How To Test For UTI At-Home

Urinary tract infections (UTIs) are common bacterial infections that affect millions of people each year. While they can be uncomfortable and sometimes painful, UTIs are generally easy to diagnose and treat. Testing is normally done in the clinic setting, but nowadays there are also ways to test for UTI at-home using dipsticks. This article will explore the reasons for UTI testing at-home, proper specimen collection, testing methodology, testing procedure, test limitations and result interpretation. We will also discuss causes, symptoms and treatment options for UTI.  

Reasons for UTI Testing At-Home

–Symptom Evaluation: The primary reason for UTI testing is to confirm whether experienced symptoms are indeed caused by a UTI.

–Preventive Screening: Some individuals, particularly those prone to recurrent UTIs, may use at-home tests as a preventive measure to catch infections early on.

–Monitoring Treatment Effectiveness: If a UTI has already been diagnosed at a doctor office, testing at-home can help determine if the infection is clearing up after antibiotics have been started.

–Diabetes Management: People with diabetes are more susceptible to UTIs and may benefit from regular testing.

At-Home UTI Testing Methodology

At-home UTI tests typically use “urine dipsticks” which detect substances in the urine that indicate the presence of an infection. They have absorbent pads that are impregnated with chemical reagents and will turn various shades of color once they’ve been dipped into urine. The degree of color change will correspond to a scale located on the bottle, box or package insert of the dipsticks. These tests usually look for:

–Nitrites: Nitrites are a byproduct from when bacteria convert nitrates into nitrites. The dipstick will measure nitrites in increments, seen by color change to various shades of a pink background. If nitrite tests are positive, it is usually indicative of a urinary tract infection (UTI). A normal urine nitrite result should be negative. However, a negative nitrite result does not necessarily rule out a UTI, since not all bacteria are capable of reducing nitrates into nitrites.  

–Leukocytes (white blood cells): Indicate an immune response to infection. Leukocyte esterase is an enzyme which is produced in certain WBCs (neutrophils, eosinophils and basophils). It indicates an immune response where leukocytes have been recruited to the site of an infection. A normal leukocyte esterase result should be 0 (negative). But a positive result will measure it in increments from 0 to 500 cells/ul. Elevated leukocyte esterase can mean that bacteria are present, usually due to a UTI. However, it can also be present for other conditions like kidney stones or tumors of the urinary tract.

UTI Test Strips vs. Standard Urinalysis Test Strips

Most at-home tests that focus specifically on UTI will only test for nitrite and leukocytes.

However, standard urinalysis strips can be used as well since they have nitrite and leukocyte testing capability, in addition to testing for 8 to 12 other analytes. These secondary analytes like pH, bilirubin, glucose and urobilinogen, among others, can give helpful information about other disease processes you may have concerns about, or it may help you catch something that has been flying under the radar.

Yet, if a UTI is your primary concern, the UTI-specific strips may be the better option.

How To Collect A “Clean Catch” Urine Specimen

A standard urinalysis test typically uses a “random” urine sample as the specimen of choice. However, the “clean catch” urine sample is the specimen of choice when a UTI is suspected since it produces a more sterile specimen due to the extra steps involved. The steps involved in collecting a clean catch urine specimen are:

-Wash hands thoroughly with soap and water.

-Clean the genital area with an antiseptic wipe to prevent any external contamination. Most laboratory’s use a Castile Soap Towelette for this purpose.

-Begin urinating into the toilet. Then collect a midstream sample in a clean container. Do this by stopping the stream, holding the cup underneath and resume urinating. Doing this method instead of just putting the cup underneath the stream, can prevent splashing and making a mess on the cup, around the toilet and on yourself. The midstream specimen is preferred since it is less likely to be contaminated from the genital area.

-Avoid touching the inside of the container to prevent contamination.

-Secure the lid tightly to avoid spilling and wash hands with soap and water.

-Test the urine as soon as possible since nitrite and leukocyte results can change significantly over time, causing false results.  

UTI Dipstick Testing Procedure

1. Remove the dipstick from its packaging.

2. Dip the strip into the urine sample for the recommended time (usually a few seconds).

3. Remove the strip and dab any excess urine off onto a paper towel or other absorbent material.

4. Wait for the specified time (typically 1-2 minutes) for the results to develop.

5. Compare the color changes on the strip to the chart provided with the test kit.

6. Write results down. This makes it easier to relay any results to a doctor for follow-up. Also, if you are tracking your progress over several days once antibiotics have been started, this can make it easier to show improvement or regression.

