Urinalysis: What Indicates a Urinary Tract Infection (UTI)?

A urinalysis or urine sample test can detect various issues, from kidney trouble to urinary tract infections. To confirm the latter, doctors examine the sample under a microscope for bacterial presence or a higher-than-normal amount of white blood cells. These point to signals of infection or resulting inflammation, respectively. Other factors, like urine pH levels, can also indicate a urinary tract infection. For a more in-depth guide on UTIs and urinalysis test results, read the comprehensive article below.

What Is Urinalysis Used For?

A urinalysis is a clinical test that aims to comprehensively break down the chemical composition and properties of a patient’s urine sample, thereby reflecting several key aspects of their health. Doctors use urinalysis to perform initial screening on the way to a narrower diagnosis. Because of its wide applicability and the ease and non-invasiveness of obtaining a sample, urinalysis screenings are among the most commonly performed tests.

Urine sample tests can help detect conditions such as urinary tract infections, chronic kidney disease, diabetes, and liver disorders early. Therefore, regular urinalysis is a generally recommended health practice for every patient.

Some parameters screened for as part of a urinalysis include:

• White and red blood cell presence
• Urine pH
• Protein in urine
• Bacterial cultures
• Ketones
• Nitrites
• Bilirubin
• Urobilinogen
• Fasting glucose
• Cholesterol
• Ascorbic acid (vitamin C)

If you suspect you’re suffering from a UTI, urinalysis samples are collected, typically as the first procedure ordered by your primary care clinician.

What indicates a Urinary Tract Infection?

After ordering and obtaining your sample, the healthcare provider will study your urine to confirm the suspected urinary tract infection. When examining the results of your urinalysis, UTI indicators can include:

1. Increased presence of white blood cells (leukocytes): when the body fights off an infection, white blood cell presence in the infected area increases. If the urinalysis results prove that the number of leukocytes exceeds the normal range, it suggests inflammation and infection.
2. Nitrite content: some bacteria can change the chemical composition of urine and elevate nitrite content. Most commonly, this occurs because of an infection caused by the E. coli bacteria.
3. Bacteria presence: using a microscope, doctors can obtain a zoomed-in view of urine to check for bacterial growth.
4. Urine pH levels: when the urinalysis returns a result which doesn’t coincide with normal pH in urine, especially if it’s higher, it could indicate a UTI.

Crucially, the presence of these common UTI markers does not single-handedly eliminate other potential problems from the equation. While the causes of UTIs are typically associated with the above-mentioned indicators, they could also signal a range of other conditions. This is especially important when performing a home urine test in order to avoid a false diagnosis.

Some of these other conditions are:

• Metabolic ketoacidosis: a dysfunction of the liver common in diabetics that elevates the presence of ketones in the body.

Renal tubular acidosis: a serious condition limiting the excretion of acids from the body, which raises urine pH.

• Diet-induced ketosis: patients can inadvertently or voluntarily enter ketosis and elevate ketones in urine by adhering to a diet low in carbohydrates.
• Diabetes: diabetic patients exhibit heightened levels of systemic sugar, which promotes bacterial growth and could increase the risk of UTIs.

Reading a UTI Diagnosis – Next Steps

Assuming your healthcare provider has ruled out any other condition and confirmed a urinary tract infection, they will undertake certain steps to outline the next steps and begin prompt treatment. However, it’s also common for doctors to order further testing of urine cultures to identify the exact strain of bacteria for a more targeted treatment.

Regardless, your doctor will usually prescribe a course of antibiotics, which needs to be completed fully in order to eradicate the infection. If the urinary tract infection causes a painful, burning, or itching sensation during urination, doctors may prescribe anti-inflammatory and pain-relieving medications to aid recovery.

Additionally, patients will frequently be advised to maintain a high fluid intake. Proper hydration is key to dealing with infections in the urinary tract or bladder. 

Should these remedies prove helpful and alleviate the condition after the full course of antibiotics, the patient won’t have to take any other action. However, if symptoms do not subside, an additional visit may be necessary to check for the potential of more severe underlying conditions.

The Takeaway

A urinalysis is an indispensable tool for diagnosing urinary tract infections. Based on several factors, such as leukocytes, bacteria, and urine pH, doctors utilize the urine sample test to confirm or rule out a suspected UTI. However, because urine sample testing finds its use in far more contexts than just UTIs, consulting with a doctor in case of doubt is recommended.

You may also read: Recurring UTIs: Tests, Reasons & Treatment