.
Name : Ms. RIDHIMA
Lab No. : 483563683 Age : 22 Years
Ref By : Dr. VIMMI ARORA Gender : Female
Collected : 17/08/2025 9:12:00AM Reported : 20/8/2025 12:02:17PM
A/c Status : P Report Status : Final
Collected at : AMRITSAR CC9 Processed at : LPL-NATIONAL REFERENCE LAB
24-D,Near Purana Shivala,Rani Ka Bagh National Reference laboratory, Block E,
Amritsar Sector 18, Rohini, New Delhi -110085
Test Report
URINE CULTURE
(Conventional culture, Automated-MIC, MALDITOF-MS, KBDD)
Type of Specimen :
Interim report
Escherichia coli grown, AST follow on next day.
Organism : Escherichia coli - >100000 colonies/ml grown.
TIER ANTIBIOTICS MIC Breakpoint BMQ AST
(ug/ml) Concentration(BK) (=BK/MIC) Interpretation
First Ampicillin >=32 <=8 NA Resistant
First Ceftriaxone >=64 <=1 NA Resistant
First Amoxycillin / Clavulanic acid 16 <=8 NA Intermediate
First Piperacillin + Tazobactam <=4 <=8 2 Susceptible
First Gentamicin >=16 <=2 NA Resistant
First Ciprofloxacin >=4 <=0.25 NA Resistant
First Trimethoprim/Sulfamethoxazole <=20 <=40 2 Susceptible
First Nitrofurantoin <=16 <=32 2 Susceptible
First Norfloxacin >=16 <=4 NA Resistant
Second Cefixime >=4 <=1 NA Resistant
Second Ertapenem <=0.5 <=0.5 1 Susceptible
Second Amikacin 8 <=4 NA Intermediate
Second Cefoxitin <=4 <=8 2 Susceptible
Third Fosfomycin <=16 <=64 4 Susceptible
Fourth Ceftazidime 4 <=4 1 Susceptible
Fourth Ofloxacin >=8 <=2 NA Resistant
*483563683* Page 1 of 7
.
Name : Ms. RIDHIMA
Lab No. : 483563683 Age : 22 Years
Ref By : Dr. VIMMI ARORA Gender : Female
Collected : 17/08/2025 9:12:00AM Reported : 20/8/2025 12:02:17PM
A/c Status : P Report Status : Final
Collected at : AMRITSAR CC9 Processed at : LPL-NATIONAL REFERENCE LAB
24-D,Near Purana Shivala,Rani Ka Bagh National Reference laboratory, Block E,
Amritsar Sector 18, Rohini, New Delhi -110085
Test Report
Tier First : Antimicrobials that are appropriate for routine, primary testing & reporting.
Tier Second : Antimicrobials that are appropriate for routine, primary testing but may be reported following cascade
reporting rules established at each institution.
Tier Third : Antimicrobials that are appropriate for routine, primary testing in institutions that serve patients at high risk for
MDROs but should only be reported following the cascade reporting rules.
Tier Fourth : Antimicrobials that may warrant testing and reporting by clinician request if antimicrobial agents in other
tiers are not optimal because of various factors.
Relevance of BMQ (Breakpoint to MIC Quotient):
BMQ, calculated as the susceptible breakpoint divided by the MIC of the test isolate, reflects the predicted efficacy of a drug,
with higher values indicating better performance. While BMQ should be interpreted within its designated tier to maintain
antibiotic stewardship, exceptions may be considered in critical situations, ensuring clinical correlation with infection severity,
patient-specific factors, and expected outcomes.
*483563683* Page 2 of 7
.
Name : Ms. RIDHIMA
Lab No. : 483563683 Age : 22 Years
Ref By : Dr. VIMMI ARORA Gender : Female
Collected : 17/08/2025 9:12:00AM Reported : 20/8/2025 12:02:17PM
A/c Status : P Report Status : Final
Collected at : AMRITSAR CC9 Processed at : LPL-NATIONAL REFERENCE LAB
24-D,Near Purana Shivala,Rani Ka Bagh National Reference laboratory, Block E,
Amritsar Sector 18, Rohini, New Delhi -110085
Test Report
E.coli
Clinical Footnotes
1. Tier Relevance:
a) Follow latest CLSI Tier system:
Ø Tier I agents preferred.
