Bacteria in urine: more than 7 reasons, what it means, explanation and norm in women, children and men. What to do if the bacteria in the analysis is “+” (plus)

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Pastushok Vladimir Georgievich

Practicing nephrologist, experience over 11 years

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According to existing standards, bacteria should not be detected in urine. When they are present in it, this indicates the presence of inflammatory diseases in the kidneys and urinary tract. Bacteria can be detected through bacteriological examination of urine.

Treatment of bacteria in urine

Treatment of bacteriuria is carried out depending on the pathogen isolated.
When a diagnosis of cystitis is made, treatment is carried out with antibacterial drugs to which the isolated microflora is sensitive. Patients are recommended to consume lingonberry and cranberry fruit drinks: they are natural uroantiseptics. Monural is currently used to treat the disease. This drug helps get rid of cystitis in one use and has low toxicity. The selection of a drug for pyelonephritis is carried out based on the results of an antibiogram. Drugs such as fluoroquinolones (Ciprofloxacin), protected penicillins (Augmentin), cephalosporins, and nitrofurans are prescribed.

Treatment of bacteriuria during pregnancy is carried out with the help of penicillin and cephalosporin drugs, which have less effect than others on the life activity and development of the unborn baby. If a doctor has prescribed medications, refusing treatment for fear of harming the baby is a big mistake, because bacteriuria can lead to cystitis and pyelonephritis in pregnant women. And these diseases can cause pathological abortion and premature birth.

Prevention of pathology

There are three advantages to preventing any disease: preventing complications, saving time on treatment and purchasing medications, and maintaining health.

Preventive measures to prevent bacteriuria include:

• using a condom during intimacy;
• maintaining personal hygiene;
• proper and high-quality nutrition;
• timely completion of preventive examinations;
• playing sports to improve immunity.

Prevention of bacteriuria in a child requires careful monitoring by parents over compliance with personal hygiene rules and urine collection for preventive purposes.

The presence of pathogenic microflora in the urine is a clear signal of poor health. Only a doctor can competently tell you how to treat this. You should not select medications on your own. This can not only harm yourself, but also provoke the development of complications.

Diagnostic and therapeutic measures

In most cases, if specialists observe single bacteria in the urine during analysis, then this is not a reason for panic, but only a prerequisite for retaking the analysis. In this case, the observation of microorganisms may be associated with contamination of the container or non-compliance with the rules for collecting urine for analysis. If microorganisms are still present in the urine after repeated testing, a culture is performed and an antibiogram is drawn up; in some cases, a smear is studied using the PCR method. There should be no bacteria in urine; their presence indicates damage to human internal organs by pathogenic microorganisms.

Until now, the main way to identify bacteria and their characteristics is urine culture for bacteriuria, which is carried out exclusively in laboratory conditions. Obtaining the results of the study requires some time from the patient, but this is the most successful way to determine the sensitivity of microflora to certain drugs and preparations.

Due to the more active manifestation of symptoms, bacteriuria in men is much more treatable, since it is detected in a timely manner, while in women, timely detection is quite rare.

The use of instrumental methods of diagnosis and treatment is much easier for women than for men, who often refuse effective therapeutic and diagnostic methods due to false shame and fear. In addition, in men, who in most cases ignore symptoms and allow pathology to provoke the occurrence of various complications, treatment of bacteriuria sometimes requires complex therapeutic procedures in a hospital setting. It is precisely because they are ignored that chronic forms of diseases are diagnosed in men on the same basis as in women, in whom they are practically asymptomatic.

Only effective suppression of pathogenic activity and the proliferation of pathogenic microorganisms makes it possible to remove bacteria from urine, eliminate the disease and restore the body to normal health. The therapeutic effect consists of the use of local agents, antibacterial prophylaxis and the use of drugs and substances that can suppress the pathogenic activity of microorganisms. The main therapeutic method is the treatment of bacteriuria with antibiotics, the composition and characteristics of which are selected taking into account the results of laboratory tests that determine the sensitivity of protozoan microorganisms.

Video: Decoding urine test

Elena Malysheva. Urine test interpretation

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Treatment and features

The presence of bacteria in urine requires mandatory medical supervision. Only a specialist can prescribe the correct treatment based on the cause of the pathology. After all, bacteriuria is just one symptom of the disease.

