dust and eat or chew lead-contaminated food. Adult lead exposure is typically linked to work or recreational activities. When lead pollution is taken home on the work clothes of parents who work with lead, their children may be exposed.

Lab tests often ordered with a Lead test:

• Heavy Metals Panel
• Mercury
• Zinc Protoporphyrin (ZPP)

Conditions where a Lead test is recommended:

• Lead poisoning

How does my health care provider use a Lead test?

The lead test is used to assess the amount of lead in a blood sample at the time it was taken. The blood lead test is performed to check for lead poisoning. It may also be ordered to evaluate treatment effectiveness and ensure that lead levels are lowering over time.

Local lead concentrations are monitored in accordance with state and national guidelines. Screening children for lead exposure is recommended by the Centers for Disease Control and Prevention, the American Academy of Pediatrics, and a number of other organizations. Over the last 45 years, testing recommendations and the definition of an elevated blood lead level have changed dramatically.

To identify children living in circumstances where they are exposed to lead hazards, the CDC utilizes a blood lead level of 5 mcg/dL as a criterion. Environmental examinations to determine lead sources, education of family members about lead poisoning, and follow-up testing to monitor the disease are all recommended for children with elevated blood lead levels. According to AAP standards, children should be tested for iron deficiency and overall nutrition. BLLs will need to be tracked over time until the environmental investigations and remedies are finished. Children with BLLs above 45 mcg/dL should be evaluated and treated.

Blood lead levels are monitored in workers who work in a lead-contaminated environment. It's used to assess both long-term and current lead exposure. A zinc protoporphyrin test is sometimes requested. When lead starts to influence red blood cell formation, the ZPP rises. Although it is not sensitive enough to be used as a screening tool for children, it may be ordered to determine average lead exposure in adults over the previous several weeks.

What do my Lead blood test results mean?

The more lead in the blood, the higher the test result. The amount of lead in the blood, on the other hand, does not always reflect the total amount of lead in the body. This is due to the fact that lead travels from the lungs and intestinal system to the blood and organs, where it is progressively eliminated and stored in tissues like bones and teeth. The danger caused by a given lead level is determined by the person's age and health, the amount of lead they are exposed to, and the length of time they are exposed to elevated lead levels.

Lead poisoning is harmful to everyone, but children are more sensitive. To identify children living in circumstances where they are exposed to lead hazards, the CDC utilizes a blood lead level of 5 mcg/dL as a criterion. Any test results that exceed this threshold should be managed and monitored. Any youngster with a high blood lead level should have his or her home or other surroundings assessed. Other members of the household should also be tested. The elevated lead level will most likely return unless the cause of the exposure - a lead danger in the environment - is eliminated or reduced.

The National Institute of Occupational Safety and Health declared 5 micrograms per deciliter of blood as an increased blood lead level in adults in 2015. Blood lead levels in adults should be kept below 10 micrograms per deciliter, according to the US Department of Health and Human Services. When BLLs are greater than or equal to 50 mcg/dL or larger than or equal to 60 mcg/dL in general industry, the US Occupational Safety and Health Administration Lead Standards require workers to be removed from lead exposure, and allow workers to return to work when their BLL is less than 40 mcg/dL. If the client is symptomatic at any dose below 70 mcg/dL, removal may be indicated.

Because lead can flow through the bloodstream to an unborn child, pregnant women should restrict their lead exposure to keep their blood levels as low as possible in order to safeguard the developing fetus.

Unless the kid is encephalopathic, most doctors agree that a youngster with a lead level more than 45 mcg/dL should be treated with succimer/chelator in the hospital. Any lead level more than 70 mcg/dL in a child or adult should be treated as a medical emergency.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

Clinical Significance
Micronutrient, Lead, Blood (Venous) - Blood lead level analysis is performed to evaluate the body burden of lead.

Patients must be 18 years of age or greater.

Reference Range(s)
≥18 years    <3.5 mcg/dL
Reference range not available for individuals <18 years for this micronutrient test.

Elevated urinary lead concentration is indicative of chronic lead toxicity. Urinary lead concentrations may be used to monitor detoxification therapy.

Description: Mercury is a blood test that is used to evaluate the amount of mercury in the blood. Mercury in large amounts can be poisonous. It can also be dangerous for pregnant women to have increased levels of mercury.