Interpreting Test Results

Nitrites

• Negative: No color change
• Positive: Pink to red color indicates the presence of nitrite-producing bacteria

Leukocytes

• Negative: No color change, 0 white blood cells/µL
• Trace: Slight purple color, 1-15 white blood cells/µL
• Positive: Darker purple color indicates the presence of white blood cells

The exact ranges can vary depending on the specific test kit, but these are general guidelines.

Are Nitrites and Leukocytes Always Present Together?

Nitrites will usually show up first, signaling the presence of nitrite producing bacteria. Leukocytes will usually follow on soon after once the immune response has been triggered by the presence of bacteria. The following criteria can be used to assess the risk of a UTI:

– Negative for both nitrites and leukocytes: There is most likely not a UTI present.

– Positive for either nitrites or leukocytes: Possible UTI. Having one present and not the either can sometimes be caused by testing at different times in the disease process. Other things like the presence of non-nitrite producing bacteria can also cause both analytes not to be seen at the same time. The bottom line is that if at least one of these is present in the urine, there is the possibility of a UTI.

– Positive for both nitrites and leukocytes: If both of these are present, there is a high likelihood of a UTI.

Limitations Of At-Home UTI Testing

While at-home UTI tests can be convenient and provide quick results, they have some limitations:

–Less Accurate Than Laboratory Tests: False positives and false negatives are more likely to occur.

–Cannot Identify Specific Bacteria: Organism identification is crucial for selecting the most effective antibiotic. Unfortunately, at-home testing is not capable of this level of specificity. It can tell you that bacteria is likely present, but it won’t tell you the specific genus or species of bacteria that is present.

–Possibly Miss Other Urinary Tract Problems: Conditions like bladder cancer or interstitial cystitis may have similar symptoms but won’t be detected by standard UTI tests.

–User Error: Improper sample collection or test administration can affect the validity of results.

–Unable To Determine Antibiotic Resistance: Unfortunately, antibiotic susceptibility/resistance testing is beyond the scope of at-home UTI testing. This normally requires a Kirby Bauer disk diffusion test and can only be performed in a hospital laboratory. This testing is especially important for treating recurrent or persistent UTIs.

What Causes UTIs?

UTIs occur when bacteria enter the urinary tract and multiply in the bladder. The most common causes include: Escherichia coli (E. coli), which is responsible for the majority of UTIs. Staphylococcus saprophyticus, Klebsiella pneumoniae and Proteus mirabilis are other bacteria which commonly cause UTIs.

Risk factors that increase the likelihood of developing a UTI include female anatomy (shorter urethra), sexual activity, certain types of birth control, menopause, blockages in the urinary tract like kidney stones, weakened immune system and catheter use.

Diabetes also puts people at increased risk for UTI since they are more likely to have sugar present in their urine. Sugar in the urine makes it easier for bacteria to grow since it is a source of nutrition for them.

Common Symptoms of UTIs

The most frequent symptoms of a UTI include frequent urge to urinate, burning sensation during urination, passing small amounts of urine frequently, cloudy urine, red/pink/cola-colored urine (sign of blood), strong-smelling urine, pelvic pain (in women), rectal pain (in men), lower back pain and abdominal pain.

If the infection spreads to the kidneys, additional symptoms may include high fever, chills, nausea, vomiting, upper back pain and side pain.

Treatment of UTIs

Most UTIs are treated with antibiotics. The choice of antibiotic and duration of treatment depend on the type of bacteria causing the infection and the severity of symptoms. Common antibiotics used to treat UTIs include: Trimethoprim/sulfamethoxazole (Bactrim, Septra), Fosfomycin (Monurol), Nitrofurantoin (Macrobid, Macrodantin), Cephalexin (Keflex) and Ceftriaxone.

Doctors may also recommend: Drinking plenty of water to help flush out bacteria, using a heating pad to relieve pelvic pain and taking pain relievers like Ibuprofen or Acetaminophen.

Implementing preventive measures like wiping from front to back after urinating as well as urinating shortly after sexual intercourse can help prevent recurrent UTIs from happening.

Conclusion

At-home UTI testing can be a useful tool for quickly assessing the possibility of a urinary tract infection. By understanding the causes, symptoms, and proper testing methodology, individuals can take proactive steps in managing their urinary health. However, it’s crucial to remember that these tests are not a substitute for professional medical care. They should be used as a preliminary screening tool, with follow-up from a healthcare provider for definitive diagnosis and treatment.

By combining the convenience of at-home testing with professional medical guidance, individuals can effectively monitor their urinary health and address potential infections promptly, leading to better health outcomes.

The dipsticks used in this article are the Urinox-10 urine test strips from Diagnox Health.