- 1 Interpretation of Urinalysis and Urine Culture for UTI Treatment
- 2 Overview
- 3 Clinical Presentation
- 4 Urinalysis Interpretation
- 5 Approach to the Asymptomatic Patient
- 6 Approach to the Symptomatic Patient
- 7 Conclusion
- 8 Urine Culture: How the Test Works
- 9 Urine Culture: Purpose, Results & What To Expect
- 9.1 What is the purpose of a urine culture?
- 9.2 Who needs a urine culture?
- 9.3 What is the difference between a urine culture test and urinalysis?
- 9.4 Can a urine culture detect a sexually transmitted disease (STD)?
- 9.5 Can a urine culture detectE. coli?
- 9.6 Can a urine culture detectStreptococcus(strep) infections?
- 10 Test Details
- 11 Results and Follow-Up
- 12 Urinalysis – Mayo Clinic
- 13 Why it’s done
- 14 How you prepare
- 15 What you can expect
- 16 Results
- 17 Interpreting Culture Results – Part 1: Urinalysis and Urine Cultures
- 18 Interpreting Urine Cultures
- 19 Know the Nuances
- 20 Understanding urine tests
- 21 What do the characteristics of urine tell us?
- 22 How do you give a urine sample?
- 23 Rapid urine test
- 24 Urinalysis
- 25 Urine culture
- 26 24-hour urine collection
- 27 Pregnancy tests
- 28 Other urine tests
- 29 Sources
Interpretation of Urinalysis and Urine Culture for UTI Treatment
United States Pharmacopeia, vol. 38, no. 11, pp. 65-68. ABSTRACT: Outpatient and inpatient populations alike are affected by urinary tract infection (UTI), which is one of the most often diagnosed illnesses. It is critical for practitioners to understand the benefits and limitations of urinalysis and urine culture in order to make an appropriate diagnosis in their patient population. It is possible to diagnose either asymptomaticbacteriuria or asymptomatic urinary tract infection (UTI) using these tests in combination with an evaluation of urine symptoms.
Urinalysis is a powerful diagnostic technique for a wide range of common illness conditions, including diabetes.
Aside from that, it can give valuable information about the screening and diagnosis of various disorders, such as cancer, proteinuria, glycosuria, ketonuria, and renal calculi.
It is the primary emphasis of this article to discuss the interpretation of urinalysis results and the subsequent urine culture results in the diagnosis and management of UTIs.
A urinary tract infection (UTI) is the second most frequent form of infection in the United States, accounting for around 10 million visits to health-care professionals in the country each year. 2A large number of these visits take place in the emergency room, when urinalysis can offer quick diagnostic findings for many conditions. However, because urinalysis is so often done in the emergency department, there is worry that misunderstanding might result in overtreatment of urinary tract infections (UTIs) and increased antibiotic use.
One study found that, although 43 percent of women over the age of 70 with a diagnosis of urinary tract infection (UTI) in the emergency department had no microbiological evidence of a UTI, nearly all (95 percent) of culture-negative patients got antibiotic treatment.
In order to schedule a urinalysis and urine culture, it is critical to recognize the symptoms of urinary tract infection (UTI). To diagnose UTI, symptoms of the urinary tract should be considered in conjunction with test findings. However, while many of the symptoms remain intuitive, there have been some recent revisions to the definitions of the nonspecific symptoms that many health care practitioners have come to identify with urinary tract infection (UTI). Upper Urinary Tract Infection (UTI) Symptoms: The most common symptoms linked with lower UTI are dysuria or acute discomfort, frequent or urgent urinating, urgency, and incontinence.
- 4,5Pyelonephritis/Upper Urinary Tract Infection (UTI) Symptoms: When compared to cystitis, pyelonephritis frequently manifests as a more severe, systemic condition.
- These nonspecific symptoms were included in prior consensus-based criteria for diagnosing urinary tract infection (UTI) in residents of skilled care institutions, which may have contributed to our finding.
- Patients with noncatheterized urinary tract infections (UTIs) who have acute mental status change are not included in the most current definitions of UTI in long-term care institutions.
5 Following this criteria, nonspecific symptoms such as fatigue, nausea, and vomiting should be ignored until the patient is catheterized or has unexplained leukocytosis.
When analyzing urinalysis for indications of infection, there are a number of elements to take into account. The presence of bacteria in the urine is the most evident sign of bacterial infection, and this is generally assessed in terms of the number of germs per high-power field (HPF). Any level of bacteria in the urine in an asymptomatic patient may imply urinary tract infection (UTI), but the traditional definition ofbacteriuria is 5+, which is roughly equivalent to 100,000 colony-forming units (CFUs) per milliliter of urine.
- It is believed that the presence of inflammation is indicated by the presence of WBC10 in the urine or a positive leukocyteesterase.
- Even though pyuria has a low specificity and positive predictive value, its absence completely excludes infection as a possible cause, with a negative predictive value of approximately 90%.
- An abnormally high level of nitrites in the urine suggests the existence of an organism that degrades nitrate, according to the test.
- A positive test is highly specific for bacterial infection, but a negative test does not rule out the possibility of infection, resulting in a poor sensitivity for this test.
- 1 The interpretation of urine tests is presented in TABLE 1, with the first four tests being the most often assessed for information that might lead to the diagnosis of UTI.
- It is common for a reflex urineculture to be requested if any of the first four tests described in TABLE 1 are positive.
- Overtreatment of asymptomatic bacteriuria is a common occurrence that may be avoided by following guidelines and following advice carefully.
Approach to the Asymptomatic Patient
In the case of a patient who has urinalysis or culture results that are compatible with UTI but does not have any urinary symptoms, a treatment dilemma arises. Age-related increases in the occurrence of this illness, which is known as symptomatic bacteriuria. 6,7 It has been observed that 50 percent of women in long-term care institutions have asymptomatic bacteriuria, and that the frequency among males over the age of 60 is significantly higher than in the general population. Sixth, routine screening of asymptomatic individuals is not suggested by the Infectious Diseases Society of America, according to their recommendations.
