ANALYSIS OF URINALYSIS

AND BODY FLUID (LAB) PRE-LIMS

COLLEGE OF MEDICAL LABORATORY SCIENCE 2022 L1: P1
SPECIMEN COLLECTION AND HANDLING
SPECIMEN COLLECTION
 50ml in capacity
 Always wear gloves when working with urine
 Disposable, wide- mouthed and flat bottom
containers with screw caps are recommended
 Adhesive bags for pediatrics and large plastic
containers for 24-hour specimen
 Test within 2 hours of Urine
collection
 Refrigerate if testing is delayed
KINDS OF URINE SPECIMEN COLLECTION

RANDOM SPECIMEN

AFB Grading:
ANALYSIS OF URINALYSIS
AND BODY FLUID (LAB) PRE-LIMS
COLLEGE OF MEDICAL LABORATORY SCIENCE 2022 L1: P1

Culture: Biochemical tests:

Requires increased protein 1. Niacin Test
A. Agar based Principle:
• Duboi’s Oleic Acid Albumin Medium • Niacin + Niacin Ribonucleotide + Aniline Dye
• Mitchison’s Medium + Cyanogen Bromide
• Middlebrook 7H10-7H11: Anti-susceptibility Result:
test • (+) yellow: MTb
B. Egg-based: Inhibitor: Malachite green • (-) no color change: M. bovis
• Petragnani medium: used or heavily 2. Catalase test at 68°C (heat stable)
contaminated specimen (increased conc. of • Medium: Tween 80 & Reagent: 30% H2O2
MG) Principle:
• Lowenstein-Jensen medium • Tween 80 + Mycobacteria + 30% H2O2+
• American Thoracic Society heat at 68°C (20 mins)
• Dorset Egg medium Result:
C. Liquid Media • (+) 45mm height of gas bubbles
• Bactec 12B, Septi-Check, Middlebrook 7H9 • (+) no bubbles M. kansasii (-) MTb
Colonies: 3. Nitrate Reduction Test
• Tan to buff colonies Principle:
• Dry, rough, warty & granular • HCL + Sulfanilamide + n-napthtylethylene
• Resembles: Cauliflower diamine
• Culture maintained for 8 weeks or 2 months Result:
Anti-tuberculosis Agents • (+) Pink/red color (M. kansasii, M. szulgai,
• Primary drugs: M. fortuitum & M. tuberculosis)
• Rifampicin, Isoniazid, Pyrazinamide, • (-) no color change (M. intracellulare)
Ethambutol, Streptomycin 4. Tween 80 HOH
• Secondary drugs: • (+) red: M. kansasii
• Ethionamide, Capreomycin, • (-) no red/ amber: M. avium
Ciprofloxacin, Ofloxacin, Kanamycin, 5. Tellurite reduction test
Cyclosrine, Rifambutin • Tellurite: black metallic tellurium
• (+) smooth fine black precipitate (M. avium)
• (-) gray clumps (M. kansasii)
6. Aryl sulfatase test
• For rapid growers
Principle:
ANALYSIS OF URINALYSIS
AND BODY FLUID (LAB) PRE-LIMS
COLLEGE OF MEDICAL LABORATORY SCIENCE 2022 L1: P1

7. TCH (Thiophene-2-Carboxylic Acid Hydrazide)

Susceptibility Test
• (S) M. bovis
• (R) MTb
8. Iron uptake
Principle:
• Convert ferric ammonium citrate to an iron
oxide
Result:
• (+) rusty brown colonies (rapid growers)
• (-) no color formation (M. chelonae)
9. Pyrazinamidase
Principle:
• Pyrazinamidase hydrolyzes pyrazinamide=
pyrazinoic acid & ammonia in 4 days
Result:
• (+) red pigment (MTb & M. marinum)
• (-) no color formation (M. bovis & M. kansasii)
10. Urease
Principle:
• Detection of urease activity
Result:
• (+) M. scrofulaceum
• (-) M. gordonae
11. Sodium Chloride Tolerance
Principle:
• High salt concentration (5% NaCl) in egg-
based media inhibits the growth of most
mycobacteria
Result:
• (+) growth (M. flavescens, M. triviale, and
most rapidly growing Mycobacterium spp.)
ANALYSIS OF URINALYSIS
AND BODY FLUID (LAB) PRE-LIMS
COLLEGE OF MEDICAL LABORATORY SCIENCE 2022 L1: P1

