What does nitrate in urine indicate

As you begin to urinate, first allow some of the urine to fall into the toilet. Then collect about two ounces of urine in the cup provided by your doctor.

Avoid touching the inside of the container. You can then finish urinating into the toilet. A positive test for nitrites in the urine is called nitrituria. If you have nitrituria, your doctor will likely want to send your urine sample to a laboratory for a urine culture test. In a urine culture, your doctor can find out which specific type of bacteria are causing your UTI.

A urine culture usually takes about two to three days to be completed, sometimes longer depending on the type of bacteria. On average though, you should expect to see your results in three days. Keep in mind that not all bacteria are capable of converting nitrate to nitrite. So, you can have a negative nitrite test and still have a UTI. This is why your doctor considers the result of many tests, not just one test, when diagnosing a UTI.

Untreated UTIs become more severe as they spread toward the kidneys. An infection in the upper urinary tract is much more challenging to treat. Eventually, the infection can spread into your blood, causing sepsis. Sepsis can be life-threatening. Additionally, UTIs in pregnant women can be dangerous for the baby and mother.

The treatment for nitrites in your urine usually involves a course of antibiotics. Proper treatment with antibiotics should resolve your symptoms within a day or two. The urine dipstick test useful to rule out infections.

A meta-analysis of the accuracy. BMC Urol. Urinary tract infection in men. Int J Clin Pharmacol Ther. Fox for his critique and agree with some of his comments. The sensitivities and specificities mentioned for the nitrite test in Table 3 of our article 1 are transposed and should read sensitivity 35 to 85 percent and specificity 92 to percent.

The meta-analysis 2 of the accuracy of the urine dipstick test cited by Dr. Fox reported that the sensitivity of the urine dipstick test for nitrites ranged from 45 to 60 percent and the specificity from 85 to 98 percent with children removed. While this reference was not available when our article was submitted, it is reassuring that the specificities are similar to the corrected table values.

The leukocyte esterase urine dipstick test, which screens for pyuria, was reported in the same meta-analysis 2 to have a sensitivity of 48 to 86 percent and a specificity of 17 to 93 percent. Perhaps this slight increase in sensitivity supports the clinical impressions of Dr. Fox that the leukocyte esterase test is more sensitive because the sensitivity was found to be the highest in primary care populations 83 to 92 percent.

Regarding the clinical use of the urine dipstick nitrite test, we are not sure what Dr. However, in the worst-case scenario sensitivity: 45 percent and specificity: 85 percent , a patient with a pretest probability of 50 percent and a positive nitrite test would have a 75 percent chance of a urinary tract infection.

Although we could agree with Dr. Fox that the absence of leukocyte esterase and nitrite cannot exclude a urinary tract infection in a patient with a high pretest probability, the meta-analysis 2 he cited does not support his more general statement. Already a member or subscriber? Infected urine may contain considerable amounts of nitrite as a result of bacterial nitrate reductase activity, and detection of nitrite in urine is routinely used in the diagnosis of bacterial cystitis.

We sought to determine whether NO was generated from acidified nitrite-containing urine. Furthermore, we also studied the growth of the urinary pathogen Escherichia coll in acidified nitrite-containing urine. The leukocyte esterase LE test detects esterase, an enzyme released by white blood cells.

Positive test results are clinically significant. The LE test is also used to screen for gonorrhea and for amniotic fluid infections. The combination of the LE test with the urinary nitrite test provides an excellent screen for predicting a urinary tract infection.