Bacteria In the Urine, Even With No Symptoms, Go Ahead and Treat

Untreated asymptomatic bacteria in the urine will turn into kidney infections about a third of the time. The definition of a bladder infection was set by Kass in a famous article reported in 1962 in the Annals of medicine . The definition was quite rigid. Dr. Kass stated for an accurate diagnosis a woman must have 100,000 bacteria grown in a culture to show positive in two separate but consecutive clean catch midstream urine cultures. 80% of the patients still had the bacteria on their second test, but about 20% didn't. So when he studied the fate of these infections he was studying a fairly high risk group, one that was not likely to clear up on their own.. None of us spend the money on two cultures for our patients any longer. When it comes to pregnant patients about 5% of patients will show this asymptomatic bacteria. Risk factors for the urinary tract infection in women include either recent or frequent sex, the use of spermicides for contraception, being obese, having diabetes, having anatomy problems like prolapse of the uterus, a cystocele, a rectocele, a urethrocele or other pelvic floor problems. If you have poor hygiene of your outer vaginal area or incompletely empty your bladder you will be more likely to get an infections.  When it comes to pregnant diabetics, the rates are much higher. So it's often true that we test more frequently in pregnancy, as the presence of bacteria cannot always be detected by waiting for the patient to exhibit typical infection symptoms. In fact women who go to the bathroom more frequently because they are pregnant may not realize they have an infection at all. When your physician uses the dip stick test right after you void they are not just looking for bacteria. The physician is looking for the substances called nitrates. Nitrates are not usually found in urine tests, but bacteria present can breakdown compounds and produce them, so it's a product of the presence of bacteria. It is also true that women with these impending bladder infections may have white blood cells, greater than 10 of them is the formal definition, but again, your physician may use a lower number for a reason to treat. But one way or the other, when you next go to the gyno to get your test: make sure you do it right: pee a bit, then collect the urine in the cup: don't just take the first couple of drops, that's not always reflective of what's in your bladder, but may be reflective of what's on your skin!


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