Bacteriological analysis of urine. Urine culture analysis: what shows how to donate, decoding Bacteriological culture of urine for microflora

Sowing urine for flora and antibiotic sensitivity is a separate type of diagnostic examination, which is indicated for carrying out if the patient has diseases of the genitourinary system of an infectious nature. The main task of physicians is to detect a pathogenic microorganism, establish its type and susceptibility to antibiotic therapy.

Performing laboratory culture of urine for flora and sensitivity, doctors most often find streptococcal infection, Staphylococcus aureus, Escherichia, yeast-type fungi, enterococci in the patient's urine.

How to prepare for the diagnosis

The analysis of urine for flora does not begin with performing the act of urination, but with preparatory measures, consisting in strict adherence to the following rules:

• awareness by the patient himself that a microbiological examination of urine will reveal the pathogenic microorganism that provoked an inflammatory process in the kidneys, bladder or ducts that remove urine outside the body;
• you do not need to observe any dietary restrictions on the use of certain types of food (the person being examined must lead a habitual lifestyle);
• before urinating for analysis for bacterial culture, a thorough toilet of the external surface of the genitals should be carried out so that the foreign microflora located on the foreskin in men and labia minora in women does not distort the results of laboratory research;
• immediately after the patient takes a shower with soap, wipes the intimate area with a dry clean towel, it is necessary to flush a small amount of morning urine into the toilet, and then collect the urine in a container for analysis;
• you need to take the culture in a sterile plastic container, it is issued to the person being examined in the laboratory, or it is purchased at the pharmacy;
• in the presence of reasonable suspicions of the presence of tuberculosis bacillus in the body, which is in the open form of the course, urine for flora and antibiotic sensitivity is taken every morning for 3 consecutive days (this analysis technique is indicated for patients if they were preliminary diagnosed with renal tuberculosis );
• it is strictly forbidden to take antibiotic drugs if their active components are able to suppress most of the pathogenic microorganisms, thereby distorting the results of urine culture on the flora.

Immediately after the sterile urine collection jar for antibiotic susceptibility is filled with urine, it must be tightly closed with a lid and immediately taken to the laboratory for testing. Patients undergoing inpatient treatment are cultured for flora at the place of receiving therapy. Compliance with these rules is the key to high-quality collection of biological material for research.

Analysis indicators and its decoding

A urine culture tank for flora is necessary to determine the severity of bacteria in patients who initially have signs of infectious inflammation of the urogenital organs. Analysis of urine for microflora makes it possible to establish the quantitative composition of pathogenic microorganisms capable of forming colonies, relative to 1 milliliter of the studied urine. Deciphering the analysis of urine with the determination of the concentration of pathogenic bacteria is carried out in compliance with the following standards:

• upon detection of infectious microorganisms with a density of 10 to 5 degrees of colony-forming units per 1 milliliter of urine, this means that the human genitourinary system has undergone extensive insemination (the patient is given a preliminary diagnosis of bacteriuria even in cases where signs of the inflammatory process are completely absent, and due to protective the functions of the immune system have not yet fully manifested themselves);
• positive is the result of laboratory analysis for pathogenic flora in urine, if bacterial microorganisms with a concentration of 10 to the 2nd degree of colony-forming units per 1 milliliter of the biological fluid under study are found in urine, but the patient has a pronounced clinical picture of acute cystitis, urethritis, pyelonephritis, glomerulonephritis or other inflammatory diseases of the organs of the excretory system;
• when bacteria are isolated in the composition of urine, which have a colonial density of 10 to the 5th degree units, but do not belong to a strain of microorganisms that can provoke the symptoms diagnosed in a patient, a second test is prescribed, since the infection could get into the urine due to that the person did not know how to properly collect the studied material.

If two or more varieties of bacterial microflora are found in the urine of one person, who does not have obvious symptoms of infectious infection of the genitourinary system, an additional examination is always assigned.

Only after this is an antimicrobial drug selected. If, according to the results of urine analysis for flora and sensitivity, a variety of infectious microorganisms was not established, but one strain of bacteria was isolated, then the reliability of the examination is 80% in female patients and 99% probability of bacteriuria in men.

