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Lab Test That Can Detect Urinary Tract Infections

Urinary tract infections (UTIs) are very common and often hurt. To get the right treatment, it’s important to be able to correctly identify and diagnose the infection. To find out if there are bacteria or other pathogens in the urinary stream, it is very important to do lab tests, especially a urinary health panel that includes urinalysis and urine culture. These tests help doctors figure out where the infection is coming from, which lets them focus on treatment that not only eases symptoms but also lowers the risk of return and damage to the urinary system.

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Urinary tract infections (UTIs) impact millions of people annually and are often painful. UTI therapy and prevention depend on accurate diagnosis. These tests are necessary to confirm the presence of bacteria or other pathogens in the urinary system. Since lab testing pinpoints the infection site, doctors can prescribe the best drugs and treat the sickness more effectively. This soothes symptoms and reduces infection and urinary system damage.

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Urinary Health Panel

UTIs can be diagnosed using urinalysis and urine culture in a urinary health panel:

Urine Analysis (Urinalysis)

In the chemical analysis part of urinalysis, a test strip (dipstick) is used to look at different chemical parts of the urine. There are different reagent pads on the tester that change color when they meet certain chemicals. During the chemistry analysis, the main factors that are looked at are:

Color

The color of urine can be anywhere from pale yellow to deep brown, based on how much urochrome is present. Different colors could mean a number of different problems.1

  • Clear or very pale yellow: This could mean that you are drinking too much water.
  • Dehydration may be indicated by dark yellow or orange urine.
  • Red or pink urine could be caused by blood (hematuria), certain foods (like beets), or drugs.
  • If your urine is brown or cola-colored, it could mean you have liver disease or old blood in your system.
Clarity or Transparency

Most of the time, urine is clear. If your urine is cloudy or thick, it could mean you have an infection in your urinary system, crystals (like in kidney stones), or another problem.2

Clarity or Transparency

Normal urine has a mild smell that is similar to ammonia. A strong or unique smell could be a sign of sickness or the presence of certain chemicals in food or medicine. A sweet or fruity smell, for instance, could mean that someone has diabetes, while a bad smell could mean that someone has a bacterial disease.

Specific Gravity

The amount of solutes in the urine is measured and a high specific gravity means that the urine is concentrated, which could be a sign of being dehydrated. Low specific gravity means that the urine is watery, which can happen if you have “diabetes insipidus” or drink too much water.

pH

It is checked to see how acidic or basic the urine is. The pH range of normal urine is between 4.5 and 8.3 Urine that has a high pH (alkaline) may be linked to kidney stones, urinary tract infections, or a meatless diet.4 Urine with a low pH (acidic) could be a sign of diabetes, diarrhea, or not getting enough food.5

Protein

Usually, there shouldn’t be much or any protein in urine. It’s possible that proteinuria is a sign of kidney damage or sickness, high blood pressure, or another problem.

Glucose

A lot of the time, glucose is not in urine. If you have glycosuria, it could mean you have diabetes or another illness that causes your blood sugar to be too high.

Ketones

The breakdown of fat leads to ketones. They aren’t often found in urine, but they can be if someone has diabetes (ketoacidosis), isn’t getting enough food, or is on a low-carbohydrate diet.

Blood (Hemoglobin)

Hematuria, or blood or hemoglobin in the urine, could be a sign of kidney disease, urinary tract diseases, or other health problems.

Bilirubin

Bilirubin is what is left over when red blood cells break down. Its appearance in urine could mean liver disease or that a bile duct is blocked.

Urobilinogen

This happens because of how bilirubin is broken down in the stomach. Different numbers are considered normal, but too much can be a sign of liver disease or hemolytic anemia.

Nitrites

Some bacteria that cause urinary tract illnesses can change nitrates, which are found naturally in urine, into nitrites. Nitrites may be a sign of a bacterial illness because of this.7

Leukocyte esterase

White blood cells, called leukocytes, make this enzyme. Its appearance in urine could mean that the body is reacting with inflammation to an infection or other problems in the urinary system.

Red Blood Cells (RBCs)

Hematuria, or red blood cells in the urine, can be a sign of an infection in the urinary tract, kidney stones, glomerulonephritis, or damage to the urinary tract. A small number of RBCs is normal, but a big number needs more study.

White Blood Cells (WBCs)

When white blood cells (WBCs) are found in urine it is called pyuria.8 It means that there is an inflammatory response, which is usually caused by an illness like a urinary tract or kidney infection. It could also mean a number of inflammation conditions affecting the kidneys or urine system.