Also Known As: Hg Test, Hg Blood Test, Mercury Blood Test

Collection Method: Blood Draw

Specimen Type: Whole Blood

Test Preparation: Avoid seafood consumption for 48 hours prior to sample collection

When is a Mercury test ordered?

When a person exhibits signs and symptoms that point to high mercury exposure, mercury testing may be recommended. Chronically exposed people may get nonspecific symptoms including the lungs, kidneys, and neurological system.

When it is known that a person has been exposed to mercury, testing may be done even if there are no symptoms to help determine the degree of the exposure.

Mercury readings, together with tests to detect lead and/or other heavy metals, may be ordered on a regular basis as a monitoring tool for those who work in industries that use mercury, and for those who work with a variety of potentially hazardous compounds.

What does a Mercury blood test check for?

Mercury is a toxic element that comes in a variety of forms. Mercury can be present in trace amounts in the environment. It is emitted as a byproduct of fossil fuel combustion and waste incineration, as well as the decomposition of minerals in rocks and soils. It is inhaled through our lungs, absorbed through our skin, and eaten through food. Some mirror coatings, medicines, and agricultural compounds include mercury. Small amounts of mercury are used in the production of energy-efficient compact fluorescent light bulbs, as well as electrical equipment, cable, and switching devices.

The minuscule amounts to which the great majority of people are exposed are generally not harmful to their health. People may acquire mercury-related symptoms or issues if they are exposed to high levels of mercury, such as those found at a hazardous waste site, or if they are exposed to mercury over a long period of time, particularly if they deal with heavy metals.

Mercury poisoning can occur if you are exposed to too much of it. The type of mercury, its quantity, and the nature of exposure all influence how much mercury a person absorbs and how it affects his or her health. Metallic mercury is absorbed relatively little by the body, according to the Agency for Toxic Substances and Disease Registry, even if it is consumed. When the same mercury is inhaled as a vapor, however, around 80% of it gets absorbed into the bloodstream.

The digestive tract absorbs about 95 percent of methyl mercury, which is found in fish and other shellfish. Consumption of contaminated seafood is the most common source of human exposure to methyl mercury. Fish from contaminated waters, as well as large predator fish that have devoured smaller fish, may have much higher methyl mercury levels. It's critical to know where your fish comes from and to keep the amount of large predator fish you eat to a minimum.

Mercury can be deposited in a range of body organs, including the kidneys and the brain, once it has been ingested. Mercury is slowly excreted by the body through urine and feces, but if an excessive amount accumulates, it can harm the kidneys, neurological system, and brain permanently.

Mercury can be passed on to an unborn baby by pregnant women with high mercury levels, impairing the development of the infant's brain, kidneys, and nerves in particular. Mercury can also be transmitted from mother to child via breast milk during breastfeeding.

Lab tests often ordered with a Mercury test:

• Lead
• Arsenic
• Heavy Metals
• Comprehensive Metabolic Panel (CMP)
• Complete Blood Count (CBC)

Conditions where a Mercury test is recommended:

• Pregnancy
• Heart Disease
• Kidney Disease
• Neuropathy
• Mercury Poisoning

How does my health care provider use a Mercury test?

Mercury testing is performed to determine whether a person's blood has an excessive amount of mercury. A health practitioner may order it to identify whether a person has been exposed to a dangerous quantity of mercury for a short period of time or for an extended period of time. Testing can also be used to keep track of those who may be exposed to mercury at work.

The presence of methyl mercury in the blood is the most common test. Other types of mercury can be found in the blood, but as the mercury goes into organs including the brain and kidneys, the amount found in the blood decreases by half every three days. As a result, blood tests must be performed within days of a possible exposure.

Other common laboratory tests may be used to assess the health of various organ systems in someone who has been exposed to dangerous levels of mercury or is suspected of having been exposed. A complete metabolic panel and a complete blood count are two examples.

What do my Mercury test results mean?

Mercury levels in the blood are generally relatively low. A test result of no mercury or a low level of mercury shows that the individual examined was not exposed to high quantities of mercury, at least not during the time period covered by the test.

A higher mercury level in the blood indicates that you were exposed to mercury recently. A blood level of more than 10 mcg/L indicates an extraordinary degree of exposure for someone who does not work with mercury on a regular basis.

