UTI DIAGNOSIS AND ROLE OF LABORATORY :

A urinary tract consists of kidneys, ureters , and urinary bladder.

Urinary tract infection is defined as presence of actively multiple bacteria in the urinary tract.

The best method to detect this is by examination of urine. Urine specimen is referred as liquid tissue biopsy of urinary tract-painlessly obtained. It yields a great deal of information quickly and is economical. Kidney has a remarkable ability to retain essential substances while excreting end products of metabolism. It maintains water and electrolyte balance .

In women , UTI is very common because the anatomy makes it vulnerable. The usual site is the urinary bladder (cystitis),next infection is pyelonephritis.(kidney).The other causes can be urinary stone, fistulas, congenital infection.

SYMTOMS OF UTI:

1)Patient presents with burning sensation while passing the urine.

2)Increased frequency of urination and pain towards the end of urination.Pain may in the lower abdomen and urine may appear cloudy or bloody .

3)Sometimes patients may present with fever with chills and backache,indicating infection of kidneys.

COLLECTION OF URINE SAMPLE:

There are certain important considerations to be borne in mind relative to collection of urine specimen for examination. These should be followed to prevent contamination in the sample. Sample must be collected in clean, dry container and should be submitted to the laboratory at the earliest (within 2 hrs).If the analysis is going to be delayed ,urine specimens should be refrigerated or preserved ,if not done RBCs, pus cells and casts can get decomposed in the urine after long standing at room temperature.For most routine examination ,a fairly concentrated specimen is preferable hence ordinarily the first morning sample is preferred,voided on rising .A clean midstream sample( i.e sample should be collected in container after the initial flow has been allowed to escape.) is desirable.Patient should be instructed to clean the parts with mild antiseptic solution ,dried and then collect the sample.For pediatric collectors of clear pliable polyethylene are available for male and female infants.These bags can be folded  and self sealed for transportation.

Routine examination is done on the sample,if infection is reported then culture is followed.For culture test the sample is collected in sterile containers and send immediately for analysis.

ROUTINE URINE ANALYSIS REPORT:

This report will normally comprise of

1)Physical tests:

Colour of urine-Normally it is pale yellow colour,Red colour indicating blood cells in urine,yellow brown indicating bilirubin i.e.jaundice,

Odour of urine-Normal urine has faint aromatic odour,odour is important in bacterial contamination ;ammonical or fetid odour.

Specific gravity of urine-This gives an indication of urine total solute concentration.

pH of urine-It is reflection of ability of kidney to maintain normal hydrogen ion concentration in body.Depending on the pH ,urine is reported as acidic or alkaline urine.

2)Chemical tests:

Protein –Normally scant amount of protein is present in the urine.Proteinuria means increased excretion of proteins in the urine.It is reliable indicator of renal disease.

Glucose-Glucose may appear in the urine with varying levels of blood glucose levels.Glucosuria occurs when blood level is more than 180-200 mg/dl.Glucosuria can occur without hyperglycemia is usually seen in renal tubular dysfunction.

Ketone-Ketone can be seen in infants in conditions like febrile illness,vomiting ,diarrhea.Ketonuira can be seen in diabetics indicating ketoacidosis may provide a warning of impending coma.

Haemoglobin-Indicates presence of blood cells in the urine.Can be seen in renal stones, infection,trauma,normal menses in female.

Bilirubin-Is found in hepatitis,Obstructive cholestasis,gall stones in the bile duct.

Other tests are urobilinogen,nitrite in the urine.

3)Urine microscopy :

Reported with epithelial cells,pus cells,RBCs,Casts,Crystals or presence of abnormal cells like tumour cells,fungi,parasites.

URINE CULTURE:

Urine report if reported to have infection or bacteria,culture of urine is advised.This test will help to identify the type of organism infecting the kidneys and also indicate the appropriate antibiotic treatment.Physician depending on the culture report and the other findings will administer proper antibiotic for period of 5 days along with plenty of fluids to be admininstered.Repeated attacks amy require longer treatment up to 3 months.

PREVENTION OF UTI.

There are no  proven ways for prevention of UTI,but certain precautions are advised:

-Drink plenty of water (8-10 glasses of water)

-Avoid delay in passing urine.

-Consult physician in case of any symptoms.