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Bacterial sowing - the norm

A negative result of bacterial culture for pathogenic microflora in the organs of the genitourinary system is the colonization of urine below 10 units to the 3rd degree. In this case, a prerequisite is the absence of a clinical picture indicating acute or chronic inflammation in the kidneys, bladder and excretory canals.

If the total number of pathogenic microorganisms is within acceptable limits, but acid-fast bacteria are detected, then with 95% probability you can be sure that the patient has kidney or urinary tract tuberculosis. To confirm the diagnosis, a repeated bacterial culture of urine is prescribed and, in addition, the method of staining urine according to the Ziehl-Nielsen system is used.

This technique allows you to separate Koch's bacillus (the causative agent of tuberculosis) from microorganisms of other strains, which shows the insemination of the excretory system with this dangerous infection. In this case, the norm of the urine flora is considered violated until the patient completely gets rid of the microorganisms that caused tuberculosis.

Factors distorting the test result

We must not forget that ignorance of how to donate urine for bacterial culture or a gross violation of the collection of biological material leads to a false conclusion of the biochemical laboratory. What does it mean? The patient will have to repeat the entire procedure from start to finish. In the case of an actual infection, bacteria will continue to develop. It is necessary to remember the following factors that can distort the results of the survey:

• violation of the established regulations for the delivery of urine (a contaminated container that has not undergone preliminary sterilization can be used, or the person urinated without washing the genitals);
• the body contains chronic diseases of an infectious etiology that affect the tissues of organs that are not related to the genitourinary system (in this case, bacteria are excreted with urine, partial insemination of the excretory organs occurs, but local inflammation of their mucous membrane is still absent);
• untimely delivery of urine to the laboratory, where the analysis for bacterial inoculation of biological material should be carried out (the longer the urine is kept in a room with room temperature and higher, the more dynamic is the growth of pathogenic microflora);
• getting into the urine of mucous discharge from the vagina in women;
• unauthorized use of antibacterial drugs, or refusal to take them.

Under the influence of antiseptic medicines and the protective reaction of the cells of the immune system, the aerobic microflora has the ability to reduce its quantitative population, and after a short time it manifests itself again in the form of acute inflammatory processes of the urinary organs.

Selection of an antibiotic

In order for antibiotic therapy to bring the expected result and the patient to get rid of infections of the genitourinary system, the individual sensitivity of bacteria to the active components of drugs is determined in laboratory conditions. The procedure itself consists of the following steps:

• doctors conduct an analysis for bacterial inoculation of the collected urine;
• isolated colonies of microorganisms are placed in a special laboratory glassware - a Petri dish, where they are provided with a nutrient medium;
• the specialist conducting the research monitors the growth of the bacterial microflora and the increase in its population;
• upon reaching the required number of microbes, a small amount of an antibacterial agent that belongs to a specific pharmacological group is applied to the infectious colony;
• the specialist monitors the reaction of pathogenic microorganisms to the medication, records the further growth of bacteria or their death.

Bacteriological sowing of urine (bacterial sowing, sowing on flora, etc.) is one of the varieties of laboratory urine testing. Unlike the general analysis of urine, the analysis of urine for flora is quite complex, but at the same time highly informative, research.

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And if a standard urine test is prescribed every time you seek medical help, urine culture on flora has strict indications for conducting. It is also worth considering the fact that this study must be carefully prepared, since in this case, sterility is important when collecting urine. Bacteriological culture is prescribed for men and women both as a preventive study and to clarify existing diagnoses.

The main task of such a study is to identify harmful bacteria in the patient's urinary system. A tank analysis is assigned to determine the presence of microflora that provokes the appearance of inflammatory processes and the development of infections in the body. Also, bacterial culture shows colonies of certain types of bacteria, which allows conclusions to be drawn about the general state of health of the genitourinary system and the whole organism as a whole.

But urine is a product of human metabolism, a kind of "trash bin" in which all substances are concentrated, which for one reason or another are not in demand by the body. This liquid, by definition, cannot be sterile, which means it is overpopulated with bacteria. How to study the state of health in such conditions?

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The analysis of urine for culture shows whether the number of bacteria exceeds the permissible norms and whether there are any conditionally harmful microorganisms among the conditionally harmful microorganisms that can cause serious damage to the patient's health.

