Assessment And Diagnostic Findings
Results of various tests help confirm the diagnosis of UTI.
- Urine cultures. Urine cultures are useful in identifying the organism present and are the definitive diagnostic test for UTI.
- STD tests. Tests for STDs may be performed because there are UTIs transmitted sexually.
- CT scan. A CT scan may detect pyelonephritis or abscesses.
- Ultrasonography. Ultrasound is extremely sensitive for detecting obstruction, abscesses, tumors, and cysts.
Combinations Of Tests From Different Categories
Nine studies including a total of 14 data sets examined the accuracy of different combinations of microscopy and dipstick tests for the diagnosis of UTI . Given the results of individual tests, the test combination that appears to be potentially the most interesting is dipstick for LE and nitrite, and microscopy for pyuria and bacteriuria. Five studies investigated different permutations of these tests. Three studies evaluated the accuracy of a positive result in one of these four tests . The results varied considerably between studies with positive likelihood ratios ranging from 0.8 to 35.9, and negative likelihood ratios ranging from 0.01 to 5.38. It is therefore not possible to draw overall conclusions from these studies. One study examined the combination of a positive result for all four tests . This study reported a very high positive likelihood ratio i.e. the combination was found to be very good for ruling in disease, but the negative likelihood ratio was less good at 0.28. These results might be expected given the results from the studies that examined combinations of dipstick tests, or combinations of microscopy tests.
As most test combinations were only evaluated by one study and the definition of a positive test varied for the tests investigated by more than one study, it was not possible to draw conclusions regarding the diagnostic accuracy of these test combinations.
My Dog Suddenly Started Asking To Go Outside Very Frequently A Sample Of Urine Revealed A Bladder Infection How Did This Happen
Urinary tract infections are fairly common in dogs. Dogs with UTIs generally attempt to urinate very frequently whenever they go outside. They also may strain to urinate, or cry out or whine when urinating if it is painful. Sometimes you might even see blood in their urine. Dripping urine, or frequent licking of the genitals, may also signal that a UTI is present. Urine that has a very strong odor to it can also be a sign that your dog has an infection.
“A break in housetraining is a red flag that something is wrong in the bladder.”
A break in housetraining is a red flag that something is wrong in the bladder. If this should happen to your previous well-mannered dog, a UTI may be to blame.
Generally, a UTI occurs when bacteria travels up the urethra and into the bladder. Urine in the bladder is supposed to be sterile, but once bacteria find their way there, they can grow and reproduce, causing a UTI. Additionally, some dogs will develop bladder stones in conjunction with their UTI, which opens the door for additional health issues.
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Can Men Develop A Urinary Tract Infection
Yes, although they are rare in men under 50 years of age. Men are less likely than women to develop a UTI because the male urinary tract has more natural defenses to infection, such as a longer urethra and further distance between the urethra and the anus.
For this reason, urinary tract infections in men are more likely to be due to a medical cause or an anatomical predisposition to UTIs.{^33]
What Is A Urinary Tract Infection
A urinary tract infection is an infection of the urinary system. This type of infection can involve your urethra , kidneys or bladder, .
Your urine typically doesnt contain bacteria . Urine is a byproduct of our filtration systemthe kidneys. When waste products and excess water is removed from your blood by the kidneys, urine is created. Normally, urine moves through your urinary system without any contamination. However, bacteria can get into the urinary system from outside of the body, causing problems like infection and inflammation. This is a urinary tract infection .
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How Are Kidney Infections Treated
A physician will treat the disease based on his or her examination. He or she may start the patient on the standard treatment of a course of antibiotics before the lab tests results are available. The medication may change once the exact strain of bacteria is revealed by the lab tests.
If the treatment is effective, the patient should feel better in two to three days. If not, your healthcare provider will start looking for additional problems. Most antibiotic treatments last for 14 days and it is essential that patients take the pills as recommended for the full 14 days even though symptoms may disappear after a few days. The disappearance of symptoms does not mean all bacteria are killed. Some may remain and the infection may reappear.
There is also a concern that those bacteria that remain may develop resistance to the medication. For some reason the disease is more difficult to treat in men and they may have to take medication for up to six weeks. Patients with severe illness, those that have significant nausea and vomiting, high fevers, significant pain and signs of dehydration may be hospitalized for a few days while the antibiotics are administered intravenously. Urine samples are taken after about six weeks of treatment and examined to insure the bacterial infection is eradicated.
How Are You Tested And Screened For A Uti
If you are experiencing symptoms like painful urination or a frequent urge to use the bathroom, you might be headed toward a UTI diagnosis. To find out for sure, youll need to have a healthcare professional, like your general practitioner, test your urine for both bacteria and other components that could indicate a urinary tract infection. When diagnosing a UTI, a urine test should be standard protocol. That, however, is not always the case. In fact, less than one in five patients treated for a UTI actually has a laboratory urine test to diagnose their problem, according to 2019 study in the journal E Clinical Medicine.30120-8/fulltext” rel=”nofollow”> 2)
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Does Cranberry Juice Prevent A Urinary Tract Infection
Many people say that cranberry juice can help treat, or even prevent, a UTI. Researchers are currently looking into the topic, but havent found a definitive answer yet. Healthcare providers recommend drinking lots of fluids if you have, or have a history of getting, a UTI. Adding a glass of unsweetened cranberry juice to your diet isnt a proven way to prevent a UTI, but it typically wont hurt you either.