Therefore, treatment and decisions about which methods are effective should be determined based on the diagnosis.

1 standard direction of combating the development of pathogenic microflora is a course of antibiotics. In parallel with them, medications are prescribed that normalize healthy microflora.

The third direction of therapy is symptomatic treatment. It consists of the use of non-steroidal anti-inflammatory drugs, vitamin therapy, and antispasmodics.

The most common diseases in which bacteria appear in the urine

The most common diseases in which the appearance of bacteria in the urine is observed are the occurrence and development in the body of such pathological processes as:

• cystitis: infectious inflammation of the tissues of the bladder, provoked by the pathogenic activity of protozoan microorganisms. With the development of this disease, there may also be blood in the urine and increased diuresis (frequent urge to urinate), as well as a feeling of false urge to empty the bladder, a feeling of nagging pain in the groin area;
• specific and nonspecific urethritis: damage by pathogenic bacteria to the internal cavity of the urinary canal - the urethra, may be accompanied by discharge and nagging pain in the area of ​​the penis and its head, as well as in the area of ​​the external opening of the urethra;
• urolithiasis disease. With this disease, fragments of deposits excreted from the body injure the mucous and other epithelial tissues of the urinary tract and bladder. A sedentary lifestyle leads to stagnation of urine, and in a constantly humid environment there are no more suitable conditions for the occurrence and development of infections;
• trichomoniasis: a sexually transmitted infection in which inflammatory processes occur on the mucous and other epithelial tissues of the genital organs;
• chlamydosis: infection by protozoan microorganisms chlamys, which is characterized by increased urination and the observation of discharge from the urethra;
• pyelonephritis: an inflammatory process in the kidneys, accompanied by purulent and mucous discharge, a significant increase in temperature and the appearance of pain in the lumbar region of the back;
• prostatitis: infection of the prostate tissue.

All of these diseases, left without medical influence, become chronic and difficult to cure.

What are the warning signs?

Often, the presence of bacteria in the urine is discovered accidentally during routine examinations and examinations for other complaints.

However, if the pathological process progresses, the patient may experience the following symptoms:

For pyelonephritis:

1. Nagging pain in the lumbar region.
2. Nausea accompanied by vomiting.
3. Increased body temperature, fever.
4. High blood pressure.
5. The process of urination is accompanied by a burning sensation or pain.
6. There is a disruption in the process of emptying the bladder - from anuria (complete cessation of urination) to polyuria (frequent copious urination). Urination may become infrequent and urine output scanty, or urinary incontinence may occur.
7. The quality of urine changes, which can be seen with the naked eye.

For urethritis:

1. Impaired urination - dysuria.
2. A large amount of pus in the urine, admixtures of blood.
3. When urinating, there is pain in the perineal area.
4. Chills, fever, elevated body temperature.
5. Weakness, decreased ability to work.
6. Urine has a foul odor and a cloudy sediment.

Symptoms of cystitis:

1. Pain in the lower abdomen, in the pubic area.
2. Copious discharge of pus from the urethra.
3. Urine is cloudy, with copious sediment.
4. The smell of urine is unnatural.

Clear, straw-yellow urine is considered normal. However, in the case of the development of pathological processes in the urinary organs in men or women, the composition of this biological fluid changes. Urine changes color to unnatural shades (brown, greenish, milky, red). It may contain elements of blood or pus. There is a huge amount of foreign matter, flakes and sediment. The smell of urine becomes pungent and offensive.

These conditions themselves are a sign of the development of serious pathological processes in the body.

Reasons for the appearance of bacteria in a general urine test

A healthy person's urine, which is produced in the kidneys and collected in the bladder, should ideally be sterile. But even normally, a laboratory test can detect a small amount of bacteria in the urine. These microorganisms enter the urine as it passes through the urethra (urethra). Thus, bacteria can be detected in a normal urine test in small quantities.

An increase in the number of bacteria in the urine is called bacteriuria. This condition indicates the possibility of development of inflammatory processes in the genitourinary system, such as urethritis, cystitis, pyelonephritis, vesiculitis, prostatitis.