(6) Treatment may also be considered in women who have bacteriuria more than 48 hours after catheter removal have been removed.
Antibiotic therapy should be initiated empirically; however, depending on the organism discovered in the urineculture, it may necessitate adjustment of the first regimen.
Approach to the Symptomatic Patient
If you have been diagnosed with urinary tract infection (UTI) based on your symptoms and urine test results, the next step is to begin empirical antibiotic medication while you await culture and susceptibility findings. As previously noted, urinary tract infection (UTI) symptoms can be classified as lower (cystitis), upper (pyelonephritis), or nonspecific in nature. An additional type of urinary tract infection (UTI) that might influence treatment and therapy duration is simple vs complex. Uncomplicated urinary tract infection (UTI) is described as a UTI that does not have any structural or urologic abnormalities.
- The physical characteristic of a longer urethra in men, which defends against the ascending transmission of germs, makes uncomplicated infections unusual in this group.
- Despite the fact that there are many different criteria for complicated UTI, the most persistent patient characteristics include the presence of a foreign body, blockage, immunosuppression, renal failure or transplantation, urine retention, and pregnancy.
- When it comes to simple infections, Escherichia coli is the most prevalent pathogen, followed by other Enterobacteriaceae such as Proteus mirabilis, Klebsiella pneumoniae, and Staphylococcus saprophyticus, among others.
- It is possible that the same infections are present in individuals with complex UTI; however, gram-negative organisms are more resistant to antibiotics.
- Several other multidrug-resistant bacteria, including Serratia, Citrobacter, Enterobacter, Pseudomonas, and Acinetobacter species, are becoming increasingly prevalent in health-care–associated illnesses.
- In the event that a urinary catheter is in situ, the catheter should be removed and a culture taken from the midstream urine or a new catheter should be used to direct therapy.
- In order to avoid excessive antibiotic exposure, urine culture findings should be utilized to de-escalate or adjust therapy as needed.
The specified length of therapy should also be followed to avoid excessive antimicrobial exposure The suggested medicines and treatment durations for symptomatic UTI are shown in TABLE 3 below. 13,14
The clinical interpretation of urinalysis and urine culture data necessitates both a grasp of the relevance of test parameters and the inclusion of patient symptoms into the decision-making process. Antimicrobial stewardship and clinical actions are carried out in conjunction with positiveurinalysis and urine culture findings, with pharmacists playing an important role in many facilities. Although it may be tempting to just prescribe an antibiotic based on test findings, in order to avoid overtreating asymptomatic people, a thorough examination of their symptoms should be carried out.
1. J.A. Simerville, W.C. Maxted, and J.J. Pahira A complete review of urine analysis. 2005;71(11):1153-1162. American Family Physician. 2. Schappert, S.M., and Burt, C.W. 2. Hospital outpatient departments and the emergency department were the most common destinations for ambulatory care visits in the United States in 2001–2002, according to the National Center for Disease Statistic. VITAL HEALTH STATISTICS (2006) 13 3. Gordon LB, Waxman MJ, Ragsdale L, Mermel LA, Waxman MJ, Waxman MJ, Waxman MJ, Waxman MJ, Waxman MJ When older women go to the emergency department with a suspected urinary tract infection, they are routinely overtreated.
- The infectious illnesses of the human body (Smith, CL, ed.).
- Stone ND, Ashraf MS, Calder J, et al.
- Journal of the American Medical Association.
- 33, pp.
- Nicolle LE, Bradley S, Colgan R, Nicolle LE, Bradley S, Colgan R, Nicolle LE Clinical Infectious Diseases, Volume 40, Number 6, Pages 643-654, 2005.
- Juthani-Mehta, M.
- Clinical Gerontology and Geriatric Medicine, Volume 23, Number 5, 585-594, 2007.
Eur J Clin Invest 2008;38(suppl 2):50-57.
The Journal of Urology 179:1379-1390 (2008).
Letter from the pharmacist/letter from the prescriber 280706 is the month of July in 2012.
Hooton, T.M., Bradley, S.F., Cardenas, D.D., and colleagues The Infectious Diseases Society of America published International Clinical Practice Guidelines in 2009 for the diagnosis, prevention, and treatment of catheter-associated urinary tract infection in adults.
Infection Control and Hospital Epidemiology, 15(3), 109-115.
Clinical Infectious Diseases, vol.
Editors: DiPiro JT, Talbert RL, Yee GC, and colleagues A Pathophysiologic Approach to Pharmacotherapy is in its eighth edition, published by McGraw-Hill Medical in New York City. If you have any comments or questions about this post, please email [email protected]
Urine Culture: How the Test Works
Overview When you have a urine culture, it can be used to identify bacteria in your urine. When a urinary tract infection occurs, this test can detect and identify the microorganisms that are causing it (UTI). The urethra is a passageway via which bacteria, which are primarily responsible for UTIs, can enter the urinary system. These bacteria can multiply fast in the environment of your urinary system, eventually resulting in an infection of the tract. More information may be found at: Do you want to discover everything there is to know about urinary system infection?
Females are more likely than males to get urinary tract infections.
As a result, germs from the intestines have a lot easier time making their way into the urinary system.
The following are the most frequent symptoms of a UTI:
- Physical symptoms include: back and stomach pain
- A strong need to pee often
- Trouble passing urine through your urine stream
- And urinary tract infection (UTI).
If you have a urinary tract infection (UTI), your urine may seem hazy or even turn pinkish or coral in color if there is blood present in it. Despite the fact that you may have a continual need to pee, you may be unable to pass more than a little volume of urine from your bladder due to bladder obstruction. Shaking, chills, and vomiting are common symptoms of an illness that is progressing to a dangerous stage. Several alternative methods are available for collecting urine for the purpose of doing a urine culture.