Ø Escalate to Tier II-IV only when Tier I fails or resistance is proven.
b) Site of infection and antimicrobial concentration at the site must guide therapy.
2. Intrinsic Resistance:
-------------------------------------------------------------------
| Bacterial species | Intrinsically Resistant Antibiotics |
|-------------------|-----------------------------------------------|
| Escherichia coli | Macrolides, Clindamycin, Daptomycin, |
| | Fusidic Acid, Vancomycin, Oritavancin, |
| | Telavancin, Teicoplanin, Rifampin, Linezolid, |
| | Tedizolid, Quinupristin-Dalfopristin. |
-------------------------------------------------------------------
3. Clinical Guide:
-------------------------------------------------------------------
| PK/PD and Clinical | Recommendation for | Advanced testing (for |
| Recommendations: | Resistant Strains | CRE within 48 hours): |
| | (ESBLs and CREs): | To confirm resistance |
| | | genes (KPC, NDM, |
| | | IMP, VIM, OXA-48), |
| | | order: |
|--------------------|----------------------|-----------------------|
| a) Tailor Beta- | a) ESBL strains: | a) M292 (Carbapenem |
| lactam dosing | Treat with | Resistant K.N.I.V.O. |
| to hepato-renal | Carbapenems (e.g., | Detection, Rapid) or |
| function and | Meropenem or | |
| MIC values | Imipenem); | |
|--------------------|----------------------|-----------------------|
| b) Use IV route | b) CREs: Use newer | b) M279 (CARBAPEN-R |
| and extended | targeted agents such | -XPERT). |
| infusion for | as Ceftazidime- | |
| severe infections | Avibactam, Meropenem | |
| to enhance tissue | -Vaborbactam, | |
| penetration. | Plazomicin, or | |
| | Cefiderocol. | |
-------------------------------------------------------------------
4. Clinical Hygiene & Stewardship
a) Avoid: All intrinsic resistant and site-irrelevant antimicrobials.
b) Dose Adjust: Especially in hepatic/renal insufficiency
c) Stewardship 4Rs: • Right Patient • Right Antimicrobial • Right Dose • Right Time
d) Infection Control: Hand hygiene, equipment sterilization, isolation of CRE cases
5. Abbreviations * ESBL: Extended Spectrum Beta Lactamase * CRE: Carbapenemase-Resistant E. coli *
MIC: Minimum Inhibitory Concentration * MDR: Multi-drug Resistant * XDR: Extra-drug Resistant * PK:
Pharmacokinetics * PD: Pharmacodynamics * CLSI: Clinical and Lab Standards Institute.
*483563683* Page 3 of 7
.
Name : Ms. RIDHIMA
Lab No. : 483563683 Age : 22 Years
Ref By : Dr. VIMMI ARORA Gender : Female
Collected : 17/08/2025 9:12:00AM Reported : 20/8/2025 12:02:17PM
A/c Status : P Report Status : Final
Collected at : AMRITSAR CC9 Processed at : LPL-NATIONAL REFERENCE LAB
24-D,Near Purana Shivala,Rani Ka Bagh National Reference laboratory, Block E,
Amritsar Sector 18, Rohini, New Delhi -110085
Test Report
Dr.Anirudh Bharat Kumar Gupta Dr Shalabh Malik Dr Puneeta Singh
MD, Microbiology MD, Microbiology Ph.D (Microbiology)
Senior Consultant Microbiologist Technical Director - Microbiology, Principal Research Scientist
NRL - Dr Lal PathLabs Ltd Infectious Disease Molecular & Serology, NRL - Dr Lal PathLabs Ltd
Clinical Pathology
NRL - Dr Lal PathLabs Ltd
IMPORTANT INSTRUCTIONS
ŸTest results released pertain to the specimen submitted .ŸAll test results are dependent on the quality of the sample received by the Laboratory .