Transmission routes

The causative agent of inflammatory diseases can enter the urinary system in several ways.

1. Ascending route - the causative agent of the disease enters the urinary tract through the urethra. This method of infection is typical mainly for women. This is due to their anatomical features (wide and short urethra). Also, the ascending route of pathogens entering the urine is likely during certain instrumental manipulations - cystoscopy, urethroscopy, bladder catheterization, urethral bougienage, transurethral surgical interventions.
2. Descending route - likely in infectious kidney diseases.
3. Lymphogenous route - the infection penetrates from infectious foci that are located near the organs of the genitourinary system through the lymphatic tract.
4. Hematogenous route - bacteria enter the urinary tract from distant foci of infection through the bloodstream.

Experts distinguish between true bacteriuria (microorganisms exist and multiply in the urine) and false bacteriuria (bacteria enter the urine through the bloodstream from distant foci of infection without multiplying in the urine).

During pregnancy

During pregnancy, bacteria are detected quite often in urine tests. Doctors note that bacteriuria in expectant mothers occurs five times more often than in other women. This is due to several reasons. Firstly, a pregnant woman's uterus is constantly enlarging. As a result, it puts more and more pressure on the kidneys, thus preventing them from functioning normally. Secondly, during pregnancy, favorable conditions are created in a woman’s body for stagnation of urine and the development of microorganisms in it. Thirdly, the appearance of bacteria in the urine during pregnancy is facilitated by hormonal changes in a woman’s body and some of her physiological characteristics (the close location of the urethra to the rectum).

General factors

We can identify factors that often provoke the appearance of bacteria in a urine test:

• disordered sex life with frequent changes of partners;
• failure to comply with personal hygiene rules;
• chronic diseases of the genitourinary system;
• recent sexually transmitted infections;
• diabetes;
• decreased general immunity of the body.

Often, bacteria are detected in a urine test due to an improperly collected urine sample. Urine should be collected in a clean (preferably a special sterile) container. A mandatory requirement is to thoroughly clean the external genitalia before collecting urine. For analysis, only average urine is collected, which must be submitted to the laboratory no later than two hours after collection.

Other types of microbial tests

General urine analysis is more common, but deciphering it takes some time. Therefore, there are express methods that give instant results:

1. Griess method. Dangerous bacteria can convert nitrates into nitrites. The German chemist’s reagent precisely determines the presence of nitrites. There is only one disadvantage of the method - bacteriuria is detected only in adults. It is impossible to find an anomaly in children using the Griess method: their urine does not contain nitrates.
2. Triphenyltetrazolium chloride is a salt that turns blue when microbes are present.
3. Reducing glucose. Microbes are known to reduce the amount of glucose in the urine. Its absence also eloquently indicates the active work of pathogens.

If large quantities of bacteria are found in the urine, bacterial culture is performed. The disadvantage of the technique is its duration, since the study requires two days or more.

Who is at risk

What are the causes of bacteria in urine?

People with weakened immune systems are mainly susceptible to bacterial infections:

• newborn children;
• elderly people;
• HIV-infected;
• People with serious illnesses (leukemia, diabetes, cystic fibrosis, chronic bronchitis and others);
• patients taking hormonal drugs for a long time;
• persons with developmental anomalies of the genitourinary organs;
• patients suffering from urolithiasis.

Pregnant women are also at risk, since their urinary system bears a double load, hormonal levels and the chemical composition of urine change, and the enlarged uterus puts pressure on all internal organs, causing stagnation of urine in the ureters and the development of bacteria in the urine. Plus, under the pressure of the growing uterus, the bladder and urethra are pressed closely to the rectum.

In children, diseases of the genitourinary organs are often caused by congenital anomalies of the kidneys, ureters, bladder and urethra, vas deferens and testicles.

What to do in case of bacteriuria

Once an abnormal number of microbes is detected, treatment for bacteriuria begins. The first step is to prescribe antibacterial drugs. They should be taken for 5 to 10 days, strictly according to the doctor’s recommendation. The duration of therapy depends on the type of bacteria and their number. The following antibiotic tablets are used:

• Maximim is a well-known drug that destroys most strains in the urine. Well tolerated by both adults (including pregnant women) and children.
• Furazolidone is a broad-spectrum tablet that does not cause bacterial resistance to antibiotics.
• Cefurabol, which helps cure not only bacteriuria, but also serious diseases - nephritis, pyelonephritis, cystitis.