When you pee, you should collect your urine in a cup as you go.
Urinary collection bag
The collection of a urine sample can also be accomplished using a urinary collection bag. With children and newborns, this strategy is the most frequently employed. A plastic bag is affixed with glue to either a girl’s labia or a boy’s penis in order to perform this surgery. A bag is placed over the child’s diaper to capture urine, which may subsequently be submitted to a laboratory for examination.
In some circumstances, a catheter is required by a healthcare professional in order to collect a urine sample. A thin rubber tube is inserted through the urethra and into the bladder in order to do this. Once the catheter is in place, the healthcare professional can take a sample of the patient’s blood. Even if you already have a urinary catheter in place, your healthcare professional may be able to obtain a sample by closing the drainage end of your catheter before it reaches the drain bag. Once urine has been collected in the clamped tube, your healthcare professional will use a syringe to retrieve a sample of urine from the tube.
When taking urine samples, it is important not to take them immediately from the catheter collecting bag since urine that has been out of the body for an extended period of time may begin to grow germs and will not form an acceptable sample in the lab.
The use of a needle to extract a urine sample from your bladder may be required in some rare situations by your doctor. If prior attempts to acquire an uncontaminated sample have been failed, this method, known as a suprapubic aspiration, is utilized to collect the sample. It is possible that your obstetrician will ask you to do a urine culture at various intervals throughout your prenatal care as a preventive step if you are pregnant. If you suffer a urinary tract infection (UTI) during your pregnancy, it is critical that you get treatment as soon as possible.
- Untreated urinary tract infections (UTIs) might result in preterm childbirth or poor labor outcomes.
- Preparing for and carrying out a urine collection pose no dangers to the individual conducting it.
- If your doctor demands a urine sample, you may experience some pressure and discomfort.
- A catheter can occasionally cause a hole to form in your urethra or bladder.
- Pre-testing preparations should include informing your doctor if you are currently taking or have recently taken any prescriptions, or if you are taking any over-the-counter vitamins, medicines, or supplements.
- Aside from cleaning your hands and your genitals before the clean-catch collection, there is no need to prepare for a urine culture prior to the collection.
- If you have any questions or concerns regarding the test, the dangers involved, or the results, you should discuss them with your doctor immediately.
Following that, the material is inspected under a microscope.
If just a small number of germs or organisms are detected, you will obtain a negative test result.
The results of a urine culture are usually available in two to three days.
It is possible that your sample contains more than one type of bacteria, or that it contains just a very little amount of bacteria.
It is possible that you will be required to retake the test.
coli bacteria, which may be found in your feces.
Some cases of urinary tract infections are caused by Candida, which is yeast that has the ability to overgrow and create an infection.
Most of the time, antibiotics are used to treat a urinary tract infection.
If you continue to get numerous UTIs, you may need to be tested to see whether you are more susceptible to them.
Every chance you have to attempt to flush out some of the germs can aid your body’s recovery by allowing it to return to normal faster.
Consider them to be ammo for your white blood cells, which will be used to battle the illness.
Once upon a time, it was believed that drinking unsweetened cranberry juice would help to expel harmful germs from the urinary system.
If you believe you have a urinary tract infection, it’s most likely because you’re experiencing unpleasant symptoms.
Wearing loose-fitting, cotton underwear and cleaning your clothes on a regular basis will help prevent the infection from returning.
However, if you suspect you have one, get medical attention immediately.
If you are experiencing pain in your low back or side below your ribs, as well as feeling shaky and weak, you should not dismiss these signs. If you experience any of these symptoms, you should consult your doctor.
Urine Culture: Purpose, Results & What To Expect
A urine culture test examines a sample of urine for the presence of germs (microorganisms) that might cause illness. Urine is the liquid waste produced by your body (pee). Growing microorganisms such as bacteria and yeast in a laboratory setting is referred to as culture in medical terminology. A urine sample is supplemented with growth-promoting chemicals in a laboratory. If bacteria or yeast (a fungus) are present, they begin to reproduce and spread. An infection in your urinary system is indicated by the presence of this growth.
What is the purpose of a urine culture?
Urine cultures are ordered by healthcare professionals to screen for urinary tract infections (UTIs). A urinary tract infection (UTI) can arise when bacteria enter your urethra, which is the tube that transports urine from your body. UTIs are most commonly caused by bacteria in your bladder (the organ that holds urine). They have the potential to spread to your kidneys (the organs responsible for the production of urine) or your prostate. A urine culture test will also reveal the following:
- The bacteria or yeast that is causing the illness must be identified before your healthcare practitioner can choose the most appropriate therapy for you. It is also necessary to know whether the bacterium is resistant to antibiotics.
Who needs a urine culture?
If you have recurrent or difficult-to-treat urinary tract infections, your healthcare professional may recommend a urine culture test. In most cases, only those who are experiencing symptoms of a UTI require a urine culture. UTIs can affect people of either gender, although women are more likely than males to experience them. The following are risk factors for recurrent UTIs:
- Having diabetes
- Having frequent sexual relations, especially with new partners or if you use spermicides
- Having diabetes Kidney disease, particularly kidney stones, is a common occurrence. Problems with completely emptying your bladder, particularly if you use a urinary catheter to drain urine
- Due to autoimmune illnesses, organ transplantation, or cancer treatment procedures, the immune system has been weakened.
What is the difference between a urine culture test and urinalysis?
A urine sample is required for both a urinalysis and a urine culture. Aurinalysis may be performed first by your healthcare professional. In a shorter amount of time, this test checks urine for the presence of red and white blood cells, as well as bacteria, which can indicate the existence of an illness. A urinalysis will not be able to identify the precise bacterium that is causing the UTI. A urine culture is required to obtain this information.
Can a urine culture detect a sexually transmitted disease (STD)?
Historically, healthcare practitioners employed bacterial culture tests to identify sexually transmitted diseases (STDs) such as chlamydia and gonorrhea. This was not a urine culture test, as the name implies. Instead, healthcare practitioners cultivated (cultured) cells from within the urethra to test their effectiveness. The indications of these STDs may now be detected by the use of a urine test. However, when it comes to diagnosing an STD, healthcare experts tend to rely on more precise measures such as analyzing fluid from the vaginal or penis.
Can a urine culture detectE. coli?
A urine culture test can be used to identify the bacterium Escherichia coli (E. coli). The bacteria E. coli is the most common cause of urinary tract infections. E. colibacteria are bacteria that dwell in the digestive system and are discovered in human feces. If fecal matter makes its way from your anus to your vulva or penis, germs can enter your urethra and cause a urinary tract infection (UTI). Close to your anus is your vulva (the outside portion of your female genitals, which is where your vagina and urethra are located).
That is one of the reasons why women are more prone to urinary tract infections. Everyone, regardless of gender, should wipe their hands from front to back after using the bathroom in order to avoid this type of illness.
Can a urine culture detectStreptococcus(strep) infections?
Group B strep bacteria are a less prevalent cause of urinary tract infections (UTIs). These bacteria, which can be found in the urinary and digestive systems, can be detected using a urine culture. Group B strep is more likely to cause urinary tract infections (UTIs) in pregnant women. It is essential to treat the infection with antibiotics before to delivery. Preventing the transmission of microorganisms to a baby through treatment is important for pregnant women. Antibiotics are also required in the case of a strep B infection in a baby.
Before delivering a urine sample, your healthcare professional will inform you whether or not you need to take any particular precautions. Your healthcare practitioner may ask you to do one or more of the following:
- Please refrain from peeing for at least an hour before providing a urine sample. Ensure that you drink at least 8 ounces of water 20 minutes before the sample collection to ensure that there is enough urine for testing. First thing in the morning, collect a sample of your pee.
What happens during a urine culture?
A clean catch pee sample is required for a successful urine culture. In this context, a urine sample that is as devoid of external pollutants as possible, such as natural bacteria that dwell on your skin, is meant. You may choose to submit this sample in person at your healthcare provider’s office or at a laboratory testing center. In some cases, you may be able to collect the urine sample at your residence. The following are the steps:
- Hands should be washed with soap and warm water. To completely clean the opening of the urethra (including the vulva and vaginal region, as well as the head of the penis), use an antiseptic wipe. Allow a tiny bit of pee to flow into the toilet and then stop in the middle of it
- Remove the cup from beneath the vulva or penis and replace it before you continue peeing. Do not allow the cup to come into contact with your skin. Fill the cup halfway with pee to the required amount (usually 1 to 2 ounces). The majority of people finish peeing before they complete filling the cup. Stop urinating in the middle of the stream once more (if feasible) and keep the cup out of the way until you’re finished
- Deposit the cup on the ground, cover it with a lid (if one is supplied), and place it in the appropriate collecting location. Remember to wash your hands one more before continuing.
What are other ways to collect a urine sample?
A healthcare professional may utilize one of the following ways to treat newborns and young children, as well as people who are unwell, hospitalized, or elderly:
- It is necessary to catheterize your bladder in order to reach it. Your healthcare practitioner will place a catheter (a thin, flexible tube) via your urethra. A sterile collecting bag is placed over the catheter to catch the urine as it exits. When you have an aspiration, your healthcare professional inserts a small needle into your bladder through numbed abdomen skin in order to pull urine into a collecting bag. Urine collection bag (U bag): For babies and young children, you may want to place a urine collection bag on their penis or to their vulva with sticky glue to prevent them from peeing in their diaper. After your kid has urinated, you should dump their pee into a container with a lid. Preserve the container in the refrigerator until you deliver it to the office or lab of your healthcare practitioner.
How long does a urine culture take?
The process of providing a clean urine sample takes only a few minutes. Making a poop in the cup shouldn’t take long at all. Do take the time to clean your vulva or penis before you pee in order to guarantee a clean urine sample is collected during the test. After receiving your urine sample, the lab will grow the culture in an incubator for 24 to 48 hours before testing it. The temperature of the incubator is set at 98.6 degrees Fahrenheit, which is the typical temperature for the human body (37 degrees Celsius).
What are the risks of a urine culture?
The clean catch method is a fairly safe way to collect a urine sample from a patient. When using the catheter or needle approach, there is a small chance of contracting an infection.
Results and Follow-Up
In certain cases, the lab may take up to three days to perform the test and deliver the findings back to you. A phone call or an appointment will be scheduled with your healthcare professional in order to go through the results.
What does a positive urine culture test result mean?
If bacteria develop in the urine culture test and you are experiencing symptoms of infection or bladder discomfort, you most likely have a urinary tract infection (UTI). An abnormal test result or a positive urine culture test result are both possible outcomes. The bacteria in the cultivated sample are subjected to an antibiotic sensitivity test in the laboratory. This test, which is also known as an antibiotic susceptibility test, determines the type of bacteria that is causing the illness as well as which antibiotics the bacterium is susceptible to, which means which medications will kill or inhibit the bacteria.
Certain antibiotics are effective exclusively against specific microorganisms.
In addition, certain bacteria are resistant to antibiotics. This signifies that the antibiotic is no longer effective at preventing the growth of that particular species of bacteria. Infections that are resistant to antibiotics are more difficult to treat.
What does a negative urine culture test result mean?
It is possible to have a positive, or normal, urine culture test result if the urine sample did not contain any bacteria or yeast. You do not have a urinary tract infection. A lab’s typical test results range might vary based on the lab that is doing the test. If you continue to have symptoms such as painful urination (dysuria) or blood in the urine (hematuria), your healthcare practitioner may recommend imaging scans or other testing. These symptoms may be indicative of bladder cancer in certain cases, however this is extremely unusual.