Mercury levels in the blood or urine do not reflect the type or amount of mercury to which a person was exposed.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

Clinical Significance
Micronutrient, Mercury, Blood - Mercury, a highly toxic metal, is present in select industrial environments and in contaminated ocean fish.

Patients must be 18 years of age or greater.

Patient Preparation
Avoid seafood consumption for 48 hours prior to sample collection.

Reference Range(s)
≥18 years    ≤10 mcg/L
Reference range not available for individuals <18 years for this micronutrient test.

Mercury, a highly toxic metal, is present in select industrial environments and in contaminated ocean fish. Urinary measurements are appropriate for assessing ongoing exposure to inorganic mercury.

Mercury, a highly toxic metal, is present in select industrial environments and in contaminated ocean fish. Urinary measurements are appropriate for assessing ongoing exposure to inorganic mercury.

Exposure to thallium is primarily through foods and may occur in highly selected industrial environments. Blood thallium may be used in assessing chronic toxicity.

Boron, Urine

Clinical Significance

Boron is used in cleaning agents, preservatives, and fungicides. Boron may cause dermatitis, cough, and shortness of breath. Most is excreted by the kidney.

 

Patient Preparation

Avoid exposure to gadolinium based contrast media for 48 hours prior to sample collection

 

Approximately 1 in every 2500 individuals has inherited a defective enzyme or a deficiency of the enzyme (Pseudocholinesterase) that metabolizes succinylcholine (an anesthetic agent). With a "normal" dosage, these individuals have prolonged apnea. Such individuals are responsive at much smaller concentrations of this anesthetic agent than the general population. Low concentrations of Pseudocholinesterase are observed in individuals exposed to organophosphorous insecticides and in patients with hepatic dysfunction.

Brief Description: The test is used to measure levels of cholinesterase in your blood’s serum, plasma, and red blood cells.

Also Known As: CHS Test, CHS Serum Test, CHS Plasma Test, CHS RBC Test, CHS Blood Test, AChE Test, AChE Serum Test, AChE RBC Test, AChE Plasma Test, AChE Blood Test, Serum Cholinesterase, RBC Cholinesterase, Plasma Cholinesterase, Red Cell Cholinesterase, Acetylcholinesterase test, butyrylcholinesterase test, BChE Test, BChE Serum Test, BChE RBC Test, BChE Plasma Test, BChE Blood Test, Pseudocholinesterase Test, PCHE Test

Collection Method: Blood Draw

Specimen Type: Whole Blood, Plasma, and Serum

Test Preparation: No preparation required

When is a Cholinesterase test ordered?

Once baseline levels have been established, those who deal with organophosphate substances in the farming or chemical industries may undergo routine monitoring to evaluate any detrimental exposure. Testing for cholinesterase can be performed to determine any acute exposure to these substances, which can harm the neuromuscular system. Rapid absorption of the substance in the lungs, skin, or digestive system may be followed by toxicity. Depending on the substance, its dose, and the exposure site, poisoning symptoms can vary. Early signs could include:

• headache and vertigo
• Nausea
• excessive sweating, salivation, and/or eye tears

As the poisoning's effects grow, more symptoms could develop, including:

• nausea, diarrhea
• vision that is dim or fuzzy because of restricted pupils
• twitching, jerking, and lack of coordination in the muscles
• slowed breathing that causes respiratory failure and calls for ventilator support to survive
• In severe situations, coma, death, and convulsions may occur.

If a person or a close relative has experienced extended paralysis and apnea following the administration of succinylcholine for anesthesia during an operation, pre-operative screening for pseudocholinesterase activity is indicated.

What does a Cholinesterase blood test check for?

Enzymes called cholinesterase play a role in the healthy operation of the nervous system. The body contains two different cholinesterase enzymes: pseudocholinesterase, which is found in the serum as well as the liver, muscle, pancreas, heart, and white matter of the brain, and acetylcholinesterase, which is found in red blood cells as well as the lungs, spleen, nerve endings, and gray matter of the brain. The activity of these enzymes is measured by cholinesterase testing.

By degrading acetylcholine, a substance that aids in signal transmission across nerve ends, acetylcholinesterase contributes to the transmission of nerve impulses. Acetylcholine is produced in excess at nerve endings when the activity of the enzyme acetylcholinesterase declines. Overstimulation of nerves in human tissues and organs may result from this. Processing and metabolizing medicines involves the enzyme pseudocysteinesterase.