For infections of the urinary system, treatment with folk remedies is allowed; for bacteria present in the urine, diuretic decoctions and teas are welcome.
Among the plants used are birch (any raw material), bearberry, rose hips. If an infection is detected in the urine, you should not begin self-medication, since getting rid of bacteria effectively is only possible under the supervision of the attending physician. A different way of solving a problem often leads to the opposite result.

General information

Urine consists of organic components and an aqueous solution of salts. 90% of urine is water. 10% is a dry substance, complex in chemical composition and including about 1000 components. The biochemical composition of urine is different for each person. The composition also varies depending on gender and age, nutrition, lifestyle and some other factors.

A urine test is considered a fairly simple test, but professional knowledge is required to interpret it correctly. The composition of urine is affected by the functioning of the kidneys, the activity of other organs, and various processes, in particular metabolism. The composition of urine is also affected by the functioning of the pelvic organs. But in any case, the first thing a urine test indicates is the condition of the kidneys and urinary system.

Urinalysis is indicated in cases where there is a need to monitor the effectiveness of therapy or identify its possible side effects. In addition, a urine test is prescribed if a person has suffered from infectious diseases, and there is a possibility of streptococci entering the body (this often happens with sore throat). For prevention, it is recommended to conduct a urine test once a year.

Bacteriuria - definition and types

This term characterizes the presence of microorganisms in a freshly collected portion of urine. Bacteria can be represented by one culture or a combination of different types of flora (Escherichia coli, staphylococci, micrococci, Pseudomonas aeruginosa, streptococci).

Normally, sterility of urine (bacterial “purity”) serves as confirmation of the health of the kidneys and urinary tract.

Based on the presence of clinical manifestations and behavior of bacteria in the urinary tract, the following types of bacteriuria are distinguished:

• true - microbes are not only present in the excretory tract, but also actively multiply, causing extensive inflammation. In this case, the patient has severe symptoms, and the laboratory value is more than 104 CFU/ml;
• asymptomatic (hidden) - bacteria are also found in significant quantities corresponding to the true form, but the patient has no symptoms;
• false – bacteria enter the urinary tract, but increasing their population is impossible due to the patient’s high immunity or taking antibacterial drugs.

Based on where exactly the microflora enters the urine, bacteriuria is distinguished:

• descending - urine contamination occurs from sources of inflammation in the bladder, kidneys, prostate;
• ascending – introduction of microorganisms during instrumental medical procedures (catheterization, cystoscopy);
• lymphohematogenous - penetration of bacteria from the genitals or intestines with constipation, proctitis, fissures;
• hematogenous – entry of pathogenic flora into the bloodstream during acute or chronic infectious diseases.

As a rule, any bacteriuria requires therapy. However, each case is considered separately; sometimes taking vitamins and measures to boost immunity is enough.

Reasons for the development of bacteriuria

To identify the cause of bacteriuria, you need to understand why bacteria appeared in the urine and what type they are. Kidney inflammation often develops with other infections, when a complication of the pathology occurs. Bacteriuria is diagnosed when urolithiasis is detected, since stones can block the ureter, causing stagnation of urine to provoke inflammation.

We list the diseases that are typical when bacteria appear in the analysis:

1. Urethritis. When opportunistic microorganisms present in the urinary canal actively multiply, the urethra becomes inflamed.
2. Pyelonephritis in the urethra. Kidney inflammation can be the primary provocateur of pathology or the secondary cause of the disease.
3. Cystitis. The most likely disease that causes an increased content of microorganisms.

If bacteria are detected in the urine, it is necessary to determine its type in order to provide adequate treatment. For this purpose, bacteriological seeding is performed - microorganisms are placed in a special environment where they are in favorable conditions. This technique allows the attending physician to determine the type of bacteria and find out how sensitive they are to various antibiotics.

Bacteriuria in men

Because the male urethra is small in diameter and too long, it is more difficult for bacteria to penetrate the genitourinary system. Because of this, the infection rarely penetrates deep into the urethra; bacteria are detected in men only with infectious urethritis, performing a general urine test.

