Bacteria in urine: diagnosis, treatment

Bacteria in the urine are an extremely unfavorable sign that indicates a severely ongoing inflammatory and infectious process affecting the kidneys, urinary tract, and possibly even the blood and other body systems. Normally, urine is sterile, that is, it should not contain any microorganisms. Any appearance of bacteria in the urine is a pathology. Depending on the number of bacteria, this may indicate both a severe infectious lesion of the urinary system, and the development of bacteremia, sepsis. [1]

Diagnostics of the bacteria in urine

To make a diagnosis, you need to contact a nephrologist, in the absence - to a urologist. In extreme cases, you can contact your local therapist, who will refer you to the appropriate specialist. Diagnostics is based on the determination of the type of bacteria that are in the urine, as well as the determination of their quantitative indicators. Indirectly, according to the clinical picture, one can roughly assume which microorganism is in the urine, but the only possible way of making a diagnosis is precisely the results of laboratory tests, which will indicate the specific and generic name of the identified microorganisms, and their exact concentration, calculated per 1 ml of urine ( bacteriological examination, bacteriological culture). [2], 

Analyzes

The main method for diagnosing bacteria in urine is urine analysis. Various types of urine tests are used:

• clinical, or general urine analysis - allows you to deduce the general picture of pathology, the direction of the main processes, indicates pronounced pathologies and shifts.
• urine analysis according to Necheporenko - counting the number of leukocytes in the urine, allows you to judge the severity, severity of the inflammatory, bacterial process.
• bacteriological examination (culture of urine according to Gould) - an analysis that allows to identify the quantitative and qualitative characteristics of microflora, the causative agent of the disease,
• microscopy of urinary sediment - allows you to identify additional structures, inclusions in the urine, as well as detect cells (erythrocytes, leukocytes, or platelets), which can also be of diagnostic value.

Other methods are also used, but we will dwell only on the most common ones, with the help of which research is carried out in ordinary clinics, without taking into account specialized departments and hospitals. [3], [4]

The main ones are still considered bacteriological methods (bacteriological culture), in which urine is taken and sown on selective nutrient media. Then they are placed in optimal conditions (thermostat), the culture is incubated, a pure culture (pathogen) is isolated, and its concentration (quantity) is determined. With the help of an analysis for antibiotic sensitivity, further treatment is selected for the isolated microorganism, aimed at eliminating this pathogen. You can choose not only the drug itself, but also determine its optimal dosage, which will make the treatment as effective as possible. [5]

Instrumental diagnostics

It is rarely used. The methods of instrumental research are resorted to only if there are concomitant pathologies, complications. For example, if bacteria caused inflammation, purulent-septic process, and more. Or, if it is assumed that there are other foci and sources of infection that the doctor wants to detect and take timely measures. Then the methods can be varied:

• rheography
• x-ray
• CT scan
• MRI
• Ultrasound.

As for the bacteria in the urine itself, their presence is confirmed by bacteriological research. [6]

Flow cytometry

This is a fairly accurate and highly effective laboratory test method that allows you to examine the urine sample received by the laboratory. After the urine enters the laboratory, the laboratory assistant independently chooses the method with which he will conduct this or that study. The choice is made in favor of the method that will allow you to quickly and efficiently solve the tasks. All methods are standardized, methods are strictly prescribed. Flow cytofluorometry is recommended for testing urine samples with suspected bacterial infection. This method is much faster than bacteriological inoculation, as there is no need to wait for the culture to grow. But at the same time, this method has a significantly higher probability of error, and slightly lower reliability indicators. Quicker. This is a method that allows you to get preliminary results if there is no time to wait for bacteriological culture. If possible, it is better to confirm the diagnosis additionally by culture.  [7]

Differential diagnosis

To make a differential diagnosis, it is usually enough to contact a nephrologist, bacteriologist. The doctor will conduct an examination, look at the tests. First of all, it is necessary to differentiate a bacterial infection from other types of diseases. It is quite simple to do this - the specific, generic name of the microorganism is indicated in the analysis results (it can be seen from it whether it belongs to viruses or bacteria). This is the first stage of differential diagnosis.