The following are the top two justifications for analyzing blood activity levels:

• exposure to organophosphate pesticides. The activity of cholinesterase and pseudocholinesterase can be inhibited by insecticides containing organophosphates. When these pesticides are exposed acutely, symptoms may be severe, while persistent exposure may cause symptoms to develop more gradually. Ingestion, inhalation, and skin contact are all possible methods of absorption. To identify acute poisoning or to keep track of people who are exposed to these chemicals on the job, such as agricultural laborers or people who work with industrial chemicals, tests for red blood cell acetylcholinesterase and serum pseudocholinesterase may be performed.
• Pseudocholinesterase deficit that is inherited. Some people have a genetic variation of the pseudocholinesterase enzyme that results in an inherited deficit. The body uses this enzyme to render succinylcholine, a popular anesthetic muscle relaxant, inactive. A prolonged muscle paralysis and apnea after anesthesia are possible side effects of the medication in people who have low levels or faulty pseudocholinesterase. Additionally, individuals who are homozygous for genetic polymorphisms may be more susceptible to negative consequences than individuals who are heterozygous. Before surgery, patients with a family history of prolonged apnea following succinylcholine use can have pseudocholinesterase testing to see if they are at risk of problems from the medication.

Lab tests often ordered with a Cholinesterase test:

• Hepatic Function Panel

How does my health care provider use a Cholinesterase test?

There are two main purposes for cholinesterase testing:

• It can be used to identify and treat exposure to or poisoning from organophosphate pesticides. As well as monitoring persons who are being treated for exposure to organophosphate chemicals, it may also be used to monitor those who may be at an elevated risk of exposure to these substances, such as those who work in the chemical and agricultural industries. Tests for serum pseudocholinesterase and red blood cell acetylcholinesterase are frequently used for this reason.
• It can be used a few days before surgery to ascertain whether a patient is at danger of developing post-operative paralysis if succinylcholine, a common muscle relaxant used for anesthesia, is used during the operation. The test for pseudocholinesterase is typically used in these circumstances. To ascertain the degree to which the enzyme's activity has been diminished, a second test known as a dibucaine inhibition test may be carried out.

What do my Cholinesterase test results mean?

In assessing the exposure to pesticides at work

AChE and PChE activity can decrease after exposure to organophosphate substances to about 80% of normal before any symptoms show up and to 40% of normal before the symptoms worsen. By first establishing a baseline activity level for acetylcholinesterase or pseudocholinesterase, and then testing on a frequent basis to look for a noticeably decreased level of activity, those who are regularly exposed to these substances can be monitored for harmful exposure.

When assessing for acute pesticide toxicity or exposure

Significantly reduced levels of cholinesterase activity typically signify an increased uptake of organophosphate substances. After exposure, pseudocholinesterase and RBC acetylcholinesterase activity typically declines between minutes to hours. While acetylcholinesterase activity will remain low for up to three months, pseudocholinesterase activity can rebuild in a matter of days to weeks. Pesticide exposure quickly affects the plasma and RBC activity, although AChE and PChE regenerate at various rates after exposure is over because AChE is created in blood cells, which have a lifespan of 120 days, whilst PChE is formed in the liver, which has a half-life of roughly two weeks.

Succinylcholine sensitivity evaluations

About 3% of individuals have poor pseudocholinesterase activity because of a hereditary deficit, and these individuals will experience extended effects from the muscle relaxant succinylcholine. Prior to surgery, total quantitative pseudocholinesterase levels will be assessed in individuals who have a personal or family history of prolonged apnea following use of this medication. Low pseudocholinesterase activity levels suggest that these individuals may be more susceptible to the long-lasting effects of the muscle relaxant. To determine how sensitive a person is to the medicine, a second test called the dibucaine inhibition test may also be carried out. The likelihood of developing medication sensitivity increases with a lower dibucaine inhibition test result.

Malnutrition and chronic liver disease are additional factors that might lead to decreased cholinesterase levels. Pregnancy, renal disease, shock, and various malignancies are just a few more circumstances that might cause a decrease in total cholinesterase activity.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

This assay is useful to monitor exposure to chromium, progress of medical treatment or determine nutritional status.

Clinical Significance
Micronutrient, Chromium, Blood - This assay is useful to monitor exposure to chromium, progress of medical treatment or to determine nutritional status.

Patients must be 18 years of age or greater.