ŸLaboratory investigations are only a tool to facilitate in arriving at a diagnosis and should be clinically correlated by the Referring Physician .ŸReport
delivery may be delayed due to unforeseen circumstances. Inconvenience is regretted .ŸCertain tests may require further testing at additional cost for
derivation of exact value. Kindly submit request within 72 hours post reporting.ŸTest results may show interlaboratory variations .ŸThe Courts/Forum at
Delhi shall have exclusive jurisdiction in all disputes /claims concerning the test(s) & or results of test(s).ŸTest results are not valid for medico legal
purposes.ŸThis is computer generated medical diagnostic report that has been validated by Authorized Medical Practitioner /Doctor. The report does not
need physical signature.
(#) Sample drawn from outside source.
If Test results are alarming or unexpected, client is advised to contact the Customer Care immediately for possible remedial action.
Tel: +91-11-49885050,Fax: - +91-11-2788-2134, E-mail: [email protected]
National Reference lab, Delhi, a CAP (7171001) Accredited, ISO 9001:2015 (FS60411) & ISO 27001:2013 (616691) Certified laboratory.
*483563683* Page 4 of 7
.
Name : Ms. RIDHIMA
Lab No. : 483563683 Age : 22 Years
Ref By : Dr. VIMMI ARORA Gender : Female
Collected : 17/8/2025 9:12:00AM Reported : 20/8/2025 12:02:17PM
A/c Status : P Report Status : Final
Collected at : AMRITSAR CC9 Processed at : LPL-AMRITSAR
24-D,Near Purana Shivala,Rani Ka Bagh SCO NO.15, FIRST FLOOR, AJNALA ROAD 97
Amritsar ACRE BLOCK D.ILAQA VIKAS SCHEME,
RANJIT AVENUE. AMRITSAR,PUNJAB
-143001
Test Report
Test Name Results Units Bio. Ref. Interval
URINE EXAMINATION, ROUTINE
Gross Examination
Colour Light Yellow Pale yellow
(Visual Examination)
Specific Gravity <=1.005 1.001 - 1.030
(Pre-treated polymeric Ion Exchange resin)
pH 6 5.0 - 8.0
(Double Indicator)
Proteins Negative Negative
(Tetra Bromophenol)
Glucose Negative Negative
(Glucose oxidase peroxidase chromogen reaction)
Ketones Negative Negative
(Sodium Nitroprusside)
Bilirubin Negative Negative
(Diazonium salt)
Urobilinogen Normal Normal
(Diazonium salt)
Blood Trace Negative
(Tetramethyl benzidine)
Leucocyte Esterase Trace Negative
(Carboxylic acid ester diazonium salt)
Nitrite Positive Negative
(Sulfananic acid Tetrahydro benzol)
*483563683* Page 5 of 7
.
Name : Ms. RIDHIMA
Lab No. : 483563683 Age : 22 Years
Ref By : Dr. VIMMI ARORA Gender : Female
Collected : 17/8/2025 9:12:00AM Reported : 20/8/2025 12:02:17PM
A/c Status : P Report Status : Final
Collected at : AMRITSAR CC9 Processed at : LPL-AMRITSAR
24-D,Near Purana Shivala,Rani Ka Bagh SCO NO.15, FIRST FLOOR, AJNALA ROAD 97
Amritsar ACRE BLOCK D.ILAQA VIKAS SCHEME,
RANJIT AVENUE. AMRITSAR,PUNJAB
-143001
Test Report
Test Name Results Units Bio. Ref. Interval
Microscopy
R.B.C. 6 - 8 RBC/HPF 0-2 RBC/hpf
(Light microscopy)
Result Rechecked,
Please Correlate Clinically.
Pus Cells 25-30 WBC/HPF 0-5 WBC / hpf
(Light microscopy)
Result Rechecked,
Please Correlate Clinically.