The causative agents of inflammation are streptococcus, intestinal, as well as Pseudomonas aeruginosa, staphylococcus. The problem is provoked by diseases that suppress the immune system, habits of drinking alcohol, hypothermia, sex without a condom, and poor nutrition. Also, male urethritis is caused by gonococcus. This disease is called gonorrhea, in the presence of which bacteria shaped like coffee beans are found in the urine. The pathology refers to sexually transmitted diseases and develops after sexual intercourse without protective equipment, when using intimate hygiene items of an infected partner.

The presence of bacteria in a male urine test can provoke infectious prostatitis. Microorganisms penetrate into urine from the prostate gland, causing pathology. Men are characterized by an asymptomatic variant of bacteriuria.

Bacteriuria in women

There are more reasons for the appearance of bacteria in women's urine than in men. This is caused by the increased diameter and short length of the urinary tract. Such features allow microorganisms to penetrate the urinary system even after any act of defecation. At the same time, this specificity determines the predominance of the ascending mode of infection in women.

If bacteria are detected during the study, then there is an infection in the reproductive system. Cystitis is usually the cause. Since the disease is classified as a polyetiological disease, several pathogens are detected when cultured for bacteriuria.

A healthy mucous surface of the bladder does not allow the proliferation of pathogenic bacteria. However, there are some unfavorable factors due to which the inflammatory process develops:

• hypothermia, prolonged exposure to hot conditions;
• decline in immunity;
• injuries of the genitourinary system;
• active sex without protection;
• failure to maintain intimate hygiene.

For pregnant women, the norm is to frequently submit urine for analysis. As the fetus grows, the load on the kidneys increases, so it is necessary to monitor their condition. The presence of bacteriuria is dangerous for the child. The infection can penetrate the placenta, after which intrauterine infection, fetal death, and premature birth inevitably occur. Because of this, bacteria should be quickly identified and treatment initiated immediately.

Bacteriological examination of urine

Bacteriological analysis of urine is carried out in several ways - express diagnostics and more thorough and lengthy methods.

TTX test

For this diagnostic method, special salts are used - triphenyltetrazolium chlorides. If bacteria are present in the urine, the colorless salts will turn blue. The test has a fairly high accuracy - more than 70-85%.

Griess test

Another name for the method is the nitrite test. The nitrates present in urine are converted into nitrites under the influence of pathogenic microflora. The test takes the form of strips impregnated with a special reagent; a color scale is also attached to the method, which is used to determine the concentration of nitrites. Express diagnostics have low accuracy (about 50-60%), so they are used in rare cases and only for quick analysis.

GRT test

The glucose reduction test is based on identifying the glucose content that pathological microorganisms can reduce. Special test strips are used for diagnostics. Dip a test strip into a portion of morning urine and look at the amount of glucose contained in the urine. If the sugar level in the urine is below normal, it means that the bacteria present in the genitourinary organs are absorbing glucose. The reliability of the result is about 90%. However, this diagnostic method is not suitable for people with diabetes, whose urine always contains a large amount of glucose.

Urine microscopy

The patient's urine is examined under a microscope (with 400x magnification). If one or more microorganisms are in the field of view, the laboratory assistant confirms the presence of bacteriuria.

General urine analysis

This method determines the presence of bacteria in urine and the content of leukocytes in it. An elevated white blood cell count is evidence that an infectious process is occurring in the human body.

Bacteriological culture of urine

The most reliable method for determining bacteriuria. Urine is sown on a nutrient medium, after which the colonies of microorganisms grown in it are counted. The diagnosis itself is quite lengthy and takes at least 2 days, but there are quick bacteriological culture tests:

1. Gould's method - a Petri dish with a nutrient medium is divided into 4 sectors, then urine culture is performed. The Petri dish is placed in a thermostat for 24 hours, the temperature of which is no more than 37ᵒC. After colonies of microorganisms appear on the nutrient medium, their number is calculated using a special table.
2. Another quick method is performed using a plate with a nutrient medium applied to it. The plate is dipped into the urine, then pulled out and placed in a special container. The plate is kept for about 16 hours, after which it is taken out and the result is compared with the table.