What should I ask my healthcare provider?
You might wish to inquire with your service provider about the following:
- What is the purpose of a urine culture test
- Is it necessary for me to fast (that is, not eat or drink) or to cease smoking or taking medications before the test
- When will I receive the results of the tests
- Is it necessary for me to be concerned about the test findings
- Will I be required to take any extra tests? What can I do to avoid getting a UTI?
An announcement from the Cleveland Clinic A urine culture is performed in order to identify microorganisms that cause UTIs. If you have a urinary tract infection, an antibiotic sensitivity test might help you identify the bacterium that is causing it. This information assists your healthcare professional in selecting the most appropriate medication to treat your infection. Following therapy, a urine culture test may be performed to check that your infection has been eradicated. For the majority of people, a simple clean catch urine sample is all that is required by the lab for the test.
If you have a history of urinary tract infections, speak with your healthcare practitioner about actions you may take to reduce your risk of developing them.
Urinalysis – Mayo Clinic
A urinalysis is a test that is performed on your pee. Urinary tract infections, renal illness, and diabetes are just a few of the conditions for which it is used to diagnose and treat patients. A urinalysis is a procedure that involves examining the appearance, concentration, and content of urine samples. An infection of the urinary system, for example, might cause urine to appear hazy rather than clear. In certain cases, increased amounts of protein in the urine might indicate the presence of renal disease.
Why it’s done
A urinalysis is a frequent test that is performed for a variety of reasons, including:
- In order to assess your general health. It is possible that a urinalysis will be performed as part of a standard medical exam, pregnancy checkup, or pre-surgical preparation. When you’re admitted to a hospital, it may be used to screen for a number of problems, such as diabetes, renal disease, or liver disease
- Or it might be used to screen for a variety of disorders, such as cancer. In order to determine the existence of a medical problem. If you are experiencing stomach discomfort, back pain, frequent or painful urination, blood in your urine, or any other urinary issues, your doctor may recommend a urinalysis. A urinalysis can aid in the identification of the underlying cause of these signs and symptoms. In order to keep track of a medical condition. After being diagnosed with a medical problem, such as kidney disease or a urinary tract infection, your doctor may recommend testing your urine on a regular basis to keep track of your progress and treatment.
A urine sample may also be used for other tests such as pregnancy testing and drug screening, although these procedures check for compounds that aren’t detected by a standard urine analysis.
How you prepare
If you’re merely having a urinalysis, you can eat and drink as much as you like before the test. In the event that you are scheduled for further exams, you may be required to fast before the test. Specific instructions will be provided to you by your health-care professional. Many medicines, including over-the-counter pharmaceuticals and dietary supplements, might have an impact on the findings of a urinalysis. Inform your doctor about any drugs, vitamins, or other supplements you are taking before having a urinalysis performed.
What you can expect
You may choose to collect a urine sample at home or at the office of your health-care provider. Typically, providers hand out containers for collecting urine samples. It is possible that you may be requested to collect the sample at your residence first thing in the morning, when your pee will be at its most concentrated.
It is possible that you will be required to collect the sample in the middle of the process, utilizing a clean-catch approach. The following are the stages involved in this method:
- Cleanse the entry of the urine bladder. Women should spread their labia and clean from the front to the back of their bodies. Men should clean the tip of their penis with a damp cloth. start using the toilet and urinating into it Pass the collecting container into your urine stream
- This will help to prevent infection. Fill the collection container with at least 1 to 2 ounces (30 to 60 milliliters) of urine
- Complete your urination in the toilet
- Deliver the sample in accordance with the instructions provided by your health care practitioner. Refrigerate the sample if it cannot be delivered to the specified place within 60 minutes after its collection, unless your provider has instructed otherwise.
It may be necessary to put a thin, flexible tube (catheter) through the entrance of the urinary tract into the bladder in order to collect a urine sample in some instances. The urine sample is taken and forwarded to a laboratory for testing. You are free to resume to your normal activities right away.
An examination of your urine sample using three methods is performed during a urinalysis. These methods are: visual examination; dipstick examination; and microscopic examination.
The look of the urine is examined by a lab professional. Urine is usually clear in color. The presence of cloudiness or an odd odor may suggest the presence of a condition such as an infection. The presence of protein in urine might cause it to appear frothy. The presence of blood in the urine might cause it to appear red or brown. Urine color might be affected by what you’ve eaten recently as well as by some medications you’re taking. Beets and rhubarb, for example, may cause your urine to become crimson.
A dipstick — a small, plastic stick with chemical strips attached to it — is inserted into the urine sample. The color of the chemical strips changes if specific compounds are present or if their concentrations are higher than normal limits. A dipstick test looks for the following things:
- Acidity is a term used to describe the state of being acidic (pH). In urine, the pH level shows the quantity of acid present in the urine. In some cases, a high pH level might suggest a kidney or urinary tract disease
- Concentration The concentration of the particles in your urine may be determined by measuring the concentration of the particles. A greater than usual concentration is frequently caused by a lack of fluid intake
- Protein intake is also inadequate. Protein concentrations in urine are typically low. In most cases, small increases in protein in urine are not a cause for worry, but bigger quantities may signal a kidney disease
- Sugar. Most of the time, the amount of sugar (glucose) present in urine is insufficient to be identified. Following the finding of sugar on this test, it is common for follow-up testing for diabetes and ketones to be performed. Ketones found in your urine, like sugar, might be an indication of diabetes and necessitate more testing
- Bilirubin is one such test. Bilirubin is a byproduct of the destruction of red blood cells. Normally, bilirubin is transported via the bloodstream and into the liver, where it is excreted and absorbed as part of the bile. The presence of bilirubin in your urine might suggest liver damage or illness
- It could also be an indication of an infection. In your urine, the presence of nitrites or leukocyte esterase – a product of white blood cells — may suggest a urinary tract infection
- Blood may be present. Additional testing is required if you have blood in your urine. Symptoms of kidney damage or infection, kidney or bladder stones, kidney or bladder cancer, and blood abnormalities can all be seen with this condition.