Patient Preparation
Patient should refrain from taking mineral supplements and multivitamin three days before specimen collection.

Reference Range(s)
≤18 years    ≤1.2 mcg/LReference range not available for individuals <18 years for this micronutrient test.
 

Uranium, Urine

Patient Preparation
Avoid exposure to gadolinium based contrast media for 48 hours prior to sample collection

Preferred Specimen(s)
1 mL urine collected in an acid-washed or metal-free container

Minimum Volume
0.4 mL

Collection Instructions
Avoid exposure to gadolinium based contrast media for 48 hours prior to sample collection

Transport Container
Plastic container (acid-washed or trace metal-free)

Transport Temperature
Room temperature

Description: A Urine Culture test is a test that is used to identify bacteria or foreign organisms in urine and test for antibiotic susceptibilities.

Also Known As: Culture Urine Routine, Urine Culture and Sensitivity, Urine C and S, UTI test

Collection Method: Urine Collection

Specimen Type: Urine

Test Preparation: No preparation required

IMPORTANT - Culture, Urine, Routine #395 can Reflex to additional testing and charges, detailed below, if Culture is positive.

If culture is positive, CPT code(s): 87088 (each isolate) will be added with an additional charge.  Identification will be performed at an additional charge (CPT code(s): 87077 or 87140 or 87143 or 87147 or 87149).

Antibiotic susceptibilities are only performed when appropriate (CPT code(s): 87181 or 87184 or 87185 or 87186).

• ORG ID 1. $ 12.45 
• ORG ID 2. $ 23.95 
• PRESUMPTIVE ID 1. $ 12.45 
• PRESUMPTIVE ID 2. $ 23.95 
• SUSC-1  $14.95 
• SUSC-2  $28.95

When is a Urine Culture test ordered?

A urine culture may be requested if a person exhibits symptoms that suggest a urinary tract infection, such as:

• Urination urges that are strong and persistent
• Urination with a burning sensation
• Urine that is murky and has a strong odor
• Back pain in the lower back

Urinary tract infections can cause pressure in the lower abdomen as well as small quantities of blood in the urine. If the UTI is severe and/or has gone to the kidneys, it can cause symptoms such as flank pain, high fever, trembling, chills, nausea, and vomiting.

For young women with signs or symptoms of a UTI and an uncomplicated lower urinary tract infection, antibiotics may be administered without obtaining a urine culture. A urine culture is advised if there is a suspicion of a complex infection or if symptoms do not respond to first treatment.

Pregnant women without symptoms should be examined for bacteria in their urine during their first trimester or first prenatal appointment, as bacteria in the urine can harm the growing baby's health.

A urine culture may be administered in conjunction with a urinalysis or as a follow-up to abnormal urinalysis results.

What does a Urine Culture test check for?

Urine is a fluid generated by the kidneys that contains both water and waste. It passes from the kidneys to the bladder through tubes called ureters before being expelled from the body through the urethra. Urine culture is a test that detects and identifies bacteria and yeast in the urine that could be the source of a urinary tract infection.

A small amount of urine is placed on one or more agar plates and incubated at body temperature for a urine culture. Any bacteria or yeast present in the urine sample will grow into little circular colonies during the next 24 to 48 hours. The number of colonies and the size, shape, and color of these colonies assist identify which bacteria are present in the urine sample, and the number of colonies shows the amount of bacteria that were initially present in the urine sample. A laboratory technician counts the total number of colonies on the agar plate and determines how many types have grown. If a good, clean catch sample was taken for the test, the only bacteria found should be from an infection. Typically, there will be only one variety of bacterium present in relatively significant quantities. More than one type of bacteria may be present at any given time. This could be the result of a multi-pathogen infection, although it's more likely owing to contamination from the skin picked up during the urine collection.

A gram stain will be performed on a colony from each type by the laboratory technician. The bacteria are examined under a microscope by the laboratory technician. Different species of bacteria will have distinct colors and forms. Under a microscope, the bacterium Escherichia coli, which is responsible for the majority of urinary tract infections, will appear as gram-negative rods. Lactobacillus, a frequent vaginal contaminant found in women's urine, will show up as gram-positive rods. Some bacteria, such as Lactobacillus, are easy to detect by a skilled lab technician, are nonpathogenic, and do not require additional research. Others, such as gram-negative rods, represent clusters of identical bacteria that will necessitate extra testing to determine which bacteria are present.