Using bacteriological culture, not only the presence of pathogenic microflora in the urine is determined, but also the type of bacteria and their resistance to a particular antimicrobial drug are identified.

Causes of bacteria in urine

Bacteriuria often accompanies inflammatory diseases of the urethra, ureters, and kidneys; these pathologies will be first on the list of its possible causes:

• cystitis, pyelonephritis, urethritis;
• acute and chronic prostatitis, hyperplasia (adenoma) of the prostate (in men) - as a rule, there is asymptomatic bacteriuria;
• inflammatory diseases of the female genital area – vaginitis, adnexitis, vulvitis;
• malfunctions of the intestines that have an inflammatory component (enterocolitis, proctitis, hemorrhoids);
• chronic constipation;
• blockage of the ureter (for example, with urolithiasis) - causes stagnation of urine, and, consequently, conditions for the proliferation of bacteria;
• diabetes mellitus – the prerequisites are reduced immunity, congestion (neuropathy) and excess glucose in urine;
• sepsis (blood poisoning) – hematogenous bacteriuria;
• unsuccessful instrumental studies - bougienage, cystoscopy;
• sexually transmitted diseases - even a small amount of gonococci found in urine should be a reason to contact the appropriate specialist:
• past infectious diseases caused by streptococci - tonsillitis, otitis media, periodontitis, pneumonia, scarlet fever;
• a history of immunodeficiency and fever of unknown origin - in such patients latent bacteriuria is more often diagnosed;
• infectious diseases - typhoid fever, leptospirosis, brucellosis, less commonly tuberculosis, dysentery, diphtheria;
• genitourinary parasitic infestations (extremely rare);
• infection of a child while passing through the birth canal can only appear at 3-4 months of the baby’s life.

Separately, it is worth highlighting cases of bacteriuria, which can be conditionally called “functional” or transient, for example:

• bacteriuria in pregnant women. Of course, it can be a consequence of infection, but often its detection is facilitated by: stagnation of urine caused by fetal growth and hormonal instability;
• proliferation of bacteria in children's urine, stagnation of urine in children caused by functional reasons (the child simply forgets to empty the bladder on time);
• contamination of urine due to impaired urine outflow in older people, including those who require constant use of a catheter;
• the entry of microorganisms into the urine of school-age children due to immunodeficiency.

Separately, it is worth noting cases of non-compliance with basic hygiene, which often explains bacteriuria in girls and women

It is necessary to understand that maintaining cleanliness is important not only to obtain an adequate analysis result, but also on a regular basis, in everyday life

Drug treatment of bacteriuria

If a large number of bacteria appear in the urine, drug therapy is carried out using antibiotics. The doctor prescribes them based on data collected by inoculating the material on a nutrient medium. The dosage and type of antibiotics are selected depending on the patient’s age, weight, and pregnancy. In the latter case, it is important to choose a drug that will not pass through the placenta.

Bacteriophages are used for therapy after bacteria are detected in the urine of women. Their combined type, consisting of several types, has the best effect. They are used as douches in the vagina and orally for 3 weeks to several months.

When using antibiotics, drugs that restore microflora are prescribed (Linex, Normobact). If the patient has a fever, antipyretics are used. They are prohibited during pregnancy.

To prevent the consequences of fetal pressure on the kidneys when bacteria are detected in the urine of a pregnant woman, it is necessary to take drugs that protect them (Canephron).

The patient must maintain a drinking regime (at least 2 liters of water per day). If a woman does not drink fluids during a fever, dehydration will occur.

How to diagnose bacteriuria

If studies have revealed a small amount, even single bacteria, this is already evidence of the onset of an inflammatory process in the bladder. When, based on symptoms, the doctor suspects such inflammation, bacteria should be identified to diagnose it and further treat it. For this purpose, laboratory tests are prescribed, supported by instrumental diagnostics.

Laboratory methods

Laboratory diagnostics consists of processing urine and blood tests in an adult. When inflammation is started, many leukocytes are found in the blood plasma. A urine test reveals the degree of kidney damage, mucus in the urine and pus, which indicates the presence of dangerous complications.

