Understanding UTI Tests and Reading Results

Updated: Sep 30, 2018

Excerpt from our UTI 101 page: For full details please go to our page at https://www.westcoastmint.com/uti-101

UTIs are often caused by bacteria, with E. coli being the most common source. Other common UTI-causing bacteria are: enterococcus faecalis, staphylococcus, klebsiella, pseudomonas and several others. It is very important to determine the source of your UTI and treat it with the appropriate antibiotic. Re-occurrence of infection and antibiotic resistance can occur with improper treatment.

UTI Test Types and Reading Results

Once at medical facility, it is vital to know the different types of tests available to you.  Often patients are ill or do not have the knowledge to ensure they are getting the best treatment possible.

Please note that for most tests, it is recommended for best results to use your first or second morning urine. The longer the urine is in the bladder, the better the sample is for test purposes. 

You may come across a term labelled "clean catch urine specimen."

This is a process that simply means collecting urine sample mid-stream to avoid contamination by contact with skin or other parts of your body.

A- UTI Test Strips / Dip Stick

Test strip is dipped into urine sample, typically during medical appointment.

Simple and quick preliminary test that can possibly show Leukocytes (white blood cells) and Nitrite in urine that are indicative of infection. The nitrite (NIT) portion of the test may not detect all types of bacteria because it relies on a chemical reaction for the bacteria.

B - Urine Analysis (UA)

Urine sample is collected and sent for further analysis either onsite or separate lab.  This analysis involves multiple tests that combine into a single report. This test may have to be requested directly by the doctor in order to be performed.  Microscope analysis of the sample is used to detect bacteria.  This test does not include a culture of the sample to better identify bacteria presence.

C - Urine Culture

Urine sample is collected and sent to lab for culture over 2-3 days.  The growth of bacteria is analyzed for "normal" vs. abnormal (ex. positive) test results.  The normal result is a low bacteria count that is denoted as no infection. 

Positive test results indicates bacteria or yeast growth in sample, and is likely pointing to an infection.  There may be a single or multiple bacteria detected in the test. 

If test is positive, the sample is tested against various antibiotics to determine the best treatment.  Part of the Urine Culture report includes Susceptibility of different antibiotics against the found bacteria.

The Susceptibility report includes listing of antibiotics and their ranking on effectiveness against the bacteria. It is vital that the report is read correctly by the doctor to ensure best treatment. Ranking is either based on MIC score (with the lower score next to the Antibiotic the better) or S (Susceptible), I (Intermediate) and R (Resistant) ranking. We highly recommend to request MIC based ranking as this provides better details.

Additionally, you should request from the doctor for a Urine Culture test to be "comprehensive urine culture."  We recommend to request this enhanced reporting of the same test to show all levels of found bacteria.  Without this add-on request, the report will likely only show bacteria with high concentration, as measured by colony forming units (CFUs).

Unfortunately, sometimes the lab is left to decide whether to perform the Urine Culture test if the Urine Analysis shows as negative.  It is possible to request for a "culture regardless" by the doctor, if applicable, to overcome any discrepancies.