Usually, the urine contains streptococci, staphylococci and diphtheroids. They are considered dangerous, but only in large quantities. And if their number exceeds the permissible norm, it means that infectious processes develop in the body.

In what cases is assigned

Not every patient is prescribed. If a referral for a general analysis of urine can be obtained from any specialist, then a tank analysis for sterility is prescribed by urologists or gynecologists. Usually, a tank study is prescribed if:

• there is a possibility of developing an infectious disease;
• monitoring of ongoing medical therapy is required;
• it is necessary to confirm the preliminary diagnosis;
• there was a relapse of the disease;
• a woman is preparing to become a mother;
• the patient suffers from diabetes mellitus;
• it is required to establish sensitivity to antibiotic drugs.

Most often, planting on flora is necessary in order to establish the presence of inflammation and diseases of the bladder and urinary tract.

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The patient's treatment will depend on what results this analysis shows. Also, this study is carried out as an analysis for sensitivity to antibiotics, that is, in the course of laboratory diagnostics, it becomes clear whether the bacteria are resistant to a particular drug and whether it is worth prescribing it for treatment. Sometimes it is carried out in the middle of treatment if the patient is not recovering and his health deteriorates. From this it can be concluded that the bacteria are resistant to the antibiotic chosen at the beginning of treatment, and it is better to replace the drug.

Sowing on flora is mandatory for pregnant women, you need to take it to patients suffering from endocrine diseases (diabetes mellitus) for general health monitoring during an annual preventive examination, as well as if any disease has caused a relapse.

Urine culture during pregnancy is prescribed for all women to monitor the health of the genitourinary system. If the pregnancy proceeds without complications and the expectant mother does not suffer from kidney and bladder ailments, urine culture during pregnancy will need to be passed before registering and before going to the hospital, at 35-36 weeks.

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If a protein is found in the general urine test or the patient complains of lower back pain, it will be necessary to undergo such a study again. Also, this study can be prescribed monthly for women suffering from chronic kidney disease, which they must inform the attending physician about when registering.

The advantage of the sterility analysis tank is the high accuracy of its results and availability to all segments of the population. But in order to make a diagnosis and choose drug therapy on the basis of diagnostic data, you need to carefully prepare for the study, otherwise it does not make sense.

If urine is collected without meeting the microflora test requirements, the results will be incorrect and this will lead to inappropriate treatment. Therefore, before taking a bacterial analysis, you need to carefully study the information on the collection of urine.

First of all, you will need to purchase a sterile container for collecting urine. The pharmacy has containers with a lid designed specifically for collecting urine.

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But in the laboratory, they usually give out their containers for collecting biomaterial, disinfected, dried and closed in accordance with the laboratory conditions. Purchase a container in a pharmacy or take it from a laboratory - the doctor who prescribes a referral to the research tank will tell you.

Before you start collecting urine, you need to prepare a towel for hygiene procedures. To do this, a clean towel is carefully ironed on both sides with an iron and folded in half. In this form, they are brought into the bathroom.

Next, you need to thoroughly wash your hands and genitals. It is forbidden to use cosmetics for washing; laundry soap is best in this case. Next, you need to wipe the genitals with a prepared towel, expanding it (with the inside). Women are advised to close the vaginal opening with a sterile cotton swab to avoid bacteria from the genitals entering the urine.

Next, you need to open the prepared container without touching the inside of the lid and container. The first stream of urine is lowered, since it helps to flush the urinary tract, and the middle stream is carefully collected. The container is closed with a lid and taken to the laboratory.

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Before taking it, it is better to refrain from sexual intercourse, excessive physical exertion and taking medications, if they are not vital medications. It is also advisable to avoid eating foods that can stain urine and thereby distort the results of the study.

For the analysis tank, the biomaterial should be collected immediately before being sent to the laboratory. The study tank requires the morning urine portion, which contains the highest concentration of bacteria. Collecting urine in the evening and then storing it in the refrigerator is strictly prohibited in this case. The shelf life of the biomaterial collected for analysis should not exceed two hours. It is allowed to store urine in the refrigerator for no more than six hours if the trip to the laboratory is scheduled for the afternoon. If all the requirements for the collection of urine are met, the results of the tank analysis will be absolutely accurate.