This test, which is sometimes done as part of a urinalysis, involves looking via a microscope at droplets of concentrated pee — urine that has been spun in a machine — to look for signs of infection. If any of the following levels are much higher than typical, you may require further testing:
- The presence of white blood cells (leukocytes) may indicate the presence of an infection. If you have high levels of red blood cells (erythrocytes), it might indicate that you have renal illness. It could also indicate that you have a blood issue or some underlying medical condition such as bladder cancer. Infection is indicated by the presence of bacteria, yeast, or parasites. Casts, which are tube-shaped proteins, can develop as a result of renal disease. In some cases, crystals formed by chemicals in urine may be an indication of kidney stones.
A urinalysis by alone does not generally yield a definitive diagnosis in most cases. Depending on the reason your physician ordered this test, you may require follow-up if the findings are out of the ordinary. The findings of the urinalysis, in conjunction with the results of other tests, can assist your provider in determining the next steps. You should never assume that you are not sick just because you have normal test results from your urinalysis. It is possible that the sickness is detected too early, or that your urine is overly diluted.
Consult with your health-care practitioner for further information on the significance of your urinalysis findings.
Interpreting Culture Results – Part 1: Urinalysis and Urine Cultures
In clinical practice, interpreting culture data and laboratory testing has long been the bread and butter of the profession. Basic chemistry is pretty straightforward, and current lab result sheets include a convenient reference that displays the upper and lower limits of what is considered ‘normal’ readings as well as the higher and lower limits of what is considered abnormal. The interpretation of culture outcomes, on the other hand, is more difficult.
This series will cover the specifics of urine cultures, blood and bodily fluid cultures, as well as other types of cultures, including those used to treat wounds and treat respiratory infections. Let’s start with a discussion of urine cultures.
Interpreting Urine Cultures
Automated or reflex urine cultures are becoming increasingly widespread in clinical practice, particularly in the hospital or emergency room environment. Most hospital-based laboratories have parameters set up that, if satisfied, would automatically initiate a culture of a urine sample that seems to be contaminated with a bacterial infection. This is really beneficial for us as physicians because it allows us to guarantee that patients with UTI symptoms are treated with the proper medications.
What criteria should we use to assess whether this patient requires antibiotic treatment or not?
Automated or reflex urine cultures are fairly prevalent in clinical practice today, particularly in the hospital or emergency room setting.1 When a urine sample seems to be infectious, most hospital-based laboratories have parameters set up that, if fulfilled, will automatically initiate a culture of the sample. We can use this information to guarantee that patients with symptoms of UTI are treated with the most suitable antibiotics, which is extremely useful for physicians. If the patient does not exhibit any of the symptoms that would indicate UTI, what should be done in this case?
Now that we have a decent specimen, let’s talk about how to interpret the urinalysis results. The dipstick method, in which a test strip is dipped into a urine sample for a predetermined period of time and then either’read’ by a colorimetric machine or compared to a standardized chart that is included with the kit, is used to perform the vast majority of urinalysis tests. In this case, the pH, specific gravity, protein content, WBC count, and presence of Leukocyte Estrace and Nitrite will all be determined by the urine test results.
- All of these information can assist the attentive clinician in determining whether or not the patient is likely to have a urinary tract infection and whether or not a urine culture should be performed.
- Although leukocyte esterase is a consequence of the presence of white blood cells in the urine (pyuria), it does not always indicate the presence of an active urinary tract infection.
- In both men and women, the presence of nitrite in the urine is a far more reliable indicator of urinary tract infection.
- However, not all urinary bacteria do this, thus a negative nitrite test does not rule out the possibility of a UTI.
- The converse is true: drugs that can cause a red colour in the urine, such as AZO, Pyridium, and beets, can result in an incorrectly positive nitrite test result.
- Several possible problems must be addressed before to proceeding with the evaluation of the culture data.
- First and foremost, the presence of bacteria in the urine does not always imply active infection, particularly in the asymptomatic patient, as previously stated.
We won’t go into detail about these things here, but I want to make certain that they are included in your differential compensation.
To culture or not to culture?
What do you think? Do we need to culture the urine because we have a UA from a symptomatic patient that shows infection? Patients who have characteristic UTI symptoms without signs of pyelonephritis on physical examination, as well as those who have often recurring UTI, are unlikely to require a culture. However, if they have a history of recurring urinary tract infections (UTIs), or if they have UTIs that are difficult to cure and require numerous rounds of antibiotics, a culture is recommended.
Interpreting Culture Results
After the C S has returned, what should we make of it? After all, if you have properly picked the patients who will be subjected to culture, the findings should be straightforward. An recognized bacterial pathogen with 100,000 CFU/ml and a list of typical antibiotic treatments, as well as the capacity of those antibiotics to kill the pathogen and their sensitivity, should be available. Providing your patient with notice and adjusting their prescriptions should be sufficient if you have prescribed them an antibiotic that has demonstrated resistance.
In most cases, if a patient exhibits characteristic UTI symptoms, any culture that produces more than 10,000 CFU/ml of a pathogenic bacterium is adequate to diagnose the infection.
In addition, keep in mind that the patient may be suffering from an underlying sexually transmitted infection (STI), making a thorough history of the patient’s medical history essential.