The second step is to quantify the microorganism. This, in fact, is also the task of the laboratory assistant who does the analysis. The results will indicate quantitative characteristics (concentration of bacteria in one milliliter of urine). If necessary, the doctor will refer you for additional advice to other specialists. If necessary, additional research methods can be prescribed: X-ray of the genitourinary tract, kidneys, computer, magnetic resonance imaging. The data will help clarify the diagnosis, differentiate it when in doubt.

Treatment of the bacteria in urine

The standard treatment is antibiotic therapy. That is, antibiotics are used that suppress or completely stop the growth and reproduction of bacteria in the urine. For this, various groups of antibiotics are used. Appointments must be made by a doctor.[8], [9]

Of paramount importance is the need to stop the inflammatory, infectious, purulent-septic process, to prevent the formation of new foci of infection, its spread throughout the genitourinary tract. It is especially important to prevent infection from entering the kidneys and other internal organs.

Symptomatic treatment is also used to eliminate the current symptoms: relieve pain, swelling, inflammation, hyperemia. Anti-inflammatory, pain relievers, decongestants are used. There are drugs of systemic action aimed at the whole body as a whole, there are local agents, drugs of targeted, local action. Such drugs include, for example, uroseptics, which stop the infectious and inflammatory process only at the level of the genitourinary system, kidneys, and act specifically, selectively. They are highly active against those bacteria that can act as causative agents of diseases of the genitourinary system, and do not act on other bacteria.

What to do if bacteria are found in urine?

If bacteria are found in the urine, the first thing to do is see a doctor (nephrologist, urologist, bacteriologist). It is better, of course, to contact a bacteriologist immediately, since he specializes directly in the treatment of bacterial infections, bacteria. As in urine. So it is in any other biological fluid and system. But not all polyclinics have such a doctor.

After you have consulted a doctor, he will look at the test results, conduct an additional survey, examination, draw conclusions, and prescribe the appropriate treatment. First, drug therapy is used (antibiotics, antibacterial drugs, uroseptics). Phytotherapy is an excellent and effective addition to medical methods of treatment. Many herbal decoctions, infusions, are used for washing, medicinal baths, compresses, for oral administration in order to relieve inflammation, eliminate the infectious process, and stimulate immunity.[10]

Medicines

Antibiotics are used to treat bacterial infections. This is the main and only remedy for eliminating infection. The rest of the drugs can only be used as ancillary drugs, for example, pain relievers, anti-inflammatory drugs.

• Tetracycline

Dosage - from 500 mg to 2 grams per day, depending on the severity of the pathological process, the concentration of bacteria in the urine.

Precautions: prescribe with caution to patients with kidney and liver pathology, since the drug is toxic to these organs.

Side effects: kidney, liver disease.

• Amoxicillin (possibly a commercial name - flemoxin)

Dosage - one tablet (500 mg) once a day, 3-5 days.

Precautions: May cause allergies. In people with a tendency to severe allergic reactions, it can cause anaphylactic shock. Fatal cases of anaphylaxis from drug administration have been reported.

Side effects: allergic reactions, anaphylaxis, Quincke's edema.

• Ciprofloxacin (commercial names - Tsiprobay, Tsifran, Ciprinol, Ciprofloxacin)

Dosage - one tablet (500 mg) once a day, 5-7 days.

Precautions: do not prescribe to patients with ulcers, ulcerative gastritis, gastric bleeding.

Side effects: exacerbation of gastritis, perforation of the ulcer.

• Biseptol

The dosage is 480 mg per day (divided into 2 doses). With a strong inflammatory process, you can double the dosage to 960 mg per day.

Precautions: do not take during pregnancy, lactation.

Side effects: none.

• Streptomycin

Dosage - 500 - 1000 mg per day, from 7 to 10 days.

Precautions: ototoxic, not for people with ear diseases, hearing impairments.

Side effects: hearing impairment, up to complete deafness.

