dr.Iva Puspitasari,Sp.MK
23
dr.Iva Puspitasari,Sp.MK
description
dr.Iva Puspitasari,Sp.MK. Spesimen unt Pemeriksaan Mikrobiologi tatacara pengambilan, penampungan, penyimpanan, pemberian label dan cara pengiriman spesimen. Tujuan: tidak dicemari oleh bakteri lain, bakteri di dalam spesimen tidak mati. - PowerPoint PPT Presentation
Transcript of dr.Iva Puspitasari,Sp.MK
drIva PuspitasariSpMK
Spesimen unt Pemeriksaan Mikrobiologi 1048774 tatacara1048774pengambilan1048774penampungan1048774penyimpanan1048774pemberian label dan1048774cara pengiriman spesimen Tujuan1048774tidak dicemari oleh bakteri lain1048774bakteri di dalam spesimen tidak mati
Memuat Identitas penderita yang meliputi1048774 Nama1048774 Umur1048774 Jenis Kelamin1048774 Jenis permintaan pemeriksaanbiakan apa1048774 Jam dan Tanggal pengambilan spesimen Jika sampel gt 1 per Px
beri tanda lsquo1 dari 3rsquolsquo2 dari 3rsquo3 dari 3rsquo
INFORMASI UMUM Urin normal adalah steril Pencemaran uretra atau periuretra Urin kumpulan 24 jam Tidak bolehJENIS SPESIMEN URIN Urin kateter Urin porsi tengah ( (lsquoClean Catch Urinersquo) Urin Aspirasi Suprapubik
PEMILIHAN Kateter resiko memasukkan bakteri Jangan pakai Bed side Catheter bag PENGAMBILAN SPESIMEN II1 Bahan yang dibutuhkan Semprit isi 10 ml dan Jarum suntik nomor 21 Kapas alkohol
helliphellipUrine kateter
II2 Cara Pengambilan Sampel Jepit kateter (lt30 menit) Bersihkan dgn Alkohol pd tempat ambil urin Tusukkan jarum ambil urin tampung tutup
rapat CARA PEMBERIAN LABEL Pedoman Umum Cara Pemberian Label Cantumkan cara pengambilan urin misalnya Kateter
III PENGIRIMAN Segera priksa dalam 30 menit atau taruh dalam almari es dan paling lama 24 jam
URIN PORSI TENGAH(lsquoCLEAN CATCH URINErsquo)
I PEMILIHAN Dianjurkan urin pagi hari Buang 13 aliran urin pertama
PENGAMBILANII1 Bahan yang dibutuhkan
BotolTabung steril bertutup ulir Sabun medis Kasa Akuadesair suling
CARA PENGAMBILAN SPESIMENPenderita diberitahu (Lisantertulis) Instruksi pada Wanita1048774Duduk di toilet1048774Buka kakilutut ke samping selebar mungkin1048774Dgn sabun medis amp sponkainkapas cuci genital dgn gerak dari depan ke belakang1048774Bilas dengan spon basah depan ke belakang1048774Ulangi beberapa kali dgn spon basah baru1048774Pegang dengan jari dan taruh cawanbotol mulut
lebar di depan genital dan jangan menyentuhtepi botol
1048774Buang urin pertama keluar dan1048774Berikutnya ditampung1048774Tutup segera botol
Instruksi pada Laki Tarik kulit preputium (lsquoForeskinrsquo untuk yang
tidak khitan) dan bersihkan Glans penis Ikuti cara pencucian seperti pada wanita
Periksa bahwa tutup rapat dan tidak pecah dan
Jika tak segera diperiksa almari es
CARA PEMBERIAN LABEL Baca pedoman Umum Cara Pemberian Label Catat apakah penderita telah mendapat
antibiotk CATATAN pd anak pakai Pediatric bag
PEMILIHAN Cara ini terbebas dari1048774pencemar uretra dan1048774perineum Diutamakan untuk1048774anak atau1048774pemeriksaan anaerobik PENGAMBILAN SPESIMEN1048774Bahan yang Dibutuhkan1048774Desinfektan kulit1048774Anastesi lokal1048774Semprit isi 10 ml dan jarum nomor 221048774Botol steril bertutup ulir
CARA PENGAMBILAN SPESIMEN Desinfeksi kulit Antar Pusar (Umbilicus) sd penis Anastesi pada tempat tusukan
( Mid-line 2 CM di atas simpisis) Masukkan jarum ke k kemih yang sedang penuh Hisap tampung dalam botol dan tutup rapat
CARA PEMBERIAN LABEL Baca Pedoman Umum Cara Pemberian Label Beri catatan1048774Urin suprapubik1048774Apakah perlu pemeriksaan anaerobik1048774Catat waktu pengambilan (Jam tanggal)
PENGIRIMAN Segera periksa dalam 30 menit atau taruh dalam almari es dan paling lama 24
jam
CATATAN Pemeriksaan anaerobik hanya atas
permintaan Anak tempat tusukan 1-2 CM di atas simpisis
pubis Jml 5 ml
BILA JUMLAH KOLONI ML URIN
lt10000 DIANGGAP KONTAMINASI
10000-100000 SANGSI PERLU DIULANG 100000 SIGNIFICANT BACTERIURIA
(JELAS UTI)
Kriteria klasifikasi UTI berdasarkan sindroma klinik
Category Clinical laboratory
Acute Uncomplicated UTI in women
bullDysuria urgencyfrequencysuprapubic painbullNo urinary symptom in last 4 wk before current episodebullNo fever or flank pain
ge10 WBCmm3
ge 103 CFUml uropathogens in CCMS urine
Acute uncomplicated pyelonephritis
bullFever chillsbullFlank pain on examinationbullOther diagnosis exludedbullNo history or clinical evidence of uropathologic abnormalities
ge10 WBCmm3
ge 104 CFUml uropathogens in CCMS urine
Complicated UTI and UTI in men
bullAny combination of symptom listed abovebullOne or more factors assosiated with complicated UTI
ge10 WBCmm3
ge 105 CFUml uropathogens in CCMS urine
Asymptomatic UTI bullNo urinary symptoms plusmngt10 WBCmm3
ge 105 CFUml in two CCMS cultures gt24 hrs apart
Factors assosiated with complicated UTI include any UTIin male indwelling or intermitten urinary catheter gt100ml of postvoided residual urine obstructionuropathy urologic abnormalities azotemia amp renal transplantationCCMS Clean Catch Midstream urine
Pedoman umum interpretasi kultur urin
Result Spsific specimen typeassociated clinical condition if known
ge104 CFUml of single potential pathogen or for each of two potential pathogens
CCMS urinepyellonephritis acute cystitis asymptomatic bacteriuria or catheterized urines
complete
ge103 CFUml of single potential pathogen
CCMS urineasymptomatic males or catheterized urines or acute urethral syndrome
Complete
ge three organisme types with no predominating organism
CCMS urine or catheterized urines
None because of possible contamination ask for another specimen
Either two or three organism types with predominant growth of one organism type and lt104 CFUml of the other organism type(s)
CCMS urine Complete workup for predominating oganism(s) description for the other organism(S)
ge102 CFUml of any number of organism types (set up with a 0001-and 001-ml calibrated loop)
Suprapubic aspirates any other surgically obtained urines (including ileal conduits cystoscopy specimens)
Complete
CFU colony forming unit Predominant growth= 104 to ge105 CFUml A complete workup includes indentification of organism and appropriate susceptibility testing
Spesimen unt Pemeriksaan Mikrobiologi 1048774 tatacara1048774pengambilan1048774penampungan1048774penyimpanan1048774pemberian label dan1048774cara pengiriman spesimen Tujuan1048774tidak dicemari oleh bakteri lain1048774bakteri di dalam spesimen tidak mati
Memuat Identitas penderita yang meliputi1048774 Nama1048774 Umur1048774 Jenis Kelamin1048774 Jenis permintaan pemeriksaanbiakan apa1048774 Jam dan Tanggal pengambilan spesimen Jika sampel gt 1 per Px
beri tanda lsquo1 dari 3rsquolsquo2 dari 3rsquo3 dari 3rsquo
INFORMASI UMUM Urin normal adalah steril Pencemaran uretra atau periuretra Urin kumpulan 24 jam Tidak bolehJENIS SPESIMEN URIN Urin kateter Urin porsi tengah ( (lsquoClean Catch Urinersquo) Urin Aspirasi Suprapubik
PEMILIHAN Kateter resiko memasukkan bakteri Jangan pakai Bed side Catheter bag PENGAMBILAN SPESIMEN II1 Bahan yang dibutuhkan Semprit isi 10 ml dan Jarum suntik nomor 21 Kapas alkohol
helliphellipUrine kateter
II2 Cara Pengambilan Sampel Jepit kateter (lt30 menit) Bersihkan dgn Alkohol pd tempat ambil urin Tusukkan jarum ambil urin tampung tutup
rapat CARA PEMBERIAN LABEL Pedoman Umum Cara Pemberian Label Cantumkan cara pengambilan urin misalnya Kateter
III PENGIRIMAN Segera priksa dalam 30 menit atau taruh dalam almari es dan paling lama 24 jam
URIN PORSI TENGAH(lsquoCLEAN CATCH URINErsquo)
I PEMILIHAN Dianjurkan urin pagi hari Buang 13 aliran urin pertama
PENGAMBILANII1 Bahan yang dibutuhkan
BotolTabung steril bertutup ulir Sabun medis Kasa Akuadesair suling
CARA PENGAMBILAN SPESIMENPenderita diberitahu (Lisantertulis) Instruksi pada Wanita1048774Duduk di toilet1048774Buka kakilutut ke samping selebar mungkin1048774Dgn sabun medis amp sponkainkapas cuci genital dgn gerak dari depan ke belakang1048774Bilas dengan spon basah depan ke belakang1048774Ulangi beberapa kali dgn spon basah baru1048774Pegang dengan jari dan taruh cawanbotol mulut
lebar di depan genital dan jangan menyentuhtepi botol
1048774Buang urin pertama keluar dan1048774Berikutnya ditampung1048774Tutup segera botol
Instruksi pada Laki Tarik kulit preputium (lsquoForeskinrsquo untuk yang
tidak khitan) dan bersihkan Glans penis Ikuti cara pencucian seperti pada wanita
Periksa bahwa tutup rapat dan tidak pecah dan
Jika tak segera diperiksa almari es
CARA PEMBERIAN LABEL Baca pedoman Umum Cara Pemberian Label Catat apakah penderita telah mendapat
antibiotk CATATAN pd anak pakai Pediatric bag
PEMILIHAN Cara ini terbebas dari1048774pencemar uretra dan1048774perineum Diutamakan untuk1048774anak atau1048774pemeriksaan anaerobik PENGAMBILAN SPESIMEN1048774Bahan yang Dibutuhkan1048774Desinfektan kulit1048774Anastesi lokal1048774Semprit isi 10 ml dan jarum nomor 221048774Botol steril bertutup ulir
CARA PENGAMBILAN SPESIMEN Desinfeksi kulit Antar Pusar (Umbilicus) sd penis Anastesi pada tempat tusukan
( Mid-line 2 CM di atas simpisis) Masukkan jarum ke k kemih yang sedang penuh Hisap tampung dalam botol dan tutup rapat
CARA PEMBERIAN LABEL Baca Pedoman Umum Cara Pemberian Label Beri catatan1048774Urin suprapubik1048774Apakah perlu pemeriksaan anaerobik1048774Catat waktu pengambilan (Jam tanggal)
PENGIRIMAN Segera periksa dalam 30 menit atau taruh dalam almari es dan paling lama 24
jam
CATATAN Pemeriksaan anaerobik hanya atas
permintaan Anak tempat tusukan 1-2 CM di atas simpisis
pubis Jml 5 ml
BILA JUMLAH KOLONI ML URIN
lt10000 DIANGGAP KONTAMINASI
10000-100000 SANGSI PERLU DIULANG 100000 SIGNIFICANT BACTERIURIA
(JELAS UTI)
Kriteria klasifikasi UTI berdasarkan sindroma klinik
Category Clinical laboratory
Acute Uncomplicated UTI in women
bullDysuria urgencyfrequencysuprapubic painbullNo urinary symptom in last 4 wk before current episodebullNo fever or flank pain
ge10 WBCmm3
ge 103 CFUml uropathogens in CCMS urine
Acute uncomplicated pyelonephritis
bullFever chillsbullFlank pain on examinationbullOther diagnosis exludedbullNo history or clinical evidence of uropathologic abnormalities
ge10 WBCmm3
ge 104 CFUml uropathogens in CCMS urine
Complicated UTI and UTI in men
bullAny combination of symptom listed abovebullOne or more factors assosiated with complicated UTI
ge10 WBCmm3
ge 105 CFUml uropathogens in CCMS urine
Asymptomatic UTI bullNo urinary symptoms plusmngt10 WBCmm3
ge 105 CFUml in two CCMS cultures gt24 hrs apart
Factors assosiated with complicated UTI include any UTIin male indwelling or intermitten urinary catheter gt100ml of postvoided residual urine obstructionuropathy urologic abnormalities azotemia amp renal transplantationCCMS Clean Catch Midstream urine
Pedoman umum interpretasi kultur urin
Result Spsific specimen typeassociated clinical condition if known
ge104 CFUml of single potential pathogen or for each of two potential pathogens
CCMS urinepyellonephritis acute cystitis asymptomatic bacteriuria or catheterized urines
complete
ge103 CFUml of single potential pathogen
CCMS urineasymptomatic males or catheterized urines or acute urethral syndrome
Complete
ge three organisme types with no predominating organism
CCMS urine or catheterized urines
None because of possible contamination ask for another specimen
Either two or three organism types with predominant growth of one organism type and lt104 CFUml of the other organism type(s)
CCMS urine Complete workup for predominating oganism(s) description for the other organism(S)
ge102 CFUml of any number of organism types (set up with a 0001-and 001-ml calibrated loop)
Suprapubic aspirates any other surgically obtained urines (including ileal conduits cystoscopy specimens)
Complete
CFU colony forming unit Predominant growth= 104 to ge105 CFUml A complete workup includes indentification of organism and appropriate susceptibility testing
Memuat Identitas penderita yang meliputi1048774 Nama1048774 Umur1048774 Jenis Kelamin1048774 Jenis permintaan pemeriksaanbiakan apa1048774 Jam dan Tanggal pengambilan spesimen Jika sampel gt 1 per Px
beri tanda lsquo1 dari 3rsquolsquo2 dari 3rsquo3 dari 3rsquo
INFORMASI UMUM Urin normal adalah steril Pencemaran uretra atau periuretra Urin kumpulan 24 jam Tidak bolehJENIS SPESIMEN URIN Urin kateter Urin porsi tengah ( (lsquoClean Catch Urinersquo) Urin Aspirasi Suprapubik
PEMILIHAN Kateter resiko memasukkan bakteri Jangan pakai Bed side Catheter bag PENGAMBILAN SPESIMEN II1 Bahan yang dibutuhkan Semprit isi 10 ml dan Jarum suntik nomor 21 Kapas alkohol
helliphellipUrine kateter
II2 Cara Pengambilan Sampel Jepit kateter (lt30 menit) Bersihkan dgn Alkohol pd tempat ambil urin Tusukkan jarum ambil urin tampung tutup
rapat CARA PEMBERIAN LABEL Pedoman Umum Cara Pemberian Label Cantumkan cara pengambilan urin misalnya Kateter
III PENGIRIMAN Segera priksa dalam 30 menit atau taruh dalam almari es dan paling lama 24 jam
URIN PORSI TENGAH(lsquoCLEAN CATCH URINErsquo)
I PEMILIHAN Dianjurkan urin pagi hari Buang 13 aliran urin pertama
PENGAMBILANII1 Bahan yang dibutuhkan
BotolTabung steril bertutup ulir Sabun medis Kasa Akuadesair suling
CARA PENGAMBILAN SPESIMENPenderita diberitahu (Lisantertulis) Instruksi pada Wanita1048774Duduk di toilet1048774Buka kakilutut ke samping selebar mungkin1048774Dgn sabun medis amp sponkainkapas cuci genital dgn gerak dari depan ke belakang1048774Bilas dengan spon basah depan ke belakang1048774Ulangi beberapa kali dgn spon basah baru1048774Pegang dengan jari dan taruh cawanbotol mulut
lebar di depan genital dan jangan menyentuhtepi botol
1048774Buang urin pertama keluar dan1048774Berikutnya ditampung1048774Tutup segera botol
Instruksi pada Laki Tarik kulit preputium (lsquoForeskinrsquo untuk yang
tidak khitan) dan bersihkan Glans penis Ikuti cara pencucian seperti pada wanita
Periksa bahwa tutup rapat dan tidak pecah dan
Jika tak segera diperiksa almari es
CARA PEMBERIAN LABEL Baca pedoman Umum Cara Pemberian Label Catat apakah penderita telah mendapat
antibiotk CATATAN pd anak pakai Pediatric bag
PEMILIHAN Cara ini terbebas dari1048774pencemar uretra dan1048774perineum Diutamakan untuk1048774anak atau1048774pemeriksaan anaerobik PENGAMBILAN SPESIMEN1048774Bahan yang Dibutuhkan1048774Desinfektan kulit1048774Anastesi lokal1048774Semprit isi 10 ml dan jarum nomor 221048774Botol steril bertutup ulir
CARA PENGAMBILAN SPESIMEN Desinfeksi kulit Antar Pusar (Umbilicus) sd penis Anastesi pada tempat tusukan
( Mid-line 2 CM di atas simpisis) Masukkan jarum ke k kemih yang sedang penuh Hisap tampung dalam botol dan tutup rapat
CARA PEMBERIAN LABEL Baca Pedoman Umum Cara Pemberian Label Beri catatan1048774Urin suprapubik1048774Apakah perlu pemeriksaan anaerobik1048774Catat waktu pengambilan (Jam tanggal)
PENGIRIMAN Segera periksa dalam 30 menit atau taruh dalam almari es dan paling lama 24
