Expanded Quantitative Urine Culture (EQUC)

We quantitatively spread 0.1 mL of urine onto BAP, Chocolate and Colistin, Naladixic Acid (CNA) agars (BD BBL™ Prepared Plated Media), then incubated for 48 hours at 35°C in 5% CO₂. We inoculated a second set of BAPs with 0.1 mL of urine and incubated for 48 hours at 30°C and 35°C in room atmosphere. We inoculated 0.1 mL of urine onto two CDC Anaerobe 5% sheep blood agar (ABAP) plates (BD BBL™ Prepared Plated Media), and incubated one in a Campy gas mixture (5% O₂, 10% CO₂, 85% N) and the other in anaerobic conditions for 48 hours at 35°C. The threshold of detection was 10 CFU/mL, which corresponds to 1 colony of growth on any plate. To prepare a pure culture for organism identification, we isolated each morphologically distinct colony type on a different plate of the same media. To identify the bacterial isolates, we used matrix-Assisted Laser Desorption Ionization Time of Flight Mass Spectrometry (MALDI-TOF MS) with the MALDI Biotyper 3.0 software (Bruker Daltonics, Billerica, MA) (1).