Epithelial Cells Few 0-5 Epi cells/hpf
(Light microscopy)
Casts None seen None seen/Lpf
(Light microscopy)
Crystals None seen None seen
(Light microscopy)
Others None seen None seen
(Light microscopy)
Dr Rachna Arora Mohan
MD, Pathology
Chief of Lab
-------------------------------End of report --------------------------------
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BNFFFNBPACJGMHBLJPMCBLEGAHFHAHFLBGJHAHJLICAONPBNFFFNB
FNCHFDFNJGAGFHLJCMGEGFKBCEHCHJBCOFHCBLHJOAKEHKFCFDHOL
NKPMIFFGDKLGLEGPPKEOOIJOMGFKOBADIFMKHLNGKNCHHKNAFBHGD
IIADBDFHKGDDOONEBGMHCKMJCKPHKDKEMLEPFDHKNFCHHDNKBCDKO
NJAPKJFCKMEHCJKHLAELBIHGGOJNDEDPOEMEAKGPKBBAEKMKBMNMC
PEMFAHFHAOBBDPLMMOECNFJDAHFHAKAKKCNDCINFMICJAHFHACPEL
GAOBDDFCHKECLPPDIOKHGHLPEFHFFHCNMKNFCMNDKAKNCBCHCHDLL
MHCOIIFOEILAJKFEADPMMKNCHPKBHCBBPEFEBANEOFCIBACDIHHEK
IIOINDFDKECNEGNDFBOCIFLKKKLGNCKGIGNKBFEKJNKONJKKLGDLK
FAKNBFFGONLEDAACFMBOOENKHKLMNLAOOMNCBLFKPBBKLBOAAMHMD
MNNFNNEPKNAIJFMKECELPOIBAHFHAAAHKCNNEKNOLAAIAHFHAKHKP
APBBBPAPBPACFHCCEPEJCIFIACHGEFCBLGMAFFNJMGKFDBDDEFHMJ
HHHHHHHPHHPPPPPPHPPPPPHHHHPHPHHHPHPHHPHHPPPPPHPPHHHPP
*483563683* Page 6 of 7
.
Name : Ms. RIDHIMA
Lab No. : 483563683 Age : 22 Years
Ref By : Dr. VIMMI ARORA Gender : Female
Collected : 17/8/2025 9:12:00AM Reported : 20/8/2025 12:02:17PM
A/c Status : P Report Status : Final
Collected at : AMRITSAR CC9 Processed at : LPL-AMRITSAR
24-D,Near Purana Shivala,Rani Ka Bagh SCO NO.15, FIRST FLOOR, AJNALA ROAD 97
Amritsar ACRE BLOCK D.ILAQA VIKAS SCHEME,
RANJIT AVENUE. AMRITSAR,PUNJAB
-143001
Test Report
Test Name Results Units Bio. Ref. Interval
IMPORTANT INSTRUCTIONS
ŸTest results released pertain to the specimen submitted .ŸAll test results are dependent on the quality of the sample received by the Laboratory .
ŸLaboratory investigations are only a tool to facilitate in arriving at a diagnosis and should be clinically correlated by the Referring Physician .ŸReport
delivery may be delayed due to unforeseen circumstances. Inconvenience is regretted .ŸCertain tests may require further testing at additional cost
for derivation of exact value. Kindly submit request within 72 hours post reporting.ŸTest results may show interlaboratory variations .ŸThe
Courts/Forum at Delhi shall have exclusive jurisdiction in all disputes /claims concerning the test(s) & or results of test(s).ŸTest results are not valid
for medico legal purposes.ŸThis is computer generated medical diagnostic report that has been validated by Authorized Medical
Practitioner/Doctor. ŸThe report does not need physical signature.
(#) Sample drawn from outside source.
If Test results are alarming or unexpected, client is advised to contact the Customer Care immediately for possible remedial action.
Tel: +91-11-49885050,Fax: - +91-11-2788-2134, E-mail: [email protected]
*483563683* Page 7 of 7