How A Urinalysis Is Done
In most cases, urine is collected in a clean container, then a small plastic strip that has patches of chemicals on it is placed in the urine. The patches change color to indicate things like the presence of white blood cells or glucose.
Next, the doctor or laboratory technologist also usually examines the same urine sample under a microscope to check for other substances that indicate different conditions.
If the dipstick test or the microscopic test shows white blood cells, red blood cells, or bacteria , the doctor may send the urine to a lab for a urine culture to identify the bacteria that may be causing the infection.
Getting a urine sample. It can be difficult to get urine samples from kids to test for a possible infection. That’s because the skin around the urinary opening normally is home to some of the same bacteria that cause UTIs. If these bacteria contaminate the urine, the doctors might not be able to use the sample to tell if there is a true infection or not.
To avoid this, the skin surrounding the urinary opening has to be cleaned and rinsed immediately before the urine is collected. In this “clean-catch” method, the patient cleans the skin, the child then urinates, stops momentarily , then urinates again into the collection container. Catching the urine in “midstream” is the goal.
If you have any questions about urine tests, talk with your doctor.
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Preventing Urinary Tract Infections
Urinary tract infections are most often caused by bacteria spreading from the anal or genital region and entering the urinary tract. Because of this, there are a number of preventative methods that can minimize the risk of experiencing a UTI:
- Regular urination
- Emptying the bladder after sexual intercourse
- Drinking lots of water, ideally at least 1.5 liters a day. Avoid alcohol and caffeine, which can irritate the bladder
- Wiping from front to back after using the toilet to avoid spreading bacteria from the anal region
- Maintaining good personal hygiene and keeping the genital area clean and dry
- Taking showers instead of baths
What Do Uti Strip Colors Mean
There are several over-the-counter UTI dipstick tests available, and they work much like youd expect: Youre instructed to offer a clean-catch urine sample by holding the provided test strip in your urine stream for a few seconds. After a short wait, the color of the test strip changes to indicate the presence of a possible infection. To ensure the most accurate reading possible, use the test right after you wake up, with urine thats been in your bladder overnight.
While some OTC UTI tests screen for just nitrites , other tests analyze leukocytes , as well. And still others add a pH-level screener, too. This means that for many UTI tests, you will need to look at more than one test pad on a single strip and those results appear at varying times. For instance, your nitrite results may appear a full minute before leukocytes show. Once all results are in, youll need to closely compare the test pads with corresponding color blocks that appear on an included chart. You might notice, for example, that the nitrites box went from white to pink. That means nitrites have been detected, which suggests that you may have a UTI.
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What Is The Treatment For A Uti
A UTI is most often treated with a round of antibiotics. The type of antibiotic prescribed can vary according to what kind of bacteria you are fighting off, your medical history, and whether or not your UTI has been recurrent. If you continue to have frequent UTIs, you may need to be tested for your susceptibility to them.
You can begin to treat a UTI at home by drinking plenty of water and urinating frequently. Every opportunity you have to try to flush out some of the bacteria will help your body to recover more quickly. Vitamin C supplements will help boost your immune system. Think of them as ammunition for your white blood cells as they fight the infection.
The herb goldenseal is sometimes recommended for supplemental treatment of UTIs. At one time, drinking unsweetened cranberry juice was believed to flush out bad bacteria from the urinary tract. However, in recent years, that claim has become hard to prove.
What Uti Test Should Children Have
A UTI diagnosis in a child requires both a urinalysis and a urine culture, according to the most recent clinical practice guidelines by the American Academy of Pediatrics. In order to gather a proper urinary sample from a very young child, catheterization or a suprapubic aspirate is often recommended. Alternatively, your healthcare provider may simply leave the child diaper-free in order to obtain a sample when the child urinates. Some physicians collect urine using a bag. Samples obtained in this way, however, have a high rate of contamination, making results unreliable.
For children who are potty trained, a midstream urine sample should be collected. Its often recommended that girls sit backward on the toilet, in order to widen the labia and prevent contamination.
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Etiology Of Uti In Children
Predisposing factors in younger children include
-
Malformations and obstructions of the urinary tract
are the most frequently implicated gram-positive organisms.
Fungi and mycobacteria are rare causes, occurring in immunocompromised hosts.
Adenoviruses rarely cause UTIs, and when they do, the disorder is predominantly hemorrhagic cystitis among immunocompromised hosts.
Medical Treatment Of Urinary Tract Infections
Because urinary tract infections are most often bacterial, they can be treated with antibiotics. As a guideline, antibiotic treatment for UTIs is usually split into two categories:
- Uncomplicated UTI, which is an infection that occurs in an otherwise healthy person with normal kidney function
- Complicated UTI, which usually occurs in people who have a medical or anatomical predisposition to urinary tract infections or treatment failure
The type of antibiotic used and the length of treatment differs, depending on the severity of the infection and medical history of the person with the condition. Symptoms from uncomplicated UTIs usually clear within three days of antibiotic treatment, whereas people with a complicated UTI may require antibiotics for up to two weeks.
