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Which Lab Test Can Detect Urinary Tract infections?

Urinary tract infections (UTIs) are a common and frequently painful illness that requires proper identification and diagnosis for appropriate treatment. Laboratory tests, particularly a urinary health panel that includes urinalysis and urine culture, are critical in determining the presence of bacteria or other pathogens in the urinary tract. These tests allow healthcare practitioners to determine the exact source of the infection, allowing for focused therapy that not only relieves symptoms but also lowers the chance of recurrence and urinary system damage.

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Urinary tract infections (UTIs) are a common, frequently unpleasant illness that affects millions of individuals each year. Detecting and precisely diagnosing UTIs is critical for successful treatment and avoiding consequences. Laboratory tests are essential in this procedure because they give clear proof of the presence of bacteria or other pathogens in the urinary system.

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Lab testing allows doctors to administer the most suitable medications and treat the disease more successfully since they determine the particular source of the infection. This not only relieves symptoms, but also lowers the chance of recurring infections and urinary system damage. In this setting, knowing which lab tests can identify UTIs is critical for prompt diagnosis and appropriate patient management.

Urinary Health Panel

A urinary health panel, which comprises urine analysis and urine culture, can diagnose urinary tract infections (UTIs) using the following techniques:

Physical Examination

Color

Urine’s hue typically ranges from pale yellow to deep amber, depending on the proportion of a pigment known as urochrome. Abnormal hues might signify a variety of problems.1

  • Clear or extremely pale yellow: This might suggest overhydration.
  • Dark yellow or amber may indicate dehydration.
  • Red or pink might be the result of blood (hematuria), specific meals (such as beets), or drugs.
  • Brown or cola-colored urine may suggest liver disease or the presence of ancient blood.
Clarity or Transparency

Urine tends to be clear. Cloudiness or turbidity may indicate a urinary tract infection, the presence of crystals (as in kidney stones), or other underlying problems.2

Odor

Normal urine has a moderate, somewhat ammonia-like odor. A strong or distinctive odor may suggest an illness or the presence of certain chemicals in the diet or drugs. For example, a sweet or fruity odor may indicate diabetes, but a nasty stench may indicate a bacterial illness.

Specific Gravity

It evaluates the concentration of solutes in the urine. High specific gravity suggests concentrated urine, which might result from dehydration. Low specific gravity indicates dilute urine, which can occur in diabetes insipidus or excessive fluid intake.

Chemical Examination

A test strip (dipstick) is used in the chemical examination portion of urinalysis to assess various chemical components of the urine. The dipstick contains various reagent pads that change color when they come into touch with certain chemicals. The primary parameters assessed during the chemical examination are:

pH

The urine’s acidity or alkalinity is tested. Normal urine pH levels vary from 4.5 to 8. A high pH (alkaline urine) may be related with urinary tract infections, kidney stones, or a vegetarian diet.34 A low pH (acidic urine) might suggest diabetes, diarrhea, or malnutrition.5

Protein

Normally, the urine should include little to no protein. Proteinuria may suggest renal injury or illness, excessive blood pressure, or other disorders.

Glucose

Glucose is often not found in urine. Its presence (glycosuria) may suggest diabetes or other illnesses causing high blood sugar levels.

Ketones

Ketones are a consequence of fat metabolism. They are seldom seen in urine, but can be present in circumstances such as diabetes (ketoacidosis), malnutrition, or a low-carbohydrate diet.

Blood (Hemoglobin)

The presence of blood or hemoglobin in urine (hematuria) might indicate urinary tract infections, kidney stones, kidney disease, or other conditions.

Bilirubin

Bilirubin is the breakdown product of red blood cells. Its presence in urine may suggest liver disease or bile duct blockage.

Urobilinogen

This is a result of bilirubin metabolism in the intestines. Normal levels vary, but excessive amounts may indicate liver disease or hemolytic anemia.

Nitrites

Some bacteria that cause urinary tract infections can convert nitrates (naturally occurring in urine) to nitrites. Thus, the presence of nitrites may suggest a bacterial infection.6

Leukocyte esterase

This enzyme is generated by white blood cells (leukocytes). Its presence in urine may suggest an inflammatory reaction to an infection or other disorders in the urinary system.

Microscopic Examination

Red Blood Cells (RBCs)

The presence of red blood cells in urine (hematuria) can suggest urinary tract infections, kidney stones, glomerulonephritis, or urinary tract trauma. A few RBCs are typical, but a large number warrants additional research.