• Furamag

The active ingredient is furazidine (50 mg). Prescribed as an antimicrobial agent. Belongs to the group of nitrofurans. It has a high degree of antimicrobial activity, relieves spasm, eliminates the inflammatory process, and prevents the development of complications. Resilience is developing extremely slowly. It is prescribed for urogenital infections, for detecting bacteria in the urine, for gynecological and some venereal diseases, for soft tissue infections. Adults are advised to take 50-100 mg per day. Children from 5 to 18 years old - 25-50 mg. The course of treatment is 7-10 days. In case of severe infection, the course can be extended to 14-15 days.

Pills for bacteria in the urine

For bacteria in the urine, three groups of antibacterial tablets are prescribed:

1. Sulfonamides
2. Nitrofurans
3. Antibiotics

Each of the groups has both its advantages and disadvantages.

Sulfanilamide preparations are derivatives of sulfanilic acid that have an antibacterial effect on the body. They are powders that are poorly soluble in water. Effective against streptococci, staphylococci, gonococci, meningococci. They are ineffective by themselves. But in combination with other drugs, they can have a powerful antibacterial effect. Today in medicine, either they are not used, or they are used in combination with other antibacterial drugs. This group includes drugs such as streptocid, norsulfazole, inhalipt, phthalazole.[11], [12]

The group of nitrofuranols includes antibacterial substances that are effective against various cocci, Trichomonas, lamblia. They are widely used as part of complex therapy. They are especially effective in the treatment of diseases of the genitourinary system, to eliminate bacteria in the urine. This includes drugs such as furacilin, furaplast, fastin.

The third group - antibiotics - is the most numerous and varied. This includes a large number of antibacterial drugs of various pharmacological actions. For example, penicillin, macrolides, tetracyclines, streptomycin group, and other drugs.

Antibiotics for bacteria in the urine

The main treatment for bacteria in urine is by taking antibiotics. They kill bacteria completely, or prevent their further reproduction, and remove their numbers. Let's consider the main drugs.

• Co-trimoxazole

Dosage: 80 mg per day, 10-14 days.

Precautions: do not take during pregnancy, lactation, children under 12 years of age. It has anticoagulant activity, thins the blood, inhibits hepatic metabolism (prescribed in conjunction with anticoagulants).

Side effects: blood thinning, decreased blood viscosity, liver disorders.

• Ampicillin

Dosage - 500 mg per day, 3 days.

Precautions: May cause allergic reactions.

Side effects: allergies.

• Levomycetin

Dosage - 1-2 tablets per day, not less than 7 days.

Precautions: do not take during pregnancy, lactation.

Side effects: headache, nausea.

• Erythromycin

The dosage is from 500 mg to 1 gram per day.

Precautions: do not take during pregnancy, breastfeeding, persons under 3 years of age.

Side effects: dysbiosis, digestive disorders, stool disorders, decreased appetite.

• Amoxiclav Kviktab

Dosage - one tablet (500 mg) once a day, 5-7 days.

Precautions: the drug contains substances that protect the stomach. Recommended for people with diseases of the digestive tract (after consultation with a gastroenterologist).

Side effects: digestive disorders, allergies.

• Co-trimoxazole (commercial name - biseptol, bactrim, septril)

Dosage: 80 mg per day, 10-14 days.

Precautions: do not take during pregnancy, lactation, children under 12 years of age. Has anticoagulant activity (thins blood, prevents blood clots, reduces blood clotting). Take with caution to persons with low blood clotting, with any diseases of the circulatory system and heart. The drug is strictly contraindicated in hemophilia, a tendency to spontaneous bleeding, in peptic ulcer disease, in the postoperative period. It is recommended to refrain from taking women during menstruation, as well as after invasive (surgical or diagnostic interventions).

Side effects: blood thinning, decreased blood viscosity, blood clotting disorders, impaired liver and heart function.

• Ampicillin

Dosage - 500 mg per day, 3 days.

Precautions: May cause allergic reactions.

Side effects: allergies.

• Chloramphenicol (commercial name - chloramphenicol)

Dosage - 1-2 tablets per day, not less than 7 days.

Precautions: do not take during pregnancy, lactation.

Side effects: headache, nausea, vomiting, intoxication.

• Doxycycline (commercial name - vibramycin)

The dosage is from 500 mg to 1 gram per day, depending on the concentration of bacteria in the urine.

