More info about Quest 3021

[massagedoula]

I just wanted to say that after I read about the Quest 3021 on this site, I was very interested in it. I really liked the fact that the lab willl get the specimen ASAP, not having to send it through the mail like to United Medical, which IMO, causes urine specimens to look like they are alot more colonized than they actually are, since they are at room temp in the mail for a few days.

I brought the info to my naturopath, and she wrote me the lab slip. However, I called Quest this evening to ask if there are any special instructions, and the rep that I spoke to in Seattle (who seemed very knowledgeable about the 3021) said that this test is only applicable to an in and out straigh cathed sample, or suprapubic aspirate sample. I asked her if "my patient" (Ok..I pretended that I was a health care provider, which I actually am, though the "patient" was actually me!) could just do a clean catch sample and send it for the 3021. She said that this would not be the best test for this, and that what Quest can do is have the "patient" take a clean catch urine sample, then I (the provider) could write on the lab slip "patient has history of multiple organisms in urine and is symptomatic--please culture ALL organisms found" and send it off for a normal UA, complete with relflex to culture. She said that they will culture out anything found in this way, and will not just put "mixed GPOs" on the slip.

So I called the naturopath back to say that I am not going to now drop off the sample for the 3021, and would like her to give me a new slip with that instructions written on it verbatim...and I am now waiting to hear back from her. What do you guys all think about this new info?

[mom_in_ma]

massagedoula,
Good to have you back - I hope on good terms, not flaring ones. What got you interested in the Quest culture? Please let us know how this turns out for you.

[massagedoula]

Hi! I am not flaring, actually. I came back because I am planning to get pregnant this summer, and am really worried about my IC getting worse once I stop my Elmiron and take vitamin supplements that may irritate my bladder, plus having a baby sitting on my bladder (though I can't wait!)

So I have been cruising the boards and saw these recent threads about the Quest 3021. I have gotten so many urine cultures through my years with IC, and have almost always had them come back with some level of "mixed gram positive flora". I always asked myself...What if they were not contaminants, but were actually IN my bladder! I don't think that bacteria causes IC, but I do think that any amount of bacteria in our bladders could hurt our already inflamed and damaged bladder lining. So that is why the 3021 interested me. But I want to make sure that I am doing it right...If it is only for cathed samples then it may not be the right way to go, since I am sure that no matter how hard we do a clean catch, there will be some vaginal flora that gets in. I wish now that I knew how to cath myself...Then I could realy do an accurate 3021!

[MarthaF]

I am one who has researched the Quest culture, #3021. If you search on their website you can look up the instructions and descriptions for testing/culturing. It appears to me that they have regional labs that do their culturing and they do not all use exactly the same methods. Some might require a catheterized specimen.

You could try the clean catch and request that they report all growth and see what happens. You could also send a clean catch to United and compare the two. We know United uses a broth culture and that means that they put a specimen in a nutrient broth and this will enable some fastidious kinds of bacteria to grow out that might not otherwise show. It is also possible that if labs let the routine cultures grow longer - say a week instead of 24 or 48 hours - more kinds of bacteria would show.

Personally, I have never sent a catheterized specimen but a broth culture has always resulted in the pathogen being found and treating it has resulted in eradication.

Please let us know what you decide to do and how it turns out.

Martha

[massagedoula]

When I looked it up online it says RE: Source of specimen: URINE FROM IN AND OUT (STRAIGHT) CATHETER OR SUPRAPUBIC ASPIRATE

That is also what the woman on the phone told me as well. I am still unsure as to what I will do. I am waiting for the ND to call me back to ask if she can write a request for a normal UA with instructions to report all bacteria found per the Quest representative's instructions. I do wish I could send in a cathed sample, that would be the #1 best thing to do in this situation, a cathed sample for the 3021. But I don't know how to cath myself plus I have extreme pain with catheters, which I have had in the past during my IC dx process.

By the way, Martha, thank you for the info about the Fem-dophilus. I researched it and found it to be a well researched product. I discussed it with the ND today and she shares that feeling, she may start carrying it. For me, I called all the local supplement stores and finally located one that carries it, I will get it tomorrow. I have had much trouble with probiotics causing flares in the past, but I hope for the best with this one. It just sounds great, anything that can positively affect the urinary tract, sign me up!

[MarthaF]

I don't like catheters since there is always the possibility of introducing bacteria into the bladder with their use. I think if you are very careful about preparing for and taking a clean catch specimen there is very little likelihood of contaminants. I think many labs are accustomed to calling Enterococcus a contaminant when in fact it is very likely to be a pathogen. Almost all bladder bacteria come from the bowel and E. coli is one of them. E. coli is a Gram negative bacteria and Enterococcus is a Gram positive. Dr. Fugazzotto explained that even a low colony count of Enterococcus can be the source of an infection. In fact he did not believe in the use of colony counts at all. As he pointed out they don't do colony counts in any other type of infectious disease. Some can tolerate almost any kind of bacteria but others cannot. No one knows why but if there are symptoms and bacteria are found it is worth treating.

I am glad you are going to try FemDophilus. I have mentioned before that you can insert them vaginally (I use an applicator with a little gel) even though the instructions do not say this. Dr. Gregor Reid, the inventor, has said that it is safe. He says that FemDophilus is able establish colonies of good lactobacilli in the vagina and help prevent yeast, BV and UTIs. The vagina can be the source of all of these problems.