Change in Reflex Criteria for Urine Culture

Change in Reflex Criteria for Urine Culture

We are changing the criteria for reflex urine cultures. In the past, the only criteria for urine cultures was WBC >10 in the urine. We will now also culture urines with positive leukocyte esterase or positive nitrite. These two parameters were added since WBCs may sometimes lyse in transport. Although there are no gold standards as to when to reflex urines for culture, these three criteria are widely used at other laboratories. Please be aware that some organisms do not elicit a typical UTI inflammatory response (such as elevated WBCs). If there is a strong initial suspicion for UTI, or if symptoms persist despite normal screening test results, a urine culture should be ordered rather than a reflex culture.