Precautions: prescribe with caution to patients with kidney and liver pathology, since the drug is toxic to these organs. Recommended to be taken in combination with hepatoprotectors. If side effects appear, it is recommended to reduce the dosage.

Side effects: kidney disease, liver disease, vomiting, diarrhea, heartburn.

• Clarithromycin (Klacid)

Dosage - one tablet (500 mg) once a day, 5-7 days.

Precautions: do not prescribe in the presence of ulcers, liver disease, heart failure.

Side effects: exacerbation of gastritis, perforation of the ulcer, increased heart rate, arrhythmia, liver disease, gall bladder.

• Kanephron

Kanephron is a remedy that contains centaury herb, lovage and rosemary leaves (aqueous-alcoholic solution). Refers to dysuretic drugs. It has an anti-inflammatory, anti-infectious effect on the body, relieves spasms. It is prescribed for the treatment of acute and chronic diseases of the kidneys and urinary tract. Adults are prescribed 50 drops, children from 12 to 18 years old - 25-30 drops each, children from 1 to 12 years old - 15 drops each. Dissolve in a little water, or drink. The duration of treatment is at least 3-4 weeks, preferably a full 28 days (full biochemical cycle). It is prescribed three times a day.

Vitamins

If bacteria are found in the urine, vitamin intake is contraindicated. This is due to the fact that any vitamins act as a nutrient substrate, growth factors for microflora. That is, they, on the contrary, stimulate the growth and reproduction of bacteria. Therefore, if we take vitamins, the infection will only progress.

An exception is vitamin C (ascorbic acid), since this vitamin, on the contrary, prevents the growth and reproduction of microorganisms. It also has a positive effect on the macroorganism (human) by stimulating the immune system, increasing the body's stamina and resistance. Vitamin C should be taken in double dosage - 1000 mg per day.

Physiotherapy treatment

It is rarely used. Nevertheless, the possibility of using physiotherapeutic treatment as part of complex therapy is not excluded, which will enhance the effect of the main therapy, or consolidate it. Electrophoresis, light treatment (ultrasound, microwave, UHF, infrared light) are used as the main means. Heat treatment is also used. Sometimes the recreational opportunities of the resources of the natural environment and the natural forces of nature are also used. For example, halotherapy, balneotherapy, mud therapy, massage, vacuum massage are prescribed. Basically, these funds are used in the process of spa treatment, or at the stage of recovery after an illness. Most experts note that physiotherapeutic treatment is effective as part of complex therapy, but physiotherapy is ineffective as an independent means.

Alternative treatment

Alternative treatments have long treated bacteria not only in urine, but also in other biological fluids.

• Recipe number 1.

Add a tablespoon of immortelle flowers, trefoil leaves, mint, fennel to alcohol (200-250 ml). All this is insisted for at least an hour, they drink 30-40 grams 2 times a day, adding half a teaspoon of ground or grated ginger root to the bottom of the glass.

• Recipe number 2.

To prepare the broth, take a tablespoon of Icelandic moss, sage leaves, bran, pour 500 ml of beer (dark). All this is brought to a boil, set aside, insisted for at least 3-4 hours, filtered, used for compresses and lotions.

• Recipe number 3.

Take brown sugar, black radish, 200 grams of melted lard in equal parts. Pour in a glass of warm milk, bring to a boil. Cook over low heat for 5-10 minutes. Remove from heat, cover with a lid, allow to brew for 1-2 hours. Consume a tablespoon per day.

• Recipe number 4.

Boiled water is taken as a basis (distilled water can be used). Bring to a boil, then add about a tablespoon of the following components: wormwood, finely chopped banana skins, goose lard. Boil on low heat for 3-5 minutes. Stir, then set aside and give the opportunity to brew. To increase the body's endurance, drink a tablespoon 1-5 times a day.

Herbal treatment

An effective method of eliminating bacteria from urine is herbal treatment.

Birch leaves and buds (decoction) have antiseptic and anti-inflammatory properties. They drink 50 ml per day.

Lingonberry (juice, decoction from the leaves) increases local immunity, normalizes and has antiviral, antibacