What is urine culture testing?
A urine culture involves analysing urine (a bodily waste product) in a laboratory to detect the presence of microorganisms, such as yeast or bacteria, that can cause infection. Laboratory professionals use growth-promoting substances to encourage any existing bacteria or fungi in the sample to multiply. This growth confirms the presence of infection within the urinary tract.
This test is designed to identify yeast or bacteria responsible for urinary tract infections (UTIs). Further antibiotic sensitivity testing can help determine the most suitable treatment if bacteria are detected in the sample. Your medical practitioner may recommend this test if you’re dealing with recurrent or difficult-to-treat urinary tract infections.
Purpose of a urine culture test
The test identifies bacteria and yeast that cause UTIs. While urine usually contains low levels of microorganisms like bacteria or yeast, these can enter the urinary tract from the skin, multiply, and cause an infection.
Common symptoms of UTIs include:
- Persistent lower back pain
- Frequent or urgent need to urinate
- Strong-smelling or cloudy urine
- Burning or discomfort during urination
Although urine tests can detect some sexually transmitted infections (STIs), a urine culture is not typically used to screen for STIs. For example, chlamydia testing via urine involves detecting genetic material rather than using culture methods.
Who may require urine culture testing?
Your healthcare provider might suggest this test if you experience frequent or persistent UTIs, particularly if symptoms are hard to manage. Women are more likely than men to experience UTIs.
Risk factors for recurrent UTIs include:
- Difficulty emptying the bladder fully or using a urinary catheter
- Frequent sexual activity, particularly with new partners or while using spermicides
- Diabetes
- A weakened immune system due to autoimmune conditions, cancer treatments, or organ transplants
- Kidney issues, such as kidney stones
How Is the test performed?
Urine is naturally produced by the kidneys and stored in the bladder until urination. Under normal circumstances, urine contains minimal microorganisms. However, when yeast or bacteria invade the urinary tract, they can multiply, leading to infection.
The most common bacteria responsible for UTIs is Escherichia coli (E. coli), found in the digestive system. Other common culprits include Staphylococcus saprophyticus, Klebsiella, and Proteus.
If bacteria are found in your sample, antibiotic susceptibility testing will determine which antibiotics are most effective in treating the infection.
Testing procedure
- Before your test
Preparation is key to obtaining an accurate urine sample for a culture test. Patients are advised to hydrate by drinking a glass of water 15–20 minutes before the test, ensuring they can produce enough urine for collection. It is also essential to avoid urinating for at least one hour before the procedure, as this helps obtain a more concentrated sample. Following these guidelines will improve the reliability of the test results.
- During the test
The urine culture test requires a mid-stream sample to minimise contamination. To begin, wash your hands thoroughly to maintain hygiene. For women, keeping the labia apart while urinating helps to prevent external bacteria from entering the sample. It is essential to avoid collecting the first part of the urine stream, as it may contain microorganisms from the urethra or skin. Instead, collect mid-stream urine in a sterile screw-top container and ensure the lid is securely tightened. Finally, rewash your hands after securing the sample. For catheterised patients, strict sterile procedures must be followed. In some rare cases, particularly for infants, a direct bladder sample may be collected through a procedure called suprapubic aspiration.
- Collecting results
Once the urine sample is delivered to the laboratory, it is cultured on an agar plate and incubated at body temperature to encourage bacterial growth. A negative result indicates no significant bacterial growth, confirming the absence of infection. However, a positive result suggests the presence of bacteria or yeast, indicating a urinary tract infection (UTI). Further molecular or biochemical testing can identify the specific organism and determine the most effective antibiotics for treatment. Results are typically ready within 1–3 days, after which a doctor reviews the findings and recommends appropriate treatment if necessary.
Understanding results
- Abnormal results: A positive result shows bacterial or fungal growth, usually indicating a UTI. Your healthcare provider may recommend antibiotics based on additional sensitivity testing.
- Normal results: A normal result indicates no significant bacterial or yeast growth, meaning there is no infection.
Sexual activity and other factors, such as hormonal changes during menopause, can increase susceptibility to UTIs. Always complete your prescribed treatment to avoid complications. Untreated UTIs can worsen and lead to kidney damage, particularly in cases where infections spread from the bladder to the kidneys.
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