2. MOTT • Group IV: Rapid Growers

1. M. fortuitum
Characteristics:
2. M. chelonei
Rounyon’s Classification
3. M. phlei: provide CO2
• Group I: Photochromogens
4. M. smegmatis: confused with MTb in urine
• Light: pigmented
• Dark: non-pigmented 3. Mycobacterium leprae
1. M. kansasii: yellow bacillus (consisting of
Characteristics:
beta carotene); nitrate (+)
• Agent of Hansen’s disease or leprosy
2. M. marinum: swimming pool granuloma
• AFB
3. M. simiae
• Described as Cigarette packet/ picket-
4. M. asiaticum
fence
• Hydrolize 3,4-hydroxyl-phenylalanine
• Group II: Scotochromogens
(DOPA)
• Light/DARK: pigmented
• Tropism to peripheral nerves
1. M. scrofulaceum (scrofula): cervical lymph
Laboratory Diagnosis:
adenitis (neck region); niacin (+); Nitrate (-)
• Specimen: Earlobe or nasal scraping
2. M. szulgai:
• Culture: Armadillo pads
3. M. xenopi
• Stain: Fite Faraco stain
4. M. gordonae: tap water bacillus; Tween 80
• Treatment:
(+)
• Dapsone
5. M. flavescens
• Sulfone
6. M. thermoresistable
Skin test: Lepromin Test
• Fernandez or Early Reaction
• Group III: Nonphotochromogens
• 24-48 hrs
• Non – pigmented
• Mitsuda or Late Reaction
1. M. avium – intracellulare complex: AIDS
• 3-4 weeks
Battey bacillus
2. M. avium: Tb in birds & chicken
3. M. ulcerans: Innert bacillus; Buruli ulcers in
skin
4. M. xenopi: Hot, cold water taps at 42° C
5. M. triviale
6. M. heamophilum
ANALYSIS OF URINALYSIS
AND BODY FLUID (LAB) PRE-LIMS
COLLEGE OF MEDICAL LABORATORY SCIENCE 2022 L1: P1

SPIROCHETES • 3 stages:
• I: appearance of lesion; Erythema
Borrelia spp. chronicum migrans (bull’s eye
• Helically coiled bacteria transmitted through rashes)
arthropod vectors • II: dissemination through blood;
• Lice & ticks bones, CNS, heart & liver
• Flexible twisted organisms resembling • III: neurological abnormalities, arthritis
stretched spiral & skin lesion (chronic stage)

1. Borrelia recurrentis Borrelia spp.

• Agent of Louse-borne relapsing fever Laboratory diagnosis:

• Vector: Human louse (Pediculus humanus) Culture:
• High fever, muscle and bone pain and • Kelly’s medium
confusion • Barbour Stoenner-Kelly’s (BSK)
Serological tests
• ELISA
• Westernblot: gold standard
• DNA: WB
• RNA: NB

Treponema spp.
ANALYSIS OF URINALYSIS
AND BODY FLUID (LAB) PRE-LIMS
COLLEGE OF MEDICAL LABORATORY SCIENCE 2022 L1: P1

• Tightly twisted organism resembling cork

2. Borrelia hermsii / Borrelia parkeri
screw
• Tick-borne relapsing fever
• Vector: Ornithodoras ticks

3. Borrelia burgdorferi

• Agent of Lyme disease

• Vector: Ixoda ticks & Deer ticks

4. Treponema pallidum subsp. pallidum

• Agent of Venereal syphilis
• Great pox, Evil pox, French/Italian pox,
Spanish disease
• Transmitted by sexual contact, direct
transmission & transplacental route
• Stages:
• Primary syphilis: hard chancre
(painless & firm)
• Secondary syphilis: condylomata lata
(wart-like lesions)
• Latent syphilis: absence of clinical
symptoms (+ serologic tests)
• Tertiary syphilis: gummas,
neurosyphilis

Congenital syphilis
Hutchinsonian Triad
• notched teeth
ANALYSIS OF URINALYSIS
AND BODY FLUID (LAB) PRE-LIMS
COLLEGE OF MEDICAL LABORATORY SCIENCE 2022 L1: P1