Beyond the Automatic Reflex
Remember what I said earlier about the instinctive impulse to culture from hospital laboratories? Well, remember that bit too. Even if the patient has no particular urinary symptoms or complaints, what happens when you acquire a UA as part of a generic “abdominal discomfort” workup and the patient has 2+ WBC, is positive for leukocyte esterase and has 3+ Squamous epithelial cells? This is the type of sample that is usually used for automated culture and is regularly reflexed. As a result of your meticulous approach to the patient’s history and examination, as well as your interpretation of the UA, you have established that the patient does not have a UTI and that the sample in question is tainted.
coli, what should you do next in this situation?
As long as they are not experiencing any urine symptoms, are afebrile, and generally stable, this may indicate that the patient has a contaminant, and the patient may be encouraged to return for another urinary assessment.
However, if they have began to experience signs of a urinary tract infection, it is apparent that they should be treated with antibiotics.
Know the Nuances
The interpretation of laboratory findings, particularly urinalysis results, might appear to be straightforward. It is, however, a skill that must be mastered. It is critical to understand the intricacies of the tests and their results in order to treat your patient effectively and to act as an effective antibiotic steward for your patients. The use of a’shotgun’ approach to ordering laboratory tests does not encourage appropriate patient care or cost management, especially when treating patients who are not displaying any signs of illness.
In subsequent sections, we will explore blood cultures and wound cultures, as well as the appropriate applications and interpretations of these cultures.
Understanding urine tests
The interpretation of laboratory findings, particularly urinalysis results, might appear to be simple. It is, however, a skill that must be learned. For you to properly treat your patient and to be an effective antibiotic steward, it is critical that you understand the subtleties of the tests and their results. In order to provide optimal patient care and manage expenses efficiently, the’shotgun’ approach of ordering laboratory tests is not recommended, especially when treating asymptomatic patients.
The appropriate use and interpretation of blood cultures and wound cultures will be discussed in more detail in subsequent publications.
What do the characteristics of urine tell us?
The removal of urine is critical for the proper functioning of several body systems. When it comes to water regulation, for example, it also eliminates compounds that are created during metabolic processes but are no longer necessary for the body to function properly. Toxic compounds found in food or medication are examples of this. Tests on the urine can aid in the early detection of disorders of the urinary system, as well metabolic diseases such as diabetes and liver disease. The color, odor, and volume of pee in the urine can all suggest whether or not there is a problem.
Urine that is cloudy or flaky might indicate the presence of a urinary tract infection.
At order to learn more, the urine must be examined either with a test strip or in a laboratory.
Two of them can also be completed at home, however the other three must be completed in a laboratory setting.
How do you give a urine sample?
A sample of urine can be contaminated by germs, cells, and other contaminants, therefore it is a good idea to thoroughly clean the genital region with water – rather than soap – before providing the sample. The use of “clean” midstream urine is necessary in order to obtain an accurate result while avoiding bacterial contamination.
By stopping the flow of pee after a few seconds and then collecting the middle section of the urine in a cup, you may get a sample of midstream urine. When you go in for your specific test, your doctor will let you know if there is anything else you should be concerned about.
Rapid urine test
A fast pee test is the most efficient method of testing urine. A test strip with little square colored fields on it is dipped into the urine sample for a few seconds, and the results are read out loud. After then, you’ll have to wait a little while for the outcome to be revealed. The color of the fields on the test strip changes depending on the concentration of the specific chemical you are testing for at the time of the test. The colors of the fields are then compared to a color table to determine which is the most accurate.
- It demonstrates which colors correspond to normal and abnormal levels.
- It is common practice to do rapid urine tests as part of normal exams, such as those performed at a family doctor’s office, during prenatal visits, when a patient is being admitted to the hospital, or before to surgery.
- It is used by certain persons with diabetes to check their blood sugar levels.
- A prescription is not required for the test strips, which may be purchased at any pharmacy or over the internet.
What substances can a rapid urine test detect?
Due to the fact that several compounds are typically detected in only specific concentrations in urine, greater or lower levels indicate a divergence from the normal range. A quick urine test can be used to screen for the presence of the following substances:
- Acidity of the urine is measured by the PH value (pH value). According to diet, normal values vary from around 5 to 7
- Values under 5 are too acidic, whereas values above 7 are not acidic enough
- Normal values range from about 5 to 7
- Protein (which is seldom seen in urine)
- Sugar (glucose, which is not often detected in urine)
- Nitrite (which is not typically found in urine)
- Ketone (which is a metabolic product, which is not typically seen in urine)
- It contains bilirubin, which is a breakdown component of hemoglobin that is not normally detected in urine. Urobilinogen (a bilirubin breakdown product that is not typically seen in urine)
- Urobilinogen (a bilirubin breakdown product that is not usually found in urine)
- Red blood cells (erythrocytes), which are not often detected in urine
- White blood cells (leukocytes), which are also not typically seen in urine
- And platelets.
What do the results tell us?
If the findings are beyond the usual range, you can use the package insert or the color chart on the package to establish whether they are outside the normal range. In order to determine whether or whether there is an increased risk of producing urinary stones, the pH value, for example, can be measured. As a result, if the pH level is excessively acidic, this will occur (if the value is below 5). A pH level greater than 7 may indicate the presence of a bacterial urinary tract infection. Tests that measure other things can aid in the detection of additional problems:
- The presence of high protein levels may indicate the presence of nephritis (kidney inflammation). High blood sugar is indicated by the presence of ketones and sugar in the urine. The presence of leukocytes or nitrite may indicate the presence of a bacterial infection.
If the findings of the test are abnormal, you should consult with a doctor. The findings of quick urine tests are not always trustworthy, just as they are with other tests. As a result, it may be beneficial to have a more in-depth test performed in a laboratory.
Urinalysis is a first-line basic test that evaluates the key characteristics of the blood. It is routinely conducted when patients are admitted to the hospital or before surgery as part of a regular assessment and is also performed frequently while people are undergoing surgery.