White Blood Cells (WBCs)

The presence of white blood cells (WBCs) in urine (pyuria) indicates an inflammatory reaction, which is frequently caused by an illness such as a urinary tract or kidney infection. It may also signify various inflammatory disorders of the kidneys or urinary system.

Epithelial Cells

These cells line the urinary system. Finding squamous epithelial cells is generally normal, but a large number may suggest sample contamination. If there are a lot of transitional epithelial cells in the bladder or renal tubular epithelial cells in the kidneys, it might signal something is wrong.

Bacteria

The presence of bacteria in urine indicates a urinary tract infection. However, this discovery should be correlated with symptoms and other test findings, as bacteria might be present owing to sample contamination.

Yeast

Yeast cells in the urine may suggest a yeast infection, such as Candida albicans, particularly in people with diabetes or who are immunocompromised.

Crystals

Depending on the pH and concentration of specific compounds, urine can form a variety of crystals. Some crystals are benign, while others, such as calcium oxalate or uric acid crystals, may suggest a risk of kidney stones.

Casts

These cylindrical structures are generated in the kidney tubules and can be constructed of a variety of components, such as cells, protein, or other substances. The existence and kind of casts (e.g., hyaline, granular, cellular) might indicate kidney health and prospective illnesses.

Microscopic examination is an important part of urinalysis because it gives extra information for diagnosing and monitoring various renal and urinary tract diseases.

A urine culture is a diagnostic test that detects and identifies the presence of bacteria or fungus in urine, which can lead to urinary tract infections. The test begins with the collection of a clean-catch midstream urine sample to reduce contamination from the skin and external genitalia. The urine is then put into a culture medium that contains the nutrients required for bacteria development. The inoculation plates are incubated for 24-48 hours at a temperature that promotes bacterial growth, usually between 35-37°C (95-98.6°F).

Following incubation, the plates are checked for the presence of bacterial colonies. A bacterial count of ≥10^5 colony-forming units (CFUs) per milliliter of urine indicates a urinary tract infection.7 However, in some therapeutic conditions or in symptomatic persons, even low numbers may be deemed relevant. Once considerable bacterial growth is established, further tests are performed to determine the type of bacteria or fungus causing the infection. Furthermore, sensitivity testing, also known as an antibiogram, is used to detect which antibiotics the bacteria are sensitive to. This information is critical in determining the most appropriate antibiotic medication for the patient.

Conclusion

Urinary tract infections (UTIs) may be precisely identified using several laboratory procedures, with urinalysis and urine culture being the most prevalent and dependable approaches. These tests detect bacteria, white blood cells, and other infection signs, aiding healthcare practitioners in diagnosing and treating UTIs efficiently. Timely identification and proper treatment are essential to avoid problems and promote a quick recovery.

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Lab Testing - Frequently Asked Questions

Why is it important to do lab tests occasionally?

It is important to do lab tests occasionally because they can provide valuable information about an individual's health and help to identify potential health issues early on. Lab tests can measure a wide range of factors, including blood count, cholesterol levels, liver and kidney function, and hormone levels, and can provide insight into an individual's overall health and wellness. Additionally, lab tests can help to diagnose and monitor the progression of certain medical conditions, such as diabetes and heart disease, and can help to identify any potential health risks or concerns. By doing lab tests occasionally, individuals can take proactive steps to maintain their health and wellbeing and reduce the risk of potential health problems in the future.

What does a routine blood test cover?

A routine blood test is used to check for a range of things, including your blood count and the levels of certain chemicals and substances in your blood. Blood tests can also be used to check how well certain organs, such as your liver and kidneys, are functioning.

How is a blood sample collected for lab testing?

A blood sample for lab testing is typically collected through a process called venipuncture, which involves inserting a small needle into a vein to draw blood. This is usually done on the inside of the elbow or the back of the hand.

What is the cost of a lab test?

In general, the cost of a lab test can range from a few dollars to several hundred dollars. It is always best to consult with your doctor or healthcare provider to get an accurate estimate of the cost of a lab test.

Read More: Lab Testing FAQ

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

[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.;

[6] 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.;

[7] Hay AD, Birnie K, Busby J, et al.; on behalf of the DUTY team. The Diagnosis of Urinary Tract infection in Young children (DUTY): a diagnostic prospective observational study to derive and validate a clinical algorithm for the diagnosis of urinary tract infection in children presenting to primary care with an acute illness. Southampton (UK): NIHR Journals Library; 2016 Jul. (Health Technology Assessment, No. 20.51.) Chapter 4, Microbiological diagnosis of urinary tract infection by NHS and research laboratories. Available from: https://www.ncbi.nlm.nih.gov/books/NBK373515/;