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Urinalysis

The urinalysis is the most important initial study in the evaluation of the patient suspected of having a UTI. A negative urinalysis makes the diagnosis of UTI unlikely. A simple midstream sample voided into a sterile container is sufficient and the more difficult and elaborate clean-caught midstream urine has not been found to be superior.



If the urine sample cannot be examined within 10 -15 minutes of obtaining it, it must be refrigerated. Uncentrifuged urine can be examined with a microscope (immersion lens) under a cover slip. The finding of bacteria by this method has a 90% correlation with the culture of >
1 million bacteria/ mL. In women the finding of greater than 7 white cells per high power field is suggestive of infection while the absence of this finding makes this diagnosis unlikely. In men the presence of any number of white cells should be considered
abnormal. If urine has been centrifuged, pyuria is significant only if there are more than ten white cells per high power field. The presence of white cell casts in centrifuged urine is an important indicator of pyelonephritis.


Simple midstream sample into a clean container is sufficient More than 7 WBC/ high power field is diagnostic Any number of WBC in men is significant WBC casts suggest pyelonephritis




Comments

dada, India

for urinary problem which doctor shall I contact Medicine or Urologist

kkgrg, India

I have UTI generally recurring. Last time I had around a years back and got treated with Ofloxacin for about 15 days. Today I am suffering for very frequent urination with sensation and unable to control. Kindly suggest some medicine.

lovetoread, United States

First UTI in over 10 yrs. Unfortunately I've had over a month of UTI symptoms. The first two urine specimens were [ ] for blood, WBC, and bacteria but were NEVER cultured. I went through two different rounds of antibiotics. Symptoms still there. My doctors were saying obviously it isn't an UTI, that it must be stress or something else. We'll finally after suffering a month, the next urine sample WAS cultured and it came back I have coagulase negative staph. And get this, the bacteria is resistant to most antibiotics, including penicillin, Levaquin, Sulfa, and Cipro. I'm not so sure not culturing a positive urine sample is such a great idea. I know I have greatly suffered. I'm now on macrobid and hoping this will take care of it.

Anglkitty77, United States

I have a recalled bladder sling and I have been having recurring UTI synptoms. Nitrites and leukocytes are always present, but cultures grow nothing. I am at a loss and so is my Dr. I am seeing a specialist at Vanderbilt and he is removing the sling in a couple of weeks. Anyone else have this issue?

edouartawil, Palestinian Territory, Occupied

i have found that UTIs with no symptoms should not be treated especially if they have ESBL or KPC.
A well known case ESBL to me I stoped treating her with antibiotics works now well for more than 8 months

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