jam
CATATAN Pemeriksaan anaerobik hanya atas
permintaan Anak tempat tusukan 1-2 CM di atas simpisis
pubis Jml 5 ml
BILA JUMLAH KOLONI ML URIN
lt10000 DIANGGAP KONTAMINASI
10000-100000 SANGSI PERLU DIULANG 100000 SIGNIFICANT BACTERIURIA
(JELAS UTI)
Kriteria klasifikasi UTI berdasarkan sindroma klinik
Category Clinical laboratory
Acute Uncomplicated UTI in women
bullDysuria urgencyfrequencysuprapubic painbullNo urinary symptom in last 4 wk before current episodebullNo fever or flank pain
ge10 WBCmm3
ge 103 CFUml uropathogens in CCMS urine
Acute uncomplicated pyelonephritis
bullFever chillsbullFlank pain on examinationbullOther diagnosis exludedbullNo history or clinical evidence of uropathologic abnormalities
ge10 WBCmm3
ge 104 CFUml uropathogens in CCMS urine
Complicated UTI and UTI in men
bullAny combination of symptom listed abovebullOne or more factors assosiated with complicated UTI
ge10 WBCmm3
ge 105 CFUml uropathogens in CCMS urine
Asymptomatic UTI bullNo urinary symptoms plusmngt10 WBCmm3
ge 105 CFUml in two CCMS cultures gt24 hrs apart
Factors assosiated with complicated UTI include any UTIin male indwelling or intermitten urinary catheter gt100ml of postvoided residual urine obstructionuropathy urologic abnormalities azotemia amp renal transplantationCCMS Clean Catch Midstream urine
Pedoman umum interpretasi kultur urin
Result Spsific specimen typeassociated clinical condition if known
ge104 CFUml of single potential pathogen or for each of two potential pathogens
CCMS urinepyellonephritis acute cystitis asymptomatic bacteriuria or catheterized urines
complete
ge103 CFUml of single potential pathogen
CCMS urineasymptomatic males or catheterized urines or acute urethral syndrome
Complete
ge three organisme types with no predominating organism
CCMS urine or catheterized urines
None because of possible contamination ask for another specimen
Either two or three organism types with predominant growth of one organism type and lt104 CFUml of the other organism type(s)
CCMS urine Complete workup for predominating oganism(s) description for the other organism(S)
ge102 CFUml of any number of organism types (set up with a 0001-and 001-ml calibrated loop)
Suprapubic aspirates any other surgically obtained urines (including ileal conduits cystoscopy specimens)
Complete
CFU colony forming unit Predominant growth= 104 to ge105 CFUml A complete workup includes indentification of organism and appropriate susceptibility testing
INFORMASI UMUM Urin normal adalah steril Pencemaran uretra atau periuretra Urin kumpulan 24 jam Tidak bolehJENIS SPESIMEN URIN Urin kateter Urin porsi tengah ( (lsquoClean Catch Urinersquo) Urin Aspirasi Suprapubik
PEMILIHAN Kateter resiko memasukkan bakteri Jangan pakai Bed side Catheter bag PENGAMBILAN SPESIMEN II1 Bahan yang dibutuhkan Semprit isi 10 ml dan Jarum suntik nomor 21 Kapas alkohol
helliphellipUrine kateter
II2 Cara Pengambilan Sampel Jepit kateter (lt30 menit) Bersihkan dgn Alkohol pd tempat ambil urin Tusukkan jarum ambil urin tampung tutup
rapat CARA PEMBERIAN LABEL Pedoman Umum Cara Pemberian Label Cantumkan cara pengambilan urin misalnya Kateter
III PENGIRIMAN Segera priksa dalam 30 menit atau taruh dalam almari es dan paling lama 24 jam
URIN PORSI TENGAH(lsquoCLEAN CATCH URINErsquo)
I PEMILIHAN Dianjurkan urin pagi hari Buang 13 aliran urin pertama
PENGAMBILANII1 Bahan yang dibutuhkan
BotolTabung steril bertutup ulir Sabun medis Kasa Akuadesair suling
CARA PENGAMBILAN SPESIMENPenderita diberitahu (Lisantertulis) Instruksi pada Wanita1048774Duduk di toilet1048774Buka kakilutut ke samping selebar mungkin1048774Dgn sabun medis amp sponkainkapas cuci genital dgn gerak dari depan ke belakang1048774Bilas dengan spon basah depan ke belakang1048774Ulangi beberapa kali dgn spon basah baru1048774Pegang dengan jari dan taruh cawanbotol mulut
lebar di depan genital dan jangan menyentuhtepi botol
1048774Buang urin pertama keluar dan1048774Berikutnya ditampung1048774Tutup segera botol
Instruksi pada Laki Tarik kulit preputium (lsquoForeskinrsquo untuk yang
tidak khitan) dan bersihkan Glans penis Ikuti cara pencucian seperti pada wanita
Periksa bahwa tutup rapat dan tidak pecah dan
Jika tak segera diperiksa almari es
CARA PEMBERIAN LABEL Baca pedoman Umum Cara Pemberian Label Catat apakah penderita telah mendapat
antibiotk CATATAN pd anak pakai Pediatric bag
PEMILIHAN Cara ini terbebas dari1048774pencemar uretra dan1048774perineum Diutamakan untuk1048774anak atau1048774pemeriksaan anaerobik PENGAMBILAN SPESIMEN1048774Bahan yang Dibutuhkan1048774Desinfektan kulit1048774Anastesi lokal1048774Semprit isi 10 ml dan jarum nomor 221048774Botol steril bertutup ulir
CARA PENGAMBILAN SPESIMEN Desinfeksi kulit Antar Pusar (Umbilicus) sd penis Anastesi pada tempat tusukan
( Mid-line 2 CM di atas simpisis) Masukkan jarum ke k kemih yang sedang penuh Hisap tampung dalam botol dan tutup rapat
CARA PEMBERIAN LABEL Baca Pedoman Umum Cara Pemberian Label Beri catatan1048774Urin suprapubik1048774Apakah perlu pemeriksaan anaerobik1048774Catat waktu pengambilan (Jam tanggal)
PENGIRIMAN Segera periksa dalam 30 menit atau taruh dalam almari es dan paling lama 24
jam
CATATAN Pemeriksaan anaerobik hanya atas
permintaan Anak tempat tusukan 1-2 CM di atas simpisis
pubis Jml 5 ml
BILA JUMLAH KOLONI ML URIN
lt10000 DIANGGAP KONTAMINASI
10000-100000 SANGSI PERLU DIULANG 100000 SIGNIFICANT BACTERIURIA
(JELAS UTI)
Kriteria klasifikasi UTI berdasarkan sindroma klinik
Category Clinical laboratory
Acute Uncomplicated UTI in women
bullDysuria urgencyfrequencysuprapubic painbullNo urinary symptom in last 4 wk before current episodebullNo fever or flank pain
ge10 WBCmm3
ge 103 CFUml uropathogens in CCMS urine
Acute uncomplicated pyelonephritis
bullFever chillsbullFlank pain on examinationbullOther diagnosis exludedbullNo history or clinical evidence of uropathologic abnormalities
ge10 WBCmm3
ge 104 CFUml uropathogens in CCMS urine
Complicated UTI and UTI in men
bullAny combination of symptom listed abovebullOne or more factors assosiated with complicated UTI
ge10 WBCmm3
ge 105 CFUml uropathogens in CCMS urine
Asymptomatic UTI bullNo urinary symptoms plusmngt10 WBCmm3
ge 105 CFUml in two CCMS cultures gt24 hrs apart
Factors assosiated with complicated UTI include any UTIin male indwelling or intermitten urinary catheter gt100ml of postvoided residual urine obstructionuropathy urologic abnormalities azotemia amp renal transplantationCCMS Clean Catch Midstream urine
Pedoman umum interpretasi kultur urin
Result Spsific specimen typeassociated clinical condition if known
ge104 CFUml of single potential pathogen or for each of two potential pathogens
CCMS urinepyellonephritis acute cystitis asymptomatic bacteriuria or catheterized urines
complete
ge103 CFUml of single potential pathogen
CCMS urineasymptomatic males or catheterized urines or acute urethral syndrome
Complete
ge three organisme types with no predominating organism
CCMS urine or catheterized urines
None because of possible contamination ask for another specimen
Either two or three organism types with predominant growth of one organism type and lt104 CFUml of the other organism type(s)
CCMS urine Complete workup for predominating oganism(s) description for the other organism(S)
ge102 CFUml of any number of organism types (set up with a 0001-and 001-ml calibrated loop)
Suprapubic aspirates any other surgically obtained urines (including ileal conduits cystoscopy specimens)
Complete
CFU colony forming unit Predominant growth= 104 to ge105 CFUml A complete workup includes indentification of organism and appropriate susceptibility testing
PEMILIHAN Kateter resiko memasukkan bakteri Jangan pakai Bed side Catheter bag PENGAMBILAN SPESIMEN II1 Bahan yang dibutuhkan Semprit isi 10 ml dan Jarum suntik nomor 21 Kapas alkohol
helliphellipUrine kateter
II2 Cara Pengambilan Sampel Jepit kateter (lt30 menit) Bersihkan dgn Alkohol pd tempat ambil urin Tusukkan jarum ambil urin tampung tutup
rapat CARA PEMBERIAN LABEL Pedoman Umum Cara Pemberian Label Cantumkan cara pengambilan urin misalnya Kateter
III PENGIRIMAN Segera priksa dalam 30 menit atau taruh dalam almari es dan paling lama 24 jam
URIN PORSI TENGAH(lsquoCLEAN CATCH URINErsquo)
I PEMILIHAN Dianjurkan urin pagi hari Buang 13 aliran urin pertama
PENGAMBILANII1 Bahan yang dibutuhkan
BotolTabung steril bertutup ulir Sabun medis Kasa Akuadesair suling
CARA PENGAMBILAN SPESIMENPenderita diberitahu (Lisantertulis) Instruksi pada Wanita1048774Duduk di toilet1048774Buka kakilutut ke samping selebar mungkin1048774Dgn sabun medis amp sponkainkapas cuci genital dgn gerak dari depan ke belakang1048774Bilas dengan spon basah depan ke belakang1048774Ulangi beberapa kali dgn spon basah baru1048774Pegang dengan jari dan taruh cawanbotol mulut
lebar di depan genital dan jangan menyentuhtepi botol
1048774Buang urin pertama keluar dan1048774Berikutnya ditampung1048774Tutup segera botol
Instruksi pada Laki Tarik kulit preputium (lsquoForeskinrsquo untuk yang
tidak khitan) dan bersihkan Glans penis Ikuti cara pencucian seperti pada wanita
Periksa bahwa tutup rapat dan tidak pecah dan
Jika tak segera diperiksa almari es
CARA PEMBERIAN LABEL Baca pedoman Umum Cara Pemberian Label Catat apakah penderita telah mendapat
antibiotk CATATAN pd anak pakai Pediatric bag
PEMILIHAN Cara ini terbebas dari1048774pencemar uretra dan1048774perineum Diutamakan untuk1048774anak atau1048774pemeriksaan anaerobik PENGAMBILAN SPESIMEN1048774Bahan yang Dibutuhkan1048774Desinfektan kulit1048774Anastesi lokal1048774Semprit isi 10 ml dan jarum nomor 221048774Botol steril bertutup ulir
CARA PENGAMBILAN SPESIMEN Desinfeksi kulit Antar Pusar (Umbilicus) sd penis Anastesi pada tempat tusukan
( Mid-line 2 CM di atas simpisis) Masukkan jarum ke k kemih yang sedang penuh Hisap tampung dalam botol dan tutup rapat
CARA PEMBERIAN LABEL Baca Pedoman Umum Cara Pemberian Label Beri catatan1048774Urin suprapubik1048774Apakah perlu pemeriksaan anaerobik1048774Catat waktu pengambilan (Jam tanggal)
PENGIRIMAN Segera periksa dalam 30 menit atau taruh dalam almari es dan paling lama 24
jam
CATATAN Pemeriksaan anaerobik hanya atas
permintaan Anak tempat tusukan 1-2 CM di atas simpisis
pubis Jml 5 ml
BILA JUMLAH KOLONI ML URIN
lt10000 DIANGGAP KONTAMINASI
10000-100000 SANGSI PERLU DIULANG 100000 SIGNIFICANT BACTERIURIA
(JELAS UTI)
Kriteria klasifikasi UTI berdasarkan sindroma klinik
Category Clinical laboratory
Acute Uncomplicated UTI in women
bullDysuria urgencyfrequencysuprapubic painbullNo urinary symptom in last 4 wk before current episodebullNo fever or flank pain
ge10 WBCmm3
ge 103 CFUml uropathogens in CCMS urine
Acute uncomplicated pyelonephritis
bullFever chillsbullFlank pain on examinationbullOther diagnosis exludedbullNo history or clinical evidence of uropathologic abnormalities
ge10 WBCmm3
ge 104 CFUml uropathogens in CCMS urine
Complicated UTI and UTI in men
bullAny combination of symptom listed abovebullOne or more factors assosiated with complicated UTI
ge10 WBCmm3
ge 105 CFUml uropathogens in CCMS urine
Asymptomatic UTI bullNo urinary symptoms plusmngt10 WBCmm3
ge 105 CFUml in two CCMS cultures gt24 hrs apart
Factors assosiated with complicated UTI include any UTIin male indwelling or intermitten urinary catheter gt100ml of postvoided residual urine obstructionuropathy urologic abnormalities azotemia amp renal transplantationCCMS Clean Catch Midstream urine
Pedoman umum interpretasi kultur urin
Result Spsific specimen typeassociated clinical condition if known
ge104 CFUml of single potential pathogen or for each of two potential pathogens
CCMS urinepyellonephritis acute cystitis asymptomatic bacteriuria or catheterized urines
complete
ge103 CFUml of single potential pathogen
CCMS urineasymptomatic males or catheterized urines or acute urethral syndrome
Complete
ge three organisme types with no predominating organism
CCMS urine or catheterized urines
None because of possible contamination ask for another specimen
Either two or three organism types with predominant growth of one organism type and lt104 CFUml of the other organism type(s)
CCMS urine Complete workup for predominating oganism(s) description for the other organism(S)
ge102 CFUml of any number of organism types (set up with a 0001-and 001-ml calibrated loop)
Suprapubic aspirates any other surgically obtained urines (including ileal conduits cystoscopy specimens)
Complete
CFU colony forming unit Predominant growth= 104 to ge105 CFUml A complete workup includes indentification of organism and appropriate susceptibility testing
helliphellipUrine kateter
II2 Cara Pengambilan Sampel Jepit kateter (lt30 menit) Bersihkan dgn Alkohol pd tempat ambil urin Tusukkan jarum ambil urin tampung tutup
rapat CARA PEMBERIAN LABEL Pedoman Umum Cara Pemberian Label Cantumkan cara pengambilan urin misalnya Kateter
III PENGIRIMAN Segera priksa dalam 30 menit atau taruh dalam almari es dan paling lama 24 jam
URIN PORSI TENGAH(lsquoCLEAN CATCH URINErsquo)
I PEMILIHAN Dianjurkan urin pagi hari Buang 13 aliran urin pertama
PENGAMBILANII1 Bahan yang dibutuhkan
BotolTabung steril bertutup ulir Sabun medis Kasa Akuadesair suling
CARA PENGAMBILAN SPESIMENPenderita diberitahu (Lisantertulis) Instruksi pada Wanita1048774Duduk di toilet1048774Buka kakilutut ke samping selebar mungkin1048774Dgn sabun medis amp sponkainkapas cuci genital dgn gerak dari depan ke belakang1048774Bilas dengan spon basah depan ke belakang1048774Ulangi beberapa kali dgn spon basah baru1048774Pegang dengan jari dan taruh cawanbotol mulut
lebar di depan genital dan jangan menyentuhtepi botol
1048774Buang urin pertama keluar dan1048774Berikutnya ditampung1048774Tutup segera botol
Instruksi pada Laki Tarik kulit preputium (lsquoForeskinrsquo untuk yang
tidak khitan) dan bersihkan Glans penis Ikuti cara pencucian seperti pada wanita
Periksa bahwa tutup rapat dan tidak pecah dan
Jika tak segera diperiksa almari es
CARA PEMBERIAN LABEL Baca pedoman Umum Cara Pemberian Label Catat apakah penderita telah mendapat
antibiotk CATATAN pd anak pakai Pediatric bag
PEMILIHAN Cara ini terbebas dari1048774pencemar uretra dan1048774perineum Diutamakan untuk1048774anak atau1048774pemeriksaan anaerobik PENGAMBILAN SPESIMEN1048774Bahan yang Dibutuhkan1048774Desinfektan kulit1048774Anastesi lokal1048774Semprit isi 10 ml dan jarum nomor 221048774Botol steril bertutup ulir
CARA PENGAMBILAN SPESIMEN Desinfeksi kulit Antar Pusar (Umbilicus) sd penis Anastesi pada tempat tusukan
( Mid-line 2 CM di atas simpisis) Masukkan jarum ke k kemih yang sedang penuh Hisap tampung dalam botol dan tutup rapat
CARA PEMBERIAN LABEL Baca Pedoman Umum Cara Pemberian Label Beri catatan1048774Urin suprapubik1048774Apakah perlu pemeriksaan anaerobik1048774Catat waktu pengambilan (Jam tanggal)
PENGIRIMAN Segera periksa dalam 30 menit atau taruh dalam almari es dan paling lama 24
jam
CATATAN Pemeriksaan anaerobik hanya atas
permintaan Anak tempat tusukan 1-2 CM di atas simpisis
pubis Jml 5 ml
BILA JUMLAH KOLONI ML URIN
lt10000 DIANGGAP KONTAMINASI
10000-100000 SANGSI PERLU DIULANG 100000 SIGNIFICANT BACTERIURIA
(JELAS UTI)
Kriteria klasifikasi UTI berdasarkan sindroma klinik
Category Clinical laboratory
Acute Uncomplicated UTI in women
bullDysuria urgencyfrequencysuprapubic painbullNo urinary symptom in last 4 wk before current episodebullNo fever or flank pain
ge10 WBCmm3
ge 103 CFUml uropathogens in CCMS urine
Acute uncomplicated pyelonephritis
bullFever chillsbullFlank pain on examinationbullOther diagnosis exludedbullNo history or clinical evidence of uropathologic abnormalities
ge10 WBCmm3
ge 104 CFUml uropathogens in CCMS urine
Complicated UTI and UTI in men
bullAny combination of symptom listed abovebullOne or more factors assosiated with complicated UTI
ge10 WBCmm3
ge 105 CFUml uropathogens in CCMS urine
Asymptomatic UTI bullNo urinary symptoms plusmngt10 WBCmm3
ge 105 CFUml in two CCMS cultures gt24 hrs apart
Factors assosiated with complicated UTI include any UTIin male indwelling or intermitten urinary catheter gt100ml of postvoided residual urine obstructionuropathy urologic abnormalities azotemia amp renal transplantationCCMS Clean Catch Midstream urine
Pedoman umum interpretasi kultur urin
Result Spsific specimen typeassociated clinical condition if known
ge104 CFUml of single potential pathogen or for each of two potential pathogens
CCMS urinepyellonephritis acute cystitis asymptomatic bacteriuria or catheterized urines
complete
ge103 CFUml of single potential pathogen
CCMS urineasymptomatic males or catheterized urines or acute urethral syndrome
Complete
ge three organisme types with no predominating organism
CCMS urine or catheterized urines
None because of possible contamination ask for another specimen
Either two or three organism types with predominant growth of one organism type and lt104 CFUml of the other organism type(s)
CCMS urine Complete workup for predominating oganism(s) description for the other organism(S)
ge102 CFUml of any number of organism types (set up with a 0001-and 001-ml calibrated loop)
Suprapubic aspirates any other surgically obtained urines (including ileal conduits cystoscopy specimens)
Complete
CFU colony forming unit Predominant growth= 104 to ge105 CFUml A complete workup includes indentification of organism and appropriate susceptibility testing
URIN PORSI TENGAH(lsquoCLEAN CATCH URINErsquo)
I PEMILIHAN Dianjurkan urin pagi hari Buang 13 aliran urin pertama
PENGAMBILANII1 Bahan yang dibutuhkan
BotolTabung steril bertutup ulir Sabun medis Kasa Akuadesair suling
CARA PENGAMBILAN SPESIMENPenderita diberitahu (Lisantertulis) Instruksi pada Wanita1048774Duduk di toilet1048774Buka kakilutut ke samping selebar mungkin1048774Dgn sabun medis amp sponkainkapas cuci genital dgn gerak dari depan ke belakang1048774Bilas dengan spon basah depan ke belakang1048774Ulangi beberapa kali dgn spon basah baru1048774Pegang dengan jari dan taruh cawanbotol mulut
lebar di depan genital dan jangan menyentuhtepi botol
1048774Buang urin pertama keluar dan1048774Berikutnya ditampung1048774Tutup segera botol
Instruksi pada Laki Tarik kulit preputium (lsquoForeskinrsquo untuk yang
tidak khitan) dan bersihkan Glans penis Ikuti cara pencucian seperti pada wanita
Periksa bahwa tutup rapat dan tidak pecah dan
Jika tak segera diperiksa almari es
CARA PEMBERIAN LABEL Baca pedoman Umum Cara Pemberian Label Catat apakah penderita telah mendapat
antibiotk CATATAN pd anak pakai Pediatric bag
PEMILIHAN Cara ini terbebas dari1048774pencemar uretra dan1048774perineum Diutamakan untuk1048774anak atau1048774pemeriksaan anaerobik PENGAMBILAN SPESIMEN1048774Bahan yang Dibutuhkan1048774Desinfektan kulit1048774Anastesi lokal1048774Semprit isi 10 ml dan jarum nomor 221048774Botol steril bertutup ulir
CARA PENGAMBILAN SPESIMEN Desinfeksi kulit Antar Pusar (Umbilicus) sd penis Anastesi pada tempat tusukan
( Mid-line 2 CM di atas simpisis) Masukkan jarum ke k kemih yang sedang penuh Hisap tampung dalam botol dan tutup rapat
CARA PEMBERIAN LABEL Baca Pedoman Umum Cara Pemberian Label Beri catatan1048774Urin suprapubik1048774Apakah perlu pemeriksaan anaerobik1048774Catat waktu pengambilan (Jam tanggal)
PENGIRIMAN Segera periksa dalam 30 menit atau taruh dalam almari es dan paling lama 24
jam
CATATAN Pemeriksaan anaerobik hanya atas
permintaan Anak tempat tusukan 1-2 CM di atas simpisis
pubis Jml 5 ml
BILA JUMLAH KOLONI ML URIN
lt10000 DIANGGAP KONTAMINASI
10000-100000 SANGSI PERLU DIULANG 100000 SIGNIFICANT BACTERIURIA
(JELAS UTI)
Kriteria klasifikasi UTI berdasarkan sindroma klinik
Category Clinical laboratory
Acute Uncomplicated UTI in women
bullDysuria urgencyfrequencysuprapubic painbullNo urinary symptom in last 4 wk before current episodebullNo fever or flank pain
ge10 WBCmm3
ge 103 CFUml uropathogens in CCMS urine
Acute uncomplicated pyelonephritis
bullFever chillsbullFlank pain on examinationbullOther diagnosis exludedbullNo history or clinical evidence of uropathologic abnormalities
ge10 WBCmm3
ge 104 CFUml uropathogens in CCMS urine
Complicated UTI and UTI in men
bullAny combination of symptom listed abovebullOne or more factors assosiated with complicated UTI
ge10 WBCmm3
ge 105 CFUml uropathogens in CCMS urine
Asymptomatic UTI bullNo urinary symptoms plusmngt10 WBCmm3
ge 105 CFUml in two CCMS cultures gt24 hrs apart
Factors assosiated with complicated UTI include any UTIin male indwelling or intermitten urinary catheter gt100ml of postvoided residual urine obstructionuropathy urologic abnormalities azotemia amp renal transplantationCCMS Clean Catch Midstream urine
Pedoman umum interpretasi kultur urin
Result Spsific specimen typeassociated clinical condition if known
ge104 CFUml of single potential pathogen or for each of two potential pathogens
CCMS urinepyellonephritis acute cystitis asymptomatic bacteriuria or catheterized urines
complete
ge103 CFUml of single potential pathogen
CCMS urineasymptomatic males or catheterized urines or acute urethral syndrome
Complete
ge three organisme types with no predominating organism
CCMS urine or catheterized urines
None because of possible contamination ask for another specimen
Either two or three organism types with predominant growth of one organism type and lt104 CFUml of the other organism type(s)
CCMS urine Complete workup for predominating oganism(s) description for the other organism(S)
ge102 CFUml of any number of organism types (set up with a 0001-and 001-ml calibrated loop)
Suprapubic aspirates any other surgically obtained urines (including ileal conduits cystoscopy specimens)
Complete
CFU colony forming unit Predominant growth= 104 to ge105 CFUml A complete workup includes indentification of organism and appropriate susceptibility testing
CARA PENGAMBILAN SPESIMENPenderita diberitahu (Lisantertulis) Instruksi pada Wanita1048774Duduk di toilet1048774Buka kakilutut ke samping selebar mungkin1048774Dgn sabun medis amp sponkainkapas cuci genital dgn gerak dari depan ke belakang1048774Bilas dengan spon basah depan ke belakang1048774Ulangi beberapa kali dgn spon basah baru1048774Pegang dengan jari dan taruh cawanbotol mulut