It can also be used to check for aberrant findings after a fast urine test has been performed. In a laboratory, a complete urinalysis is performed. Typically, there are three phases involved:
- The color, cloudiness, and concentration of the urine are all evaluated. The chemical composition of the urine is determined by utilizing a test strip. Examination of the urine under a microscope for the presence of germs, cells, and cell fragments
Red blood cells (top), white blood cells (center), and a cast of clumped-together white blood cells (bottom) are shown under a microscope while examining the solid sections of urine (below). Urinalysis is used to determine the source of – or to monitor – urinary tract infections, urinary system hemorrhage, kidney or liver illness, and other conditions. It can also be used to treat diabetes, some blood illnesses, and bladder stones, among other things.
What does urinalysis test for?
An urinalysis, in addition to testing for the chemicals that may be identified with a quick test, can additionally check for the following things:
- It contains creatinine, a breakdown product of muscle metabolism that serves as a sign of renal function. Bacteria (which is unusually common in urine)
- Urinary casts (cylindrical, stuck-together structures that form in the renal tubules and are not frequently seen in urine)
- Urinary casts (cylindrical, stuck-together structures that form in the urinary bladder)
- In urine, crystals are observed if there are significant quantities of particular compounds in the urine
- Crystals are not normally found in urine. ureteric epithelial cells (cells that line the ureter, bladder, and urethra)
- Urethral epithelial cells
What do the results tell us?
Aurinalysis can also be used to detect symptoms of other disorders, such as those associated with diabetes and kidney disease.
- High quantities of cholesterol in the urine, for example, might result in the formation of cholesterol crystals. urinary casts are often indicative of kidney illness, such as an inflammation of the renal pelvis
- However, they can also be an indication of other conditions.
An abnormal result may necessitate further discussion with a doctor, who may then order more specific testing, such as a blood test.
A urine culture is a test that is performed in a laboratory to determine whether or not urine contains microorganisms. A sample of midstream pee is collected and placed in a collection container. In order for the germs to develop, little plates containing a growth medium that allows them to do so are placed into the sample and the container is carefully closed. The urine culture is then put in an incubator for one to two days to allow the bacteria to grow. There might be visible colonies formed in the urine if there are bacteria or fungus present.
When placed in an incubator for two to four days, they become apparent.
What can urine cultures test for?
Urine cultures can be performed to determine whether or not there are bacteria or fungus present in the urine. Because of the size, shape, and color of the colonies, you can frequently tell what sort of bacteria or fungi they are before you even see them. This is because bacteria and fungi are classified according to their size, shape, and color.
What do the results tell us?
When testing for a urinary tract infection, urine cultures are typically performed to identify bacteria and fungus present in the urine. The type of antibiotic to be used is typically established at the same time as the presence of bacteria is discovered through laboratory examination.
24-hour urine collection
It is necessary to collect urine during a 24-hour period for this examination: The initial pee sample taken after waking up is not utilized, but the time at which the sample was taken is recorded. For the following 24 hours, every single drop of pee is collected in a container and disposed of appropriately. Once the 24-hour period has expired, you should empty your bladder one more time, and the pee will be added to the sample that has already been collected. The container for the urine sample will be given to you by your doctor.
While the urine is still being collected, the container is generally already contaminated with a chemical that prevents germs from developing in it. A refrigerator is recommended for the whole 24-hour period in which the urine is to be stored. After that, it is put through its paces in a laboratory.
What can be tested with a 24-hour urine sample?
It is possible to determine the quantity of specific compounds (such as proteins, hormones, salts, and metabolic products) expelled from the body using 24-hour urine samples.
What do the results tell us?
The results of the test can tell us a variety of things, such as how much protein and creatinine is in the urine. If the kidneys are filtering out too little of the metabolic product creatinine from the bloodstream, this indicates that the kidneys are not functioning correctly. Proteinuria, a disorder characterized by high amounts of protein in urine, can be caused by a variety of illnesses including heart failure, diabetes, inflammation of the renal pelvis, urinary tract infections, kidney disease, and kidney cancer.
In order to identify those problems, urine is frequently collected over a 24-hour period over a number of days and then analyzed for the presence of those disorders.
A variety of tests are available to determine whether or not you are pregnant if your menstrual cycle is late. However, they are not completely dependable. The majority of tests can already tell whether or not a woman is pregnant eight to ten days after her period is scheduled to arrive. They are typically performed in the morning after waking up, much as quick urine tests, and require a urine sample to be collected. The packaging insert has detailed instructions on how to use the product. Pregnancy tests are available for purchase in pharmacies, drugstores, department shops, and on the internet, among other places.
What can be checked with a pregnancy test?
This particular hormone called human chorionic gonadotropin (hCG) is found in the urine of pregnant women because it is created in the placenta.
What do the results tell us?
Many women who are interested in learning whether or not they are pregnant may first perform a pregnancy test. If a woman performs the test too soon, if she is taking medication, or if she drinks a lot of fluids before performing the test, the findings may be inaccurate. Only a doctor can determine with certainty whether or not you are pregnant.
Other urine tests
Drugs can also be identified in urine for a period of time after they have been consumed. Cannabis can be identified up to many weeks after it has been used, depending on the type of test performed. Drugs such as cocaine, ecstasy, and heroin can be detected in test results for up to five days after use. There are a variety of tests that may be utilized in this situation as well: Rapid testing can provide police with findings on the spot, whereas conventional drug tests must be forwarded to a laboratory for analysis.
- Andreae S, Avelini P, Berg M, Blank I, Burk A. Lexikon der Krankheiten und Untersuchungen. Lexikon der Krankheiten und Untersuchungen. Thieme Publishing Company, Stuttgart, 2008
- Pschyrembel, Klinisches Wörterbuch. De Gruyter, Berlin, Germany, 2017. Working Conditions and Diagnosis by Thomas L. Identification and evaluation of laboratory findings in the context of medical diagnosis 2007
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