After 24 to 48 hours of incubation, if there is no or little growth on the agar, the urine culture is declared negative for pathogens and the culture is complete. If one or more pathogens are found, more testing is done. Testing is performed to determine which bacteria are present, as well as susceptibility testing to determine which antibiotics are most likely to cure the infection.

Lab tests often ordered with a Urine Culture test:

• Urinalysis, Complete
• C-Reactive Protein
• ANA
• Rheumatoid Factor
• Complete Blood Count (CBC)
• Comprehensive Metabolic Panel (CMP)

Conditions where a Urine Culture test is recommended:

• Diabetes
• Kidney Disease
• Liver Disease
• Hypertension
• Pregnancy
• Hematuria
• Proteinuria
• Kidney Stones
• Urinary Tract Infection (UTI)

How does my health care provider use a Urine Culture test?

The urine culture is often used to diagnose a urinary tract infection and to identify the bacteria or yeast that is causing it. It can be used in conjunction with susceptibility testing to discover which drugs will stop the infection-causing bacterium from growing. The findings will aid a doctor in determining which treatments are most likely to be beneficial in treating a patient's infection.

The kidneys, a pair of bean-shaped organs positioned near the bottom of the ribcage on the right and left sides of the back, produce urine. To transport wastes out of the body, the kidneys filter waste from the blood and generate urine, a yellow fluid. Urine goes from the kidneys to the bladder, where it is briefly stored, and then via the urethra to be emptied. Urine is normally sterile, but bacteria or, more rarely, yeast can migrate up the urinary tract from the skin outside the urethra and produce a urinary tract infection.

The majority of UTIs are considered simple and treatable. The infection may spread up through the ureters and into the kidneys if they are not treated. A kidney infection is more hazardous and can result in renal damage that is irreversible. In some situations, a urinary tract infection can escalate to a life-threatening infection in the bloodstream.

People with renal disease or other illnesses that impact the kidneys, such as diabetes or kidney stones, as well as people with compromised immune systems, may be more susceptible to UTIs.

What do my Urine Culture test results mean?

Urine culture results are frequently interpreted in conjunction with urinalysis results, as well as how the sample was taken and whether symptoms are present. Because certain urine samples may contain bacteria that are ordinarily found on the skin, some culture results must be interpreted with caution.

A positive urine culture is usually defined as the presence of a single kind of bacteria growing at high colony counts. Cultures containing more than 100,000 CFU/mL of one species of bacteria in clean catch samples that have been correctly collected usually indicate infection. Even if an infection is present, there may not be a large number of germs present in some circumstances. Lower levels can sometimes suggest infection, particularly if symptoms are present. Similarly, values of 1,000 to 100,000 CFU/mL may be deemed significant for samples acquired using a technique that reduces contamination, such as a sample collected with a catheter.

Although UTIs can be caused by a variety of bacteria, the majority are caused by Escherichia coli, a kind of bacteria that is widespread in the digestive tract and frequently detected in stool. Proteus, Klebsiella, Enterococcus, and Staphylococcus are among the bacteria that can cause UTIs. A yeast infection, such as Candida albicans, can cause a UTI, but urethritis is more commonly caused by a sexually transmitted illness, such as herpes, chlamydia, or gonorrhea.

When a culture says "no growth in 24 or 48 hours," it usually means there isn't an infection. If the symptoms persist, a urine culture on a new sample may be performed to test for bacteria with reduced colony numbers or other microorganisms that could be causing the symptoms. Acute urethral syndrome is defined as the presence of white blood cells and low quantities of bacteria in a sick person's urine.

If multiple different species of bacteria thrive in a culture, the growth is almost certainly due to contamination. This is notably true in urine samples containing Lactobacillus and/or other prevalent nonpathogenic vaginal bacteria in women. If the symptoms persist, the healthcare provider may order a second culture on a more thoroughly collected sample. However, if one species of bacteria has considerably larger colony counts than the others, such as 100,000 CFUs/mL versus 1,000 CFUs/mL, further testing to determine the dominating bacterium may be required.

Susceptibility testing may be used to guide treatment if a culture is positive. Any bacterial infection can be dangerous and, if left untreated, can spread to other parts of the body. Pain is frequently the first sign of infection. Treatment as soon as possible, generally with antibiotics, will help to relieve the pain.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.