lebar di depan genital dan jangan menyentuhtepi botol
1048774Buang urin pertama keluar dan1048774Berikutnya ditampung1048774Tutup segera botol
Instruksi pada Laki Tarik kulit preputium (lsquoForeskinrsquo untuk yang
tidak khitan) dan bersihkan Glans penis Ikuti cara pencucian seperti pada wanita
Periksa bahwa tutup rapat dan tidak pecah dan
Jika tak segera diperiksa almari es
CARA PEMBERIAN LABEL Baca pedoman Umum Cara Pemberian Label Catat apakah penderita telah mendapat
antibiotk CATATAN pd anak pakai Pediatric bag
PEMILIHAN Cara ini terbebas dari1048774pencemar uretra dan1048774perineum Diutamakan untuk1048774anak atau1048774pemeriksaan anaerobik PENGAMBILAN SPESIMEN1048774Bahan yang Dibutuhkan1048774Desinfektan kulit1048774Anastesi lokal1048774Semprit isi 10 ml dan jarum nomor 221048774Botol steril bertutup ulir
CARA PENGAMBILAN SPESIMEN Desinfeksi kulit Antar Pusar (Umbilicus) sd penis Anastesi pada tempat tusukan
( Mid-line 2 CM di atas simpisis) Masukkan jarum ke k kemih yang sedang penuh Hisap tampung dalam botol dan tutup rapat
CARA PEMBERIAN LABEL Baca Pedoman Umum Cara Pemberian Label Beri catatan1048774Urin suprapubik1048774Apakah perlu pemeriksaan anaerobik1048774Catat waktu pengambilan (Jam tanggal)
PENGIRIMAN Segera periksa dalam 30 menit atau taruh dalam almari es dan paling lama 24
jam
CATATAN Pemeriksaan anaerobik hanya atas
permintaan Anak tempat tusukan 1-2 CM di atas simpisis
pubis Jml 5 ml
BILA JUMLAH KOLONI ML URIN
lt10000 DIANGGAP KONTAMINASI
10000-100000 SANGSI PERLU DIULANG 100000 SIGNIFICANT BACTERIURIA
(JELAS UTI)
Kriteria klasifikasi UTI berdasarkan sindroma klinik
Category Clinical laboratory
Acute Uncomplicated UTI in women
bullDysuria urgencyfrequencysuprapubic painbullNo urinary symptom in last 4 wk before current episodebullNo fever or flank pain
ge10 WBCmm3
ge 103 CFUml uropathogens in CCMS urine
Acute uncomplicated pyelonephritis
bullFever chillsbullFlank pain on examinationbullOther diagnosis exludedbullNo history or clinical evidence of uropathologic abnormalities
ge10 WBCmm3
ge 104 CFUml uropathogens in CCMS urine
Complicated UTI and UTI in men
bullAny combination of symptom listed abovebullOne or more factors assosiated with complicated UTI
ge10 WBCmm3
ge 105 CFUml uropathogens in CCMS urine
Asymptomatic UTI bullNo urinary symptoms plusmngt10 WBCmm3
ge 105 CFUml in two CCMS cultures gt24 hrs apart
Factors assosiated with complicated UTI include any UTIin male indwelling or intermitten urinary catheter gt100ml of postvoided residual urine obstructionuropathy urologic abnormalities azotemia amp renal transplantationCCMS Clean Catch Midstream urine
Pedoman umum interpretasi kultur urin
Result Spsific specimen typeassociated clinical condition if known
ge104 CFUml of single potential pathogen or for each of two potential pathogens
CCMS urinepyellonephritis acute cystitis asymptomatic bacteriuria or catheterized urines
complete
ge103 CFUml of single potential pathogen
CCMS urineasymptomatic males or catheterized urines or acute urethral syndrome
Complete
ge three organisme types with no predominating organism
CCMS urine or catheterized urines
None because of possible contamination ask for another specimen
Either two or three organism types with predominant growth of one organism type and lt104 CFUml of the other organism type(s)
CCMS urine Complete workup for predominating oganism(s) description for the other organism(S)
ge102 CFUml of any number of organism types (set up with a 0001-and 001-ml calibrated loop)
Suprapubic aspirates any other surgically obtained urines (including ileal conduits cystoscopy specimens)
Complete
CFU colony forming unit Predominant growth= 104 to ge105 CFUml A complete workup includes indentification of organism and appropriate susceptibility testing
Instruksi pada Laki Tarik kulit preputium (lsquoForeskinrsquo untuk yang
tidak khitan) dan bersihkan Glans penis Ikuti cara pencucian seperti pada wanita
Periksa bahwa tutup rapat dan tidak pecah dan
Jika tak segera diperiksa almari es
CARA PEMBERIAN LABEL Baca pedoman Umum Cara Pemberian Label Catat apakah penderita telah mendapat
antibiotk CATATAN pd anak pakai Pediatric bag
PEMILIHAN Cara ini terbebas dari1048774pencemar uretra dan1048774perineum Diutamakan untuk1048774anak atau1048774pemeriksaan anaerobik PENGAMBILAN SPESIMEN1048774Bahan yang Dibutuhkan1048774Desinfektan kulit1048774Anastesi lokal1048774Semprit isi 10 ml dan jarum nomor 221048774Botol steril bertutup ulir
CARA PENGAMBILAN SPESIMEN Desinfeksi kulit Antar Pusar (Umbilicus) sd penis Anastesi pada tempat tusukan
( Mid-line 2 CM di atas simpisis) Masukkan jarum ke k kemih yang sedang penuh Hisap tampung dalam botol dan tutup rapat
CARA PEMBERIAN LABEL Baca Pedoman Umum Cara Pemberian Label Beri catatan1048774Urin suprapubik1048774Apakah perlu pemeriksaan anaerobik1048774Catat waktu pengambilan (Jam tanggal)
PENGIRIMAN Segera periksa dalam 30 menit atau taruh dalam almari es dan paling lama 24
jam
CATATAN Pemeriksaan anaerobik hanya atas
permintaan Anak tempat tusukan 1-2 CM di atas simpisis
pubis Jml 5 ml
BILA JUMLAH KOLONI ML URIN
lt10000 DIANGGAP KONTAMINASI
10000-100000 SANGSI PERLU DIULANG 100000 SIGNIFICANT BACTERIURIA
(JELAS UTI)
Kriteria klasifikasi UTI berdasarkan sindroma klinik
Category Clinical laboratory
Acute Uncomplicated UTI in women
bullDysuria urgencyfrequencysuprapubic painbullNo urinary symptom in last 4 wk before current episodebullNo fever or flank pain
ge10 WBCmm3
ge 103 CFUml uropathogens in CCMS urine
Acute uncomplicated pyelonephritis
bullFever chillsbullFlank pain on examinationbullOther diagnosis exludedbullNo history or clinical evidence of uropathologic abnormalities
ge10 WBCmm3
ge 104 CFUml uropathogens in CCMS urine
Complicated UTI and UTI in men
bullAny combination of symptom listed abovebullOne or more factors assosiated with complicated UTI
ge10 WBCmm3
ge 105 CFUml uropathogens in CCMS urine
Asymptomatic UTI bullNo urinary symptoms plusmngt10 WBCmm3
ge 105 CFUml in two CCMS cultures gt24 hrs apart
Factors assosiated with complicated UTI include any UTIin male indwelling or intermitten urinary catheter gt100ml of postvoided residual urine obstructionuropathy urologic abnormalities azotemia amp renal transplantationCCMS Clean Catch Midstream urine
Pedoman umum interpretasi kultur urin
Result Spsific specimen typeassociated clinical condition if known
ge104 CFUml of single potential pathogen or for each of two potential pathogens
CCMS urinepyellonephritis acute cystitis asymptomatic bacteriuria or catheterized urines
complete
ge103 CFUml of single potential pathogen
CCMS urineasymptomatic males or catheterized urines or acute urethral syndrome
Complete
ge three organisme types with no predominating organism
CCMS urine or catheterized urines
None because of possible contamination ask for another specimen
Either two or three organism types with predominant growth of one organism type and lt104 CFUml of the other organism type(s)
CCMS urine Complete workup for predominating oganism(s) description for the other organism(S)
ge102 CFUml of any number of organism types (set up with a 0001-and 001-ml calibrated loop)
Suprapubic aspirates any other surgically obtained urines (including ileal conduits cystoscopy specimens)