Another question - how much urine does the bacterial culture require? As with the general analysis, it is better to bring 50 to 70 ml of urine to the laboratory. But there are modern laboratories that require up to 10 ml.

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Therefore, this information should be clarified with the attending physician or in the laboratory itself.

What the results will tell you

The results are prepared within 10-14 days. This time is necessary in order to grow a colony of bacteria, and then study them. The decryption usually consists of two forms: direct data on the presence of certain bacteria and an antibioticogram, that is, information on the sensitivity of microflora to antibiotics.

The results form includes information on the detected microorganisms, which are indicated in the CFU. The higher the CFU, the greater the concentration of certain bacteria in one ml of liquid. Usually CFUs have upper and lower limits, the excess of which indicates that an inflammatory process develops in the body.

An antibiogram includes information about all types of bacteria that are present in human urine. Opposite each representative of the pathogenic microflora there is information about whether this particular species was found in the material under study. It is also mandatory to contain information about what types of antibiotics they have sensitivity to.

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Thanks to the first decoding point, the attending physician will be able to determine whether the patient has a disease, the second will help to identify the causative agent of the disease and make the correct diagnosis. Thanks to the third decoding point, the specialist will be able to choose the drugs for therapeutic therapy as correctly as possible.

Since urine is non-sterile, bacteria are present in it within acceptable limits. When decrypting the received data, the doctor first of all examines their number. If the total number of microorganisms does not exceed 1000 CFU / ml, it is safe to say that the patient is healthy. Indications exceeding 100,000 CFU / ml indicate the development of an infectious disease and require appropriate treatment. Intermediate data require a repeat study. Usually this is evidence of non-compliance with the requirements for the collection of biomaterial, less often - information about the onset of the inflammatory process.

Urine tests are often done to check for antibiotic sensitivity. The method is used to diagnose microorganisms in the genitourinary system in order to prevent the appearance of cystitis, pyelonephritis and urethritis in a person.

According to urine tests, one can easily understand the presence of abnormalities in the work of certain organs, the presence of diabetes mellitus, kidney stones, arterial hypertension and liver pathologies.

Antibiotics - scope, possible harm

Antibiotics are drugs of natural, semi-synthetic and synthetic origin, the action of which is aimed at stopping the multiplication of pathogenic microorganisms, at stopping their metabolism. Urine tests for antibiotic susceptibility are taken at any hospital.

These medicines are used to treat inflammatory processes. According to the spectrum of action, antibiotics are divided into:

• destroying the cell wall of bacteria (they will be inactive when interacting with mycoplasmas). Drugs with a narrow specificity affect a small number of gram-positive and gram-negative microorganisms. Broad-specific antibiotics affect large numbers of bacteria;
• antifungal;
• antiprotozoal;
• antiviral;
• antineoplastic.

According to the mechanism of biological action, antibiotics are divided into:

• drugs that suppress the synthesis of the cell wall (Cycloserine, Fosfomycin);
• drugs that disrupt the functions of the cell membrane (Nystatin, Gramicidin);
• drugs that slow down protein synthesis on ribosomes (Macrolides, Aminoglycosides);
• medicines that slow down the synthesis of nucleic acids - RNA and DNA (Nitrofurans, Trimethoprim);
• antibiotics that disrupt the synthesis of nitrogenous compounds and amino acids (actinomycin D, remantadine).

Side effects of antibiotics and possible harm:

• high toxicity (depends on properties, dosage, administration) - hepatotoxic effect (effect on the liver), nephrotoxic (effect on the kidneys), neurotoxic (effect on the nervous system). Hematotoxic (damage to the cardiovascular system), cardiotoxic (damage to the heart) and embryotoxic (effect on the fetus);
• dysbiosis (violation of the normal intestinal microflora);
• allergic reactions;
• decreased immunity;
• endotoxic shock;
• the emergence of drug resistance.

Infectious diseases that can be detected by urinalysis

Urine tests are best able to identify a large number of pathologies. They are used in all medical fields. Experienced experts recommend regularly donating urine to prevent chronic diseases and further complications.

When urine becomes acidic, water depletion in the human body, an increase in blood sugar, and a decrease in potassium in blood cells can be foreseen. If there is a lack of potassium, there is a possibility of the appearance of chronic renal failure, disturbed blood balance, cancer of the genitourinary system.

