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Send stool cultures for other enteric pathogens and examine for ova and parasites only if epidemiologically appropriate or evaluating an immunocompromised host (level 2). 6. Test stool for norovirus if the clinical and epidemiologic setting is appropriate. Testing for norovirus is usually only available in state laboratories and is usually performed in outbreak settings. Obtain consultation with infection control and public health authorities (level 3). Recommendations for Evaluation of the Gastrointestinal Tract-3 Urinary Tract Infection Recommendations for Evaluation of the Urinary Tract Recommendations for Evaluation of the Urinary Tract-1 1. For patients at high risk for urinary tract infection (kidney transplant patients, granulocytopenic patients, or patients with recent urologic surgery or obstruction), if clinical evaluation suggests a patient may have symptomatic urinary tract infection, a laboratory evaluation is necessary. Obtain urine for microscopic exam, Gram-negative stain, and culture (level 2). 2. Patients who have urinary catheters in place should have urine collected from the sampling port of the catheter and not from the drainage bag (level 2). Recommendations for Evaluation of the Urinary Tract-2 3. Urine should be transported to the laboratory and processed within 1 hr to avoid bacterial multiplication. If transport to the laboratory will be delayed for 1 hr, the specimen should be refrigerated. Alternatively, a preservative could be used but is less preferable to refrigeration (level 2). 4. Cultures from catheterized patients showing 103 cfu/mL represent true bacteriuria or candiduria, but neither higher counts nor the presence of pyuria alone are of much value in determining if the catheter-associated bacteriuria or candiduria is the cause of a patient’s fever; in most cases, it is not the cause of fever (level 1). Recommendations for Evaluation of the Urinary Tract-3 5. Gram stains of centrifuged urine will reliably show the infecting or