CHROMagar Orientation Medium Reduces Urine Culture Workload

Abstract

Microbiology laboratories continually strive to streamline and improve their urine culture algorithms because of the high volumes of urine specimens they receive and the modest numbers of those specimens that are ultimately considered clinically significant. In the current study, we quantitatively measured the impact of the introduction of CHROMagar Orientation (CO) medium into routine use in two hospital laboratories and compared it to conventional culture on blood and MacConkey agars. Based on data extracted from our Laboratory Information System from 2006 to 2011, the use of CO medium resulted in a 28% reduction in workload for additional procedures such as Gram stains, subcultures, identification panels, agglutination tests, and biochemical tests. The average number of workload units (one workload unit equals 1 min of hands-on labor) per urine specimen was significantly reduced (P < 0.0001; 95% confidence interval [CI], 0.5326 to 1.047) from 2.67 in 2006 (preimplementation of CO medium) to 1.88 in 2011 (postimplementation of CO medium). We conclude that the use of CO medium streamlined the urine culture process and increased bench throughput by reducing both workload and turnaround time in our laboratories.

Culture of Urine Specimens by Use of chromID CPS Elite Medium Can Expedite Escherichia coli Identification and Reduce Hands-On Time in the Clinical Laboratory

“…In addition, no significant differences were measured for the time to final report of any culture. This is consistent with a previous report in which there was no significant difference demonstrated for turnaround time between pre-and postimplementation of CHROMagar orientation medium for uropathogen identification in a clinical microbiology laboratory (26). Chromogenic media are not FDA-cleared for performing MALDI-TOF MS or antimicrobial susceptibility testing directly without subculture to conventional media; this has the potential to delay these results by approximately 1 day.…”

“…Hands-on time and consumable use were reduced using chromID compared to conventional media for clinically significant cultures, particularly cultures of E. coli. This benefit may offset the increased cost of chromogenic media compared to standard culture media (24,26,28). While emerging and uncommon uropathogens will likely require conventional methods for identification, chromID CPS Elite agar may be a feasible alternative to conventional media for isolation and identification of most common uropathogens in urine specimens.…”

“…Other studies have reported decreased processing time for urine culture work-up with chromogenic media (23,26). However, the assessment of time saved relied upon extrapolation of hands-on time for all cultures based on a predetermined average work-up time or retrospective analysis of time stamps pulled from a laboratory information system.…”

A Study on Evaluation of Different Culture Media for the Isolation of Routine Urinary Pathogens

“…Early information enables the selection of the appropriate antibiotics prior to the results of susceptibility tests and may thereby prevent outbreaks. Therefore any new medium or method with the ability to streamline urine culture processing in a meaningful way would be clinically useful and has the potential to have considerable laboratory Impact ( Kanchana et al, 2013 …”

High bacterial titers in urine are predictive of abnormal postvoid residual urine in patients with urinary tract infection

“…Urine culture is by far the most common microbiological analysis performed in daily practice worldwide, due to both the high incidence of urinary tract infection (UTI) or asymptomatic bacteriuria (AB) that deserve detection and treatment (e.g., during pregnancy or before an urological surgery) and to the high feasibility and acceptability of the method (Foxman, 2002;Manickam et al, 2013). Because of a common contamination of the sample by periurethral bacteria (even for midstream urines), colony count thresholds have been established to help interpret positive culture (Hooton et al, 2013).…”