With an increase in protein in the urine, it is worth thinking about kidney problems, inflammatory processes of the ureter, urethra, and cardiovascular insufficiency.

When the level of leukocytes in the urine rises sharply, there is the possibility of kidney stones and pyelonephritis. Often, tuberculosis of the kidneys or their tumors, prostate cancer develops.

An increased level of red blood cells in the urine indicates nephrotic syndrome and malignant tumors in the kidneys. Bilirubin indicates liver damage, malaria, gallstones, and hepatitis.

Urogenital tract

With the help of urine tests, the following diseases can be detected:

• pathology of the upper urinary tract (pyelonephritis);
• pathology of the lower urinary tract (cystitis, urethritis, prostatitis, problems with the penis);
• symptomatic problems;
• asymptomatic.

There should be no nitrites, protein compounds, sugars, ketone bodies, urobilinogen and bilirubin in the liquid. The white blood cell count must be up to 7. Bacteria must be free.

With a decrease in the weight and density of the fluid, you need to think about the fact that the urinary system is not able to control the process of creating urine. Conclusion: pathogenic substances, salts, toxins remain in the body. This contributes to the development of kidney failure.

Protein compounds in urine indicate the appearance of persistent glomerulonephritis, problems with urination, amyloid in the kidneys and nephropathy in diabetes mellitus. Pus and inflammation in the bladder can increase the level of protein in the fluid. Only the attending physician can decipher the study.

Other infectious pathologies

According to the indicators and norms of urine, it is possible to identify the development of infections in the human body. The color of urine can change with many medications. If the density of the liquid becomes more than 1.025 g / l, it means that the person is tormented by gag reflexes, bouts of nausea, diabetes mellitus, flatulence and dehydration. Indicators below 1.008 g / l indicate an excess of water in the body, getting rid of edema, diabetes insipidus.

Usually the urine environment is acidic. The appearance of a weakly acidic and alkaline environment indicates the development of inflammatory processes. A strongly acidic environment occurs during fasting and fevers.

There are a lot of protein compounds in the liquid for nephropathy in pregnant women. Bile pigments often appear in hepatitis, liver cirrhosis and poisoning.

The presence of epithelial cells in the urine indicates the presence of stones and sand. There should be no fungi in the urine, their appearance indicates the development of candidiasis.

About the examination procedure and material sampling

All indicators should always be normal. Good Results Table:

Rules for taking material from adults, children and pregnant women

Materials are taken for research in the laboratory according to the following rules:

• collect a portion after waking up;
• do not eat before the morning toilet;
• do not pour over the edge - start emitting into the toilet, after a few seconds substitute the container for the liquid, after filling it, continue the process of getting rid of the liquid into the toilet.

To collect a portion of liquid from a little girl, you should keep the labia in a divorced state, let the girl let the urine pass by for the first seconds, then direct it to a special container.

To take tests from boys, you should remember the correct sequence: keep the foreskin in the abducted position, allow a few seconds to release the liquid past the jar, then direct it to the container.

A pregnant woman needs to give urine early in the morning. Pre-wash the container, fill it up to 125 ml, then close the container tightly. Do not allow the analyzes to be overcooled, so that the results are not distorted.

Bacterial urine culture

Bacterial culture is carried out only in complete sterility. The process is necessary if:

• suspicions of pathology in the genitourinary system;
• control over the effectiveness of antimicrobial treatment of diseases of the urinary system;
• pregnancy.

The specialist applies drops of liquid to the nutrient medium. Then they are located in a thermostat. A day later, the doctor takes out a Petri dish and carefully examines the nutrient medium. The development of the infectious process occurs only if the human body has:

• saprophytic staphylococcus;
• proteas;
• colibacillus;
• Pseudomonas aeruginosa;
• Klebsiels.

What is an antibioticogram

An antibioticogram is a study in which doctors determine the sensitivity to various antibiotics. The procedure is carried out in a special laboratory. Experts sow on a nutrient medium to identify pathogenic organisms. This will allow doctors to further implement the antibacterial program.