Epithelial Cells

These cells line the tubes that carry urine. It is normal to find squamous epithelial cells, but a lot of them could mean that the sample is contaminated. You might know something is wrong if there are a lot of intermediate epithelial cells in the bladder or renal tubular epithelial cells in the kidneys.

Bacteria

If you have bacteria in your urine, you probably have an infection in your system. That being said, this finding should be linked to symptoms and other test results, since germs could be present because the sample was tainted.

Yeast

If you have yeast cells in your urine, it could mean you have a yeast infection like Candida albicans. This is especially true for people with diabetes or weak immune systems.

Crystals

Urine can form a variety of crystals depending on its pH level and the amount of certain chemicals in it. Crystals of some types, like calcium oxalate or uric acid, are harmless, but they may be a sign that you might get kidney stones.

Casts

These cylinder-shaped structures are made in the kidney tubules and can be made of different things, like cells, protein, or other substances. The presence and type of casts (such as hyaline, grainy, or cellular) may show how healthy the kidneys are or if they might get sick.

Urine Culture

UTIs can be caused by bacteria or fungus that are found in urine. A urine culture is a diagnostic test that finds and names these organisms. To keep the sample from being contaminated by skin and external genitalia, the test starts with a clean-catch middle urine sample. After that, the urine is put into a growth medium that has the nutrients bacteria need to grow. The inoculation plates are kept warm for 24 to 48 hours at a setting that helps bacteria grow, which is generally between 95 and 98.6°F (35 and 37°C).

After the plates have been incubated, they are looked at to see if there are any bacterial colonies. A urinary tract infection is present when there are at least 10^5 colony-forming units (CFUs) of bacteria per milliliter of urine. But in some healing situations or with people who are having symptoms, even low numbers may be important. Once there is a lot of bacterial growth, more tests are done to find out what kind of bacteria or fungus is causing the problem. Also, an antibiogram, which is another name for sensitivity tests, is used to find out which drugs the bacteria are not resistant to.

Final Thoughts

UTIs may be diagnosed using numerous laboratory methods, although urinalysis and urine culture are the most common and reliable. These tests identify bacteria, white blood cells, and other infection indicators, helping doctors diagnose and treat UTIs. To avoid issues and speed healing, early detection and treatment are crucial.

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References

[1] Raymond JR, Yarger WE. Abnormal urine color: differential diagnosis. South Med J. 1988 Jul;81(7):837-41. doi: 10.1097/00007611-198807000-00008. PMID: 3393939.

[2] Gadalla AAH, Friberg IM, Kift-Morgan A, Zhang J, Eberl M, Topley N, Weeks I, Cuff S, Wootton M, Gal M, Parekh G, Davis P, Gregory C, Hood K, Hughes K, Butler C, Francis NA. Identification of clinical and urine biomarkers for uncomplicated urinary tract infection using machine learning algorithms. Sci Rep. 2019 Dec 23;9(1):19694. doi: 10.1038/s41598-019-55523-x. PMID: 31873085; PMCID: PMC6928162.

[3] Yıldırım İ, Koçan H. The pH of Drinking Water and Its Effect on the pH of Urine. Cureus. 2023 Oct 21;15(10):e47437. doi: 10.7759/cureus.47437. PMID: 38022142; PMCID: PMC10659234.

[4] Wattengel BA, Schroeck J, DiTursi S, Sellick JA, Mergenhagen KA. 1466. Alkaline Urine: A Cause for Urinary Tract Infection Recurrence. Open Forum Infect Dis. 2019 Oct 23;6(Suppl 2):S535. doi: 10.1093/ofid/ofz360.1330. PMCID: PMC6809364.

[5] Maalouf NM, Cameron MA, Moe OW, Sakhaee K. Metabolic basis for low urine pH in type 2 diabetes. Clin J Am Soc Nephrol. 2010 Jul;5(7):1277-81. doi: 10.2215/CJN.08331109. Epub 2010 Apr 22. PMID: 20413437; PMCID: PMC2893060.

[7] Lundberg JO, Carlsson S, Engstrand L, Morcos E, Wiklund NP, Weitzberg E. Urinary nitrite: more than a marker of infection. Urology. 1997 Aug;50(2):189-91. doi: 10.1016/S0090-4295(97)00257-4. PMID: 9255286.

[8] Kuo IC, Lee JJ, Hwang DY, Lim LM, Lin HY, Hwang SJ, Chen HC, Hung CC. Pyuria, urinary tract infection and renal outcome in patients with chronic kidney disease stage 3-5. Sci Rep. 2020 Nov 10;10(1):19460. doi: 10.1038/s41598-020-76520-5. PMID: 33173137; PMCID: PMC7655801.



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