Whatever the cause, it is important to complete the entire course of antibiotics prescribed in full, even if symptoms appear to have cleared. This can help to prevent antibiotic resistance developing.
In the rare cases where a urinary tract infection is caused by a virus or fungi, this can be treated with antiviral or antifungal medication respectively.
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Can Kidney Infections Be Prevented
Kidney infections can be prevented by keeping bacteria out of the urinary tract and bladder. Infections in the kidney often start as a lower tract infection in the bladder. By preventing these infections, you may be able to prevent kidney infections.
There are several ways to avoid infection and keep your kidneys healthy. These tips can include:
- Hydration: It is important to drink adequate fluid every day but there is no specific recommendation that applies to every patient.. The amount can change if you have certain medical conditions or live in a particularly hot climate. Talk to your healthcare provider about the recommended amount of water you need each day.
- Urinate completely: When you need to urinate, empty your bladder completely. Holding in your urine can be harmful and can promote the growth of bacteria. Urinating every several hours can help to flush any bacteria out of your body, protecting it from an infection.
- Urinate after having sex: Urinating after sex helps to remove any bacteria that may have gotten into the body. Men and women should both do this to prevent infections.
- Practice good hygiene: Keeping yourself clean can help protect your body from infections. After a bowel movement, wipe from front to back to push bacteria away from the urethra . This is especially important for women.
Symptoms Of A Urinary Tract Infection
Signs and symptoms of a urinary tract infection often vary from person to person. Factors such as age, gender and the type of UTI may determine precisely which symptoms are experienced and to what degree. However, there are some common symptoms to look out for as an indication of a urinary tract infection.
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Can I Become Immune To The Antibiotics Used To Treat A Uti
Your body can actually get used to the antibiotics typically used to treat a urinary tract infection . This happens in people who have very frequent infections. With each UTI and use of antibiotics to treat it, the infection adapts and becomes harder to fight. This is called an antibiotic-resistant infection. Because of this, your healthcare provider may suggest alternative treatments if you have frequent UTIs. These could include:
- Waiting: Your provider may suggest that you watch your symptoms and wait. During this time, you may be encouraged to drink plenty of fluids in an effort to flush out your system.
- Intravenous treatment: In some very complicated cases, where the UTI is resistant to antibiotics or the infection has moved to your kidneys, you may need to be treated in the hospital. The medicine will be given to you directly in your vein . Once youre home, you will be prescribed antibiotics for a period of time to fully get rid of the infection.
Approach To The Symptomatic Patient
Once a diagnosis of UTI has been made based upon symptoms and urinalysis results, the next step is to start empirical antibiotic therapy and await culture and susceptibility results. As previously discussed, UTI symptoms may be defined as lower , upper , or nonspecific. Another classification of UTI that can determine treatment and therapy duration is uncomplicated versus complicated.
Uncomplicated UTI is defined as a UTI without structural or urologic abnormalities.12 Uncomplicated cystitis is often associated with healthy community-dwelling women.13 Uncomplicated infections are rare in males because of the anatomical feature of a longer urethra, which protects against the ascending spread of bacteria. Uncomplicated UTI in young males may be a result of homosexual activity or noncircumcision, but otherwise UTIs in men are often classified as complicated.14
Complicated UTI has various definitions, but the mostconsistent patient features are presence of foreign body, obstruction, immunosuppression, renal failure or transplantation, urinary retention, or pregnancy.12
Once the likely pathogens have been established, an appropriate antibiotic that will achieve good urinary concentrations should be prescribed. Urine culture results should be used to de-escalate or change therapy, if needed, and the recommended duration of therapy should be followed to prevent excessive antimicrobial exposure. TABLE 3 provides the recommended agents and therapy durations for symptomatic UTI.13,14
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Urinary Tract Infections In Adults
ROBERT ORENSTEIN, D.O., Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, Virginia
EDWARD S. WONG, M.D., Virginia Commonwealth University, Medical College of Virginia, Richmond, Virginia
Am Fam Physician. 1999 Mar 1 59:1225-1234.
See related patient information handout on urinary tract infections, written by the authors of this article.
Urinary tract infections remain a significant cause of morbidity in all age groups. Recent studies have helped to better define the population groups at risk for these infections, as well as the most cost-effective management strategies. Initially, a urinary tract infection should be categorized as complicated or uncomplicated. Further categorization of the infection by clinical syndrome and by host helps the physician determine the appropriate diagnostic and management strategies. Uncomplicated urinary tract infections are caused by a predictable group of susceptible organisms. These infections can be empirically treated without the need for urine cultures. The most effective therapy for an uncomplicated infection is a three-day course of trimethoprim-sulfamethoxazole. Complicated infections are diagnosed by quantitative urine cultures and require a more prolonged course of therapy. Asymptomatic bacteriuria rarely requires treatment and is not associated with increased morbidity in elderly patients.