Bacterial cultures are necessary to determine the causative agent of the infection. After this, narrowly targeted antibiotics can be prescribed. Women are certainly referred to a gynecologist, since if there are pathologies transmitted through sexual contact, they must be identified before therapy is prescribed. Men are examined by a urologist for the same reason.

The rules for collecting biomaterial for bacteriological culture and OAM are the same:

1. Morning urine required.
2. Before collecting, you should first urinate a little into the toilet, and after a couple of seconds - into a clean container.
3. It is better to buy a sterile container for urine, although you can collect it in another clean container.
4. First, the jar should be thoroughly washed, preferably sterilized, and then dried. Before collecting biomaterial, it must be completely dry.
5. If you are going to collect urine, you should wash yourself first. Women are advised to first insert a tampon into the vagina to prevent secretions from getting into the urine. OAM cannot be taken during menstruation.
6. The urine must be delivered to the laboratory within an hour.
7. When urination is problematic or a person finds it difficult to wait until the morning, set an alarm for 2 a.m., visit the toilet, and then drink a cup of water.

Instrumental methods

If the doctor has certain suspicions, he prescribes an instrumental examination. Such diagnostic methods include cystoscopy and urography. With the latter option, the doctor takes a series of images that allow you to see the tissue structure of organs, changes in them, the presence of tumors, cysts or erosions. Sometimes contrast is used, administered intravenously before diagnosis.

Cystoscopy involves inserting a thin tube with an optical device into the urinary duct. On the monitor, the doctor sees the surface of the mucous membrane and all the changes that have occurred on it. Before such a study, it is necessary to assess the patient’s condition, since in case of severe inflammation this technique is contraindicated.

How is such a disorder diagnosed?

A general clinical urine test for bacteria is the most popular among all diagnostic methods. This study is quite simple, it is often carried out for prophylactic purposes to exclude possible illnesses, and during pregnancy. OAM allows the doctor to determine the stage and severity of the disease. This diagnostic method involves microscopic examination of the discharge to identify casts, red blood cells, bacteria and leukocytes. The specialist also evaluates the color of urine and its chemical composition.

If pathogenic microbes are found in the secreted fluid, then another method of examination - bacterial culture - will help establish the specifics of the lesion and the type of pathogen. To carry out such laboratory analysis, pathogenic microorganisms are placed on special nutrient media. In such favorable conditions, infectious agents multiply very quickly. When bacteria completely cover the field of view of the microscope, the laboratory technician can easily determine their type. Part of this diagnostic method is to determine the sensitivity of pathogenic microflora to the action of various antibiotics.

Bacteria in urine - what does this mean for the patient? If during an examination harmful microorganisms are found in the discharge, this is not always a sign of pathology. Patients often have to have urine tested again, since the likelihood of introducing microbes from the genitals into it due to insufficient hygiene or violation of collection rules is quite high. That is why, before performing a urine test for bacteriuria, the health care provider instructs the patient on the correct collection of secretions.

How to collect biomaterial for a general study of urine and bacterial culture? There are several rules that must be followed in this case:

1. Only a fresh portion of discharge collected in the morning is suitable for examination. Immediately, the person must drain the urine into the toilet, and then urinate in a specially prepared container.
2. The ideal option would be to purchase a sterile container for this purpose. It can be easily purchased at any pharmacy. A small, clean container (a jar with a lid) is also suitable for collecting urine. To ensure that bacteria from the walls of this container are not detected in the urine during the study, it should be washed well and sterilized.
3. The container must be thoroughly dried. Immediately before control urination, the patient is recommended to wash himself.
4. To prevent other secretions from getting into the biomaterial being studied, women are advised to insert a tampon into the vaginal cavity before collecting urine. If you are menstruating, you are prohibited from taking OAM.
5. The liquid should be taken to the laboratory no later than 1-2 hours after collection. Otherwise, it will become unusable and bacteria can multiply in this urine, which will lead to a false positive result. If this is not possible, urine for testing is stored in the refrigerator, but not more than 2-3 hours.
6. The results of general analysis and bacterial culture should be deciphered by an appropriate specialist.