Complete
CFU colony forming unit Predominant growth= 104 to ge105 CFUml A complete workup includes indentification of organism and appropriate susceptibility testing
PEMILIHAN Cara ini terbebas dari1048774pencemar uretra dan1048774perineum Diutamakan untuk1048774anak atau1048774pemeriksaan anaerobik PENGAMBILAN SPESIMEN1048774Bahan yang Dibutuhkan1048774Desinfektan kulit1048774Anastesi lokal1048774Semprit isi 10 ml dan jarum nomor 221048774Botol steril bertutup ulir
CARA PENGAMBILAN SPESIMEN Desinfeksi kulit Antar Pusar (Umbilicus) sd penis Anastesi pada tempat tusukan
( Mid-line 2 CM di atas simpisis) Masukkan jarum ke k kemih yang sedang penuh Hisap tampung dalam botol dan tutup rapat
CARA PEMBERIAN LABEL Baca Pedoman Umum Cara Pemberian Label Beri catatan1048774Urin suprapubik1048774Apakah perlu pemeriksaan anaerobik1048774Catat waktu pengambilan (Jam tanggal)
PENGIRIMAN Segera periksa dalam 30 menit atau taruh dalam almari es dan paling lama 24
jam
CATATAN Pemeriksaan anaerobik hanya atas
permintaan Anak tempat tusukan 1-2 CM di atas simpisis
pubis Jml 5 ml
BILA JUMLAH KOLONI ML URIN
lt10000 DIANGGAP KONTAMINASI
10000-100000 SANGSI PERLU DIULANG 100000 SIGNIFICANT BACTERIURIA
(JELAS UTI)
Kriteria klasifikasi UTI berdasarkan sindroma klinik
Category Clinical laboratory
Acute Uncomplicated UTI in women
bullDysuria urgencyfrequencysuprapubic painbullNo urinary symptom in last 4 wk before current episodebullNo fever or flank pain
ge10 WBCmm3
ge 103 CFUml uropathogens in CCMS urine
Acute uncomplicated pyelonephritis
bullFever chillsbullFlank pain on examinationbullOther diagnosis exludedbullNo history or clinical evidence of uropathologic abnormalities
ge10 WBCmm3
ge 104 CFUml uropathogens in CCMS urine
Complicated UTI and UTI in men
bullAny combination of symptom listed abovebullOne or more factors assosiated with complicated UTI
ge10 WBCmm3
ge 105 CFUml uropathogens in CCMS urine
Asymptomatic UTI bullNo urinary symptoms plusmngt10 WBCmm3
ge 105 CFUml in two CCMS cultures gt24 hrs apart
Factors assosiated with complicated UTI include any UTIin male indwelling or intermitten urinary catheter gt100ml of postvoided residual urine obstructionuropathy urologic abnormalities azotemia amp renal transplantationCCMS Clean Catch Midstream urine
Pedoman umum interpretasi kultur urin
Result Spsific specimen typeassociated clinical condition if known
ge104 CFUml of single potential pathogen or for each of two potential pathogens
CCMS urinepyellonephritis acute cystitis asymptomatic bacteriuria or catheterized urines
complete
ge103 CFUml of single potential pathogen
CCMS urineasymptomatic males or catheterized urines or acute urethral syndrome
Complete
ge three organisme types with no predominating organism
CCMS urine or catheterized urines
None because of possible contamination ask for another specimen
Either two or three organism types with predominant growth of one organism type and lt104 CFUml of the other organism type(s)
CCMS urine Complete workup for predominating oganism(s) description for the other organism(S)
ge102 CFUml of any number of organism types (set up with a 0001-and 001-ml calibrated loop)
Suprapubic aspirates any other surgically obtained urines (including ileal conduits cystoscopy specimens)
Complete
CFU colony forming unit Predominant growth= 104 to ge105 CFUml A complete workup includes indentification of organism and appropriate susceptibility testing
CARA PENGAMBILAN SPESIMEN Desinfeksi kulit Antar Pusar (Umbilicus) sd penis Anastesi pada tempat tusukan
( Mid-line 2 CM di atas simpisis) Masukkan jarum ke k kemih yang sedang penuh Hisap tampung dalam botol dan tutup rapat
CARA PEMBERIAN LABEL Baca Pedoman Umum Cara Pemberian Label Beri catatan1048774Urin suprapubik1048774Apakah perlu pemeriksaan anaerobik1048774Catat waktu pengambilan (Jam tanggal)
PENGIRIMAN Segera periksa dalam 30 menit atau taruh dalam almari es dan paling lama 24
jam
CATATAN Pemeriksaan anaerobik hanya atas
permintaan Anak tempat tusukan 1-2 CM di atas simpisis
pubis Jml 5 ml
BILA JUMLAH KOLONI ML URIN
lt10000 DIANGGAP KONTAMINASI
10000-100000 SANGSI PERLU DIULANG 100000 SIGNIFICANT BACTERIURIA
(JELAS UTI)
Kriteria klasifikasi UTI berdasarkan sindroma klinik
Category Clinical laboratory
Acute Uncomplicated UTI in women
bullDysuria urgencyfrequencysuprapubic painbullNo urinary symptom in last 4 wk before current episodebullNo fever or flank pain
ge10 WBCmm3
ge 103 CFUml uropathogens in CCMS urine
Acute uncomplicated pyelonephritis
bullFever chillsbullFlank pain on examinationbullOther diagnosis exludedbullNo history or clinical evidence of uropathologic abnormalities
ge10 WBCmm3
ge 104 CFUml uropathogens in CCMS urine
Complicated UTI and UTI in men
bullAny combination of symptom listed abovebullOne or more factors assosiated with complicated UTI
ge10 WBCmm3
ge 105 CFUml uropathogens in CCMS urine
Asymptomatic UTI bullNo urinary symptoms plusmngt10 WBCmm3
ge 105 CFUml in two CCMS cultures gt24 hrs apart
Factors assosiated with complicated UTI include any UTIin male indwelling or intermitten urinary catheter gt100ml of postvoided residual urine obstructionuropathy urologic abnormalities azotemia amp renal transplantationCCMS Clean Catch Midstream urine
Pedoman umum interpretasi kultur urin
Result Spsific specimen typeassociated clinical condition if known
ge104 CFUml of single potential pathogen or for each of two potential pathogens
CCMS urinepyellonephritis acute cystitis asymptomatic bacteriuria or catheterized urines
complete
ge103 CFUml of single potential pathogen
CCMS urineasymptomatic males or catheterized urines or acute urethral syndrome
Complete
ge three organisme types with no predominating organism
CCMS urine or catheterized urines
None because of possible contamination ask for another specimen
Either two or three organism types with predominant growth of one organism type and lt104 CFUml of the other organism type(s)
CCMS urine Complete workup for predominating oganism(s) description for the other organism(S)
ge102 CFUml of any number of organism types (set up with a 0001-and 001-ml calibrated loop)
Suprapubic aspirates any other surgically obtained urines (including ileal conduits cystoscopy specimens)
Complete
CFU colony forming unit Predominant growth= 104 to ge105 CFUml A complete workup includes indentification of organism and appropriate susceptibility testing
PENGIRIMAN Segera periksa dalam 30 menit atau taruh dalam almari es dan paling lama 24
jam
CATATAN Pemeriksaan anaerobik hanya atas
permintaan Anak tempat tusukan 1-2 CM di atas simpisis
pubis Jml 5 ml
BILA JUMLAH KOLONI ML URIN
lt10000 DIANGGAP KONTAMINASI
10000-100000 SANGSI PERLU DIULANG 100000 SIGNIFICANT BACTERIURIA
(JELAS UTI)
Kriteria klasifikasi UTI berdasarkan sindroma klinik
Category Clinical laboratory
Acute Uncomplicated UTI in women
bullDysuria urgencyfrequencysuprapubic painbullNo urinary symptom in last 4 wk before current episodebullNo fever or flank pain
ge10 WBCmm3
ge 103 CFUml uropathogens in CCMS urine
Acute uncomplicated pyelonephritis
bullFever chillsbullFlank pain on examinationbullOther diagnosis exludedbullNo history or clinical evidence of uropathologic abnormalities
ge10 WBCmm3
ge 104 CFUml uropathogens in CCMS urine
Complicated UTI and UTI in men