Laboratory diagnosis: 5. Treponema pallidum subsp. pertenue

• Direct microscopic examination using Dark • Agent of Yaws (chronic nonvenereal disease
field microscope of skin and bones)
• Serological tests • Transmission: direct contact of traumatized
Treatment: skin with infected lesion
• Heavy metals
6. Treponema pallidum subsp. endecume
• Ex: Arsenic, Arsphenamine,
Salvarsan • Non-vereal syphilis & endemic syphilis
• Drug of choice • Agent of Bejel (lesion in oral cavity, oral
• Penicillin mucosa, skin, bones & nasopharynx)
• Jorisch-Herxheimer reaction • Transmission: mouth to mouth by utensils
• Large quantities of toxins are
7. Treponema pallidum subsp. endecume
released as the bacterium dies
during treatment • Agent of Pinta (ulcerative skin disease)
• Transmission: direct contact of traumatized
One of the potential side-effects of Penicillin
skin with infected lesion
treatment for syphilis. It frequently starts within one
hour and lasts for 24 hours, with symptoms of fever,
muscle pains, headache, and fast heart rate.

Leptospira spp. CHLAMYDIA, MYCOPLASMA, &

RICKETSSIA
• Tightly twisted with one or both ends bent
Chlamydia spp.
into a hook
• Formerly Bedsonia (“large virus”)
8. Leptospira biflexa • Obligate intracellular
• Non-pathogenic • Gram (-) like CW; binary fission
• Found in water & soil • Infectious particle Elementary bodies

9. Leptospira interorgans 10. Chlamydia psittaci

• Agent of leptospirosis (human and animals) • Agent of Psittacosis/ ornithosis (disease of

• Zoonosis birds, parrots, parakeets & cockatoos)
• Parasitic in vertebrates other than • Transmission: inhalation of contaminated
human aerosols or fomites
• Rodents, cattle, dogs, cats, raccoons
& bats
• Shed in urine of animals
• Transmission: direct contact with urine of
animals
• Infection may involve kidney, liver & central
 nervous system

ANALYSIS OF URINALYSIS
AND BODY FLUID (LAB) PRE-LIMS
COLLEGE OF MEDICAL LABORATORY SCIENCE 2022 L1: P1

11. Chlamydia pneumoniae

• Associated with mild respiratory tract

Leptospira interrogans serovar. infections
Principal leptospiral diseases: • TWAR (Taiwan Acute Respiratory) strain
• Icterohemorrhagiae Weil’s disease
• Canicola Infectious jaundice
• Autumnalis Fo’rt Bragg or Pretibial fever
• Grippotyphosa Marsch fever
• Hebdomadis 7-day fever
• Mitis/Pomona Swine-herd’s disease
Culture:
• Specimen: Blood (early infection); Urine
(2nd week)
• Media:
• Elllinghausen-McCullough-Johnson-
Harris
• Fletcher’s & Stuart’s (6-8 weeks)

12. Chlamydia trachomatis Ricketssiae

Subtypes: • Genera: Rickettsia, Ehlichia, Coxiella &

• A, B, Ba, C: Endemic trachoma (multiple/ Rochalimea
persistent infections that leads to blindness) • Gram (-) obligate intracellular bacteria
• Inclusion conjunctivitis • Vector transmitted (lice, fleas & ticks)
• D-K: Urethritis, cervicitis, pelvic inflammatory • Coxiella: cannot survive outside animal
disease, epididymitis, infant pneumonia host or insect vector EXCEPT C. burnetti
• L1, L2, L3: Lymphogranuloma venereum
Laboratory diagnosis:
• Culture: McCoy’s cell
14.
• Mycoplasma hominis
FREI’s test: delayed & Ureaplasma
hypersensitivity skin test
for LGV urealyticum
• Genital mycoplasmas
Mycoplasma spp.
• Colonize adults asymptomatically
•• Smallest
Cause of free-living organisms
nongonococcal (gram -)
urethritis in males
• Found in plants & animals
M. hominis
•• Formerly known as &
Agent of salpingitis pleuropneumonia-like
postpartal fever in
organisms (PPLOs) Afipia felis
females
• Causing pleuropneumonia in cattles
ANALYSIS OF URINALYSIS
AND BODY FLUID (LAB) PRE-LIMS
COLLEGE OF MEDICAL LABORATORY SCIENCE 2022 L1: P1

• Associated with cat-scratch disease (CSD)

• Despite its rare isolation, indirect evidence
suggests that the organism may be more
commonly linked to CSD than is currently
appreciated
• Due to lack of appropriate laboratory
methods for detection