Bacteriuria: how to identify and what it can mean

Bacteriuria corresponds to the presence of bacteria in the urine, which may be due to inadequate collection of urine, with contamination of the sample, or due to urinary infection, and other changes in the urine test, such as the presence of leukocytes, epithelial cells, may also be observed in these situations. and, in some cases, red blood cells.

The presence of bacteria in the urine is verified through a type I urine test, in which the presence or absence of these microorganisms is indicated. According to the result of the urine test, the general practitioner, urologist or gynecologist can indicate the appropriate treatment, if necessary, or request additional tests.

How to identify bacteriuria

Bacteriuria is identified through a type 1 urine test, in which, by viewing the urine under a microscope, it is possible to observe whether or not there are bacteria, as indicated in the examination report:

• Absent bacteria, when bacteria are not observed; Rare bacteria, when 1 to 10 bacteria are visualized in 10 microscopic fields observed; Some bacteria, when between 4 and 50 bacteria are observed; Frequent bacteria, when up to 100 bacteria are observed in 10 fields read; Numerous bacteria, when more than 100 bacteria are identified in the observed microscopic fields.

In the presence of bacteriuria, the doctor who ordered the test must evaluate the urine test as a whole, observing any other changes present in the report so that a diagnosis can be made and treatment can be started. Generally, when the report indicates the presence of rare or some bacteria, it is indicative of the normal microbiota of the urinary system, and is not a cause for concern or initiation of treatment.

Normally in the presence of bacteria in the urine, urine culture is requested, especially if the person has symptoms, so that the species of the bacteria is identified, the number of colonies formed and the resistance and sensitivity profile of the bacteria, which is important information for that the doctor recommends the most appropriate antibiotic for the treatment. Understand how urine culture is made.

What may mean bacteria in the urine

The presence of bacteria in the urine should be evaluated together with the result of the other parameters of the urine test, such as leukocytes, cylinders, red blood cells, pH, smell and color of the urine. Thus, according to the result of the type 1 urine test, it is possible that the doctor will reach a diagnostic conclusion or request other laboratory tests to be able to indicate the most appropriate treatment.

The main causes of bacteriuria are:

1. Sample contamination

Sample contamination is one of the most frequent causes of bacteria in the urine, especially when several epithelial cells and absence of leukocytes are observed. This contamination occurs at the time of collection, when the person does not perform the correct hygiene for collection or does not neglect the first stream of urine. In these cases, in most cases, the bacteria identified are part of the urinary system, not posing a health risk.

What to do: If no other changes in the blood count have been identified, the doctor may not take into account the increase in the number of bacteria, however, in some cases, a new collection may be requested, being important this time to perform the correct hygiene of the intimate region, discard the first jet and take it to the laboratory up to 60 minutes after collection for evaluation.

2. Urinary infections

When it is not a question of contamination of the sample, the presence of bacteria in the urine, especially when frequent or numerous bacteria are seen, is indicative of infection of the urinary system. In addition to bacteriuria, some or numerous epithelial cells can be seen, as well as several or numerous leukocytes depending on the microorganism responsible for the infection and its quantity.

What to do: Antibiotic treatment of urinary infections is usually only indicated when the person has symptoms related to the infection, such as pain or burning when urinating, urine with blood or a feeling of heaviness in the bladder, for example. In these cases, the general practitioner, urologist or gynecologist may recommend the use of antibiotics according to the bacteria identified and their sensitivity profile.

However, when symptoms are not observed, the use of antibiotics is usually not indicated, as it can induce bacterial resistance, which makes treatment more complicated.

Learn to recognize the symptoms of urinary tract infection and how to avoid it.

3. Tuberculosis

Although it is rare, it is possible that in systemic tuberculosis bacteria may be found in the urine and, therefore, the doctor may request a urine test to search for Mycobacterium tuberculosis , which is the bacterium responsible for tuberculosis.

Normally, urine Mycobacterium tuberculosis research is only performed as a way to monitor the patient and the response to treatment, and the diagnosis is made by examining sputum or tuberculin test, known as PPD. Understand how tuberculosis is diagnosed.

What to do: When the presence of bacteria is verified in the urine of the patient with tuberculosis, the doctor must assess whether the treatment is being carried out correctly or if the bacteria has become resistant to the indicated drug, which may indicate a change in the antibiotic or therapeutic regimen. Treatment for tuberculosis is done with antibiotics and must be continued even if the person does not show any more symptoms, because not all bacteria may have been eliminated.