bullAny combination of symptom listed abovebullOne or more factors assosiated with complicated UTI
ge10 WBCmm3
ge 105 CFUml uropathogens in CCMS urine
Asymptomatic UTI bullNo urinary symptoms plusmngt10 WBCmm3
ge 105 CFUml in two CCMS cultures gt24 hrs apart
Factors assosiated with complicated UTI include any UTIin male indwelling or intermitten urinary catheter gt100ml of postvoided residual urine obstructionuropathy urologic abnormalities azotemia amp renal transplantationCCMS Clean Catch Midstream urine
Pedoman umum interpretasi kultur urin
Result Spsific specimen typeassociated clinical condition if known
ge104 CFUml of single potential pathogen or for each of two potential pathogens
CCMS urinepyellonephritis acute cystitis asymptomatic bacteriuria or catheterized urines
complete
ge103 CFUml of single potential pathogen
CCMS urineasymptomatic males or catheterized urines or acute urethral syndrome
Complete
ge three organisme types with no predominating organism
CCMS urine or catheterized urines
None because of possible contamination ask for another specimen
Either two or three organism types with predominant growth of one organism type and lt104 CFUml of the other organism type(s)
CCMS urine Complete workup for predominating oganism(s) description for the other organism(S)
ge102 CFUml of any number of organism types (set up with a 0001-and 001-ml calibrated loop)
Suprapubic aspirates any other surgically obtained urines (including ileal conduits cystoscopy specimens)
Complete
CFU colony forming unit Predominant growth= 104 to ge105 CFUml A complete workup includes indentification of organism and appropriate susceptibility testing
BILA JUMLAH KOLONI ML URIN
lt10000 DIANGGAP KONTAMINASI
10000-100000 SANGSI PERLU DIULANG 100000 SIGNIFICANT BACTERIURIA
(JELAS UTI)
Kriteria klasifikasi UTI berdasarkan sindroma klinik
Category Clinical laboratory
Acute Uncomplicated UTI in women
bullDysuria urgencyfrequencysuprapubic painbullNo urinary symptom in last 4 wk before current episodebullNo fever or flank pain
ge10 WBCmm3
ge 103 CFUml uropathogens in CCMS urine
Acute uncomplicated pyelonephritis
bullFever chillsbullFlank pain on examinationbullOther diagnosis exludedbullNo history or clinical evidence of uropathologic abnormalities
ge10 WBCmm3
ge 104 CFUml uropathogens in CCMS urine
Complicated UTI and UTI in men
bullAny combination of symptom listed abovebullOne or more factors assosiated with complicated UTI
ge10 WBCmm3
ge 105 CFUml uropathogens in CCMS urine
Asymptomatic UTI bullNo urinary symptoms plusmngt10 WBCmm3
ge 105 CFUml in two CCMS cultures gt24 hrs apart
Factors assosiated with complicated UTI include any UTIin male indwelling or intermitten urinary catheter gt100ml of postvoided residual urine obstructionuropathy urologic abnormalities azotemia amp renal transplantationCCMS Clean Catch Midstream urine
Pedoman umum interpretasi kultur urin
Result Spsific specimen typeassociated clinical condition if known
ge104 CFUml of single potential pathogen or for each of two potential pathogens
CCMS urinepyellonephritis acute cystitis asymptomatic bacteriuria or catheterized urines
complete
ge103 CFUml of single potential pathogen
CCMS urineasymptomatic males or catheterized urines or acute urethral syndrome
Complete
ge three organisme types with no predominating organism
CCMS urine or catheterized urines
None because of possible contamination ask for another specimen
Either two or three organism types with predominant growth of one organism type and lt104 CFUml of the other organism type(s)
CCMS urine Complete workup for predominating oganism(s) description for the other organism(S)
ge102 CFUml of any number of organism types (set up with a 0001-and 001-ml calibrated loop)
Suprapubic aspirates any other surgically obtained urines (including ileal conduits cystoscopy specimens)
Complete
CFU colony forming unit Predominant growth= 104 to ge105 CFUml A complete workup includes indentification of organism and appropriate susceptibility testing
Kriteria klasifikasi UTI berdasarkan sindroma klinik
Category Clinical laboratory
Acute Uncomplicated UTI in women
bullDysuria urgencyfrequencysuprapubic painbullNo urinary symptom in last 4 wk before current episodebullNo fever or flank pain
ge10 WBCmm3
ge 103 CFUml uropathogens in CCMS urine
Acute uncomplicated pyelonephritis
bullFever chillsbullFlank pain on examinationbullOther diagnosis exludedbullNo history or clinical evidence of uropathologic abnormalities
ge10 WBCmm3
ge 104 CFUml uropathogens in CCMS urine
Complicated UTI and UTI in men
bullAny combination of symptom listed abovebullOne or more factors assosiated with complicated UTI
ge10 WBCmm3
ge 105 CFUml uropathogens in CCMS urine
Asymptomatic UTI bullNo urinary symptoms plusmngt10 WBCmm3
ge 105 CFUml in two CCMS cultures gt24 hrs apart
Factors assosiated with complicated UTI include any UTIin male indwelling or intermitten urinary catheter gt100ml of postvoided residual urine obstructionuropathy urologic abnormalities azotemia amp renal transplantationCCMS Clean Catch Midstream urine
Pedoman umum interpretasi kultur urin
Result Spsific specimen typeassociated clinical condition if known
ge104 CFUml of single potential pathogen or for each of two potential pathogens
CCMS urinepyellonephritis acute cystitis asymptomatic bacteriuria or catheterized urines
complete
ge103 CFUml of single potential pathogen
CCMS urineasymptomatic males or catheterized urines or acute urethral syndrome
Complete
ge three organisme types with no predominating organism
CCMS urine or catheterized urines
None because of possible contamination ask for another specimen
Either two or three organism types with predominant growth of one organism type and lt104 CFUml of the other organism type(s)
CCMS urine Complete workup for predominating oganism(s) description for the other organism(S)
ge102 CFUml of any number of organism types (set up with a 0001-and 001-ml calibrated loop)
Suprapubic aspirates any other surgically obtained urines (including ileal conduits cystoscopy specimens)
Complete
CFU colony forming unit Predominant growth= 104 to ge105 CFUml A complete workup includes indentification of organism and appropriate susceptibility testing
Pedoman umum interpretasi kultur urin
Result Spsific specimen typeassociated clinical condition if known
ge104 CFUml of single potential pathogen or for each of two potential pathogens
CCMS urinepyellonephritis acute cystitis asymptomatic bacteriuria or catheterized urines
complete
ge103 CFUml of single potential pathogen
CCMS urineasymptomatic males or catheterized urines or acute urethral syndrome
Complete
ge three organisme types with no predominating organism
CCMS urine or catheterized urines
None because of possible contamination ask for another specimen
Either two or three organism types with predominant growth of one organism type and lt104 CFUml of the other organism type(s)
CCMS urine Complete workup for predominating oganism(s) description for the other organism(S)
ge102 CFUml of any number of organism types (set up with a 0001-and 001-ml calibrated loop)
Suprapubic aspirates any other surgically obtained urines (including ileal conduits cystoscopy specimens)
Complete
CFU colony forming unit Predominant growth= 104 to ge105 CFUml A complete workup includes indentification of organism and appropriate susceptibility testing