When bacteria are identified, doctors transplant them to another nutrient medium to see their further development. Next, special paper disks are applied, which are pre-soaked in antibiotics. Those microorganisms that are most sensitive to this type of drug will not multiply and grow, while others will continue their vital activity. The concentration of MIC is capable of suppressing bacterial development.

Decoding the results

The provided fluid is not sterile. If it contains less than 1000 bacteria, there are no infectious processes in the body. The questionable result would be when more than 10,000 infectious agents are present in the urine. From 100,000 bacteria in the liquid indicates that a person is sick with genitourinary diseases.

The patient can find out the results within 6 days. They will indicate the presence of pathogenic organisms in the urinary system, but will not specify exactly where they are, in which organ. Only doctors can figure this out.

In what cases are decryption errors?

Errors in decoding urine analyzes are affected by the following situations:

• staff;
• the patient himself;
• methods of conducting;
• special devices;
• technology of carrying out.

Conclusion

Urinalysis to determine antibiotic susceptibility should be performed in order to prescribe the correct treatment. It is important to understand the classification of drugs, side effects, therapeutic effects. Self-medication is contraindicated. Infectious diseases can be detected by urinalysis.

To determine the inflammatory processes, it is recommended to use other analyzes. Only experienced specialists can decipher them, but they sometimes make mistakes. For reliable results, it is important to correctly collect materials, to culture urine on nutrient media. An antibiogram will allow you to determine the sensitivity to drugs in the best way.

This is a microbiological study that allows you to determine the qualitative and quantitative composition of urine microflora, including identifying opportunistic microorganisms in a high titer and pathogenic microorganisms. Listed below main groups of microorganisms that can be highlighted in the course of this study:

• Streptococcus spp. (Str.pneumoniae, Str.pyogenes, etc.)
• Staphylococcus spp.
• Haemophilus influenza
• Enterobacteriaceae (Klebsiella spp., Citrobacter spp., Salmonella, Proteus, etc.)
• Non-fermenting gram-negative bacteria (Pseudomonas aeruginosa, Acinetobacter spp., Etc.)
• Moraxella spp.
• Neisseria spp.
• Corynobacterium
• Candida spp.

Indications for the purpose of the study

Preparation for research

For analysis, obtain consumables in any laboratory department: a container with an adapter, a test tube and a reminder for collecting biomaterial.

Urine collection must be carried out before the start of drug treatment and not earlier than 14 days after the course of treatment.

Immediately after sleep, collect urine: flush a small amount of urine into the toilet, collect about 30-40 ml of urine in a sterile container, flush the rest of the urine into the toilet. Do not take urine from a vessel or pot. Deliver the biomaterial to the laboratory within 1.5 - 2 hours after collection... It is allowed to store biomaterial in a refrigerator only in a test tube (at t from + 2 ° C to + 4 ° C) for no more than 3 hours.

Why is a urine culture test taken? This is a common question. Let's figure it out in this article.

Ninety-five percent of all inflammations of the bladder, kidneys, urethra are provoked by infectious agents, the main ones being proteus, staphylococci and enterobacteria. They are called uropathogenic flora. To identify the source of the patient's disease, the patient's urine is taken. This method requires strict adherence to urine collection standards, special equipment with media and thermostats, as well as competent specialists.

Where are they held?

• with pyelonephritis - 1000 CFU and more;
• with cystitis - 100 CFU.

If the CFU index exceeds 100,000, then there is no need to doubt the activity of the pathogen. It is necessary to urgently begin treatment, since this picture happens with a catheter infection.

Tank. urine culture for antibiotic susceptibility

To determine the optimal method of therapy, you can use culture analysis for its sensitivity to various antibiotics. Its result is also called an antibioticogram.

What is the essence of this study? Divide the Petri dish into parts and place in each strip or circle soaked in antibiotic. They are marked either on the outside of the cup or by color.

Sowing in sectors. The cup is then placed in a thermostat at the human body temperature and monitored daily. If the antibiotic is ideal, it will kill bacteria and there will be no growth in the sector. In the case of resistance of the pathogen, the growth of the colony will be noted.

To get the result, you need to wait four to five days. Thanks to new methods, it is possible to perform a study in two days, while not only the sensitivity of the drugs, but also their therapeutic dose will be determined.

We found out what the urine culture shows.