Causes of bacteria in urine

A large number of bacteria in the urine are most often detected during a urinary tract infection, since microorganisms, once in the urethra, bladder and ureter, multiply in favorable conditions and cause inflammation. Bacteriuria in these cases is often accompanied by the appearance of leukocytes or protein in the urine. Urine may change color, flakes and turbidity appear in it, and the physiological fluid acquires an unpleasant odor.

Cystitis is characterized by the production of cloudy urine with a high content of bacteria, mucus and white blood cells. You can think about this disease with frequent trips to the toilet, pain and burning during urination, and a feeling of incomplete emptying of the bladder. Nagging pain appears in the lower abdomen, which becomes permanent. The smell of urine changes (it smells sharp and unpleasant), the physiological fluid becomes cloudy and may contain an admixture of blood and pus. Body temperature rises during an exacerbation. The provoking factors for the development of cystitis are the following: hypothermia, viral infections, insufficient hygiene, decreased immunity.

Pyelonephritis is a kidney disease, which is often a complication of cystitis. Bacteria in a child’s urine most often indicate pyelonephritis, because this disease often occurs in preschool children. Bacteria enter the kidney tissue from the bladder through an ascending route and provoke inflammation there. The pathological process in the kidneys develops quite rapidly, with an increase in temperature to 39 degrees, nausea, and vomiting. When inflammation invades the kidney capsule, where the nerve endings are located, pain occurs in the lumbar region or lower abdomen. The presence of bacteria in the urine is often combined with the appearance of a large number of leukocytes and protein.

Bacteria in the urine of men can be a sign of urethritis - inflammation of the urethra. Urethritis is caused by both specific bacterial flora (gonococci, trichomonas) and nonspecific microflora (chlamydia, E. coli, mycoplasmas, staphylococci). Urethritis can be suspected by such signs as pain during urination, purulent or bloody discharge from the genital organ, irritation on the foreskin and skin. The disease can be complicated by inflammation of the bladder and prostate, and untimely treatment contributes to the inflammation becoming chronic.

Urolithiasis is another cause of the appearance of bacteria in the urine. Small formations may not cause any unpleasant symptoms, but if the stone moves, it causes severe pain to the patient. The cause of bacteriuria in urolithiasis is a chronic violation of the outflow of urine; in addition, bacteria can settle on the surface of stones and actively multiply. In urine tests, in addition to bacteria, an admixture of blood is often detected, which can only be seen under a microscope (microhematuria). When large stones move through the urinary tract, the patient produces pink-colored urine due to the high content of red blood cells.

Rules for collecting material for analysis

The day before, you should not eat foods that radically change the color of your urine. Another important point: before the collection procedure, the external genitalia must be thoroughly washed. The first portion of morning urine (2-3 seconds) is not collected; clean material is subject to examination. Use sterile containers purchased at a pharmacy. Women need to insert a cotton swab into the vagina before collecting biomaterial.

The period of menstruation is a contraindication for testing.

Characteristic symptoms for bacteriuria

Signs of bacteriuria may be completely absent, or may appear as features of the underlying disease (for example, diabetes mellitus). Specific symptoms are fully characteristic only of inflammatory diseases of the genitourinary area. In this case, the following manifestations will be common for any inflammation of the urinary tract:

• urination disorders - frequent, painful, with effort;
• temperature increase;
• pain localized in the perineum (urethritis), lower abdomen (cystitis), abdomen or lower back (kidneys).

Characteristic for pyelonephritis will be the appearance of:

• involuntary urination;
• changes in the transparency of urine, the presence of purulent inclusions, a strong odor;
• temperatures above normal, but not exceeding 38 (subfebrile) for 10-14 days.

Cystitis should be suspected if the following are added to the general symptoms:

• frequent urination, accompanied by a burning sensation and a decrease in the volume of urine produced;
• cloudiness and unpleasant odor of urine, the appearance of mucus or bloody impurities;
• the presence of discharge from the urethra (separate from urination), often with pus.

Urethritis is characterized by severe hyperemia and irritation of the edges of the urethra and significant purulent discharge.

Symptoms of bacteriuria in prostatitis may be absent (if the pathology is chronic), or expressed by pain in the perineum, fever and frequent urination with a feeling of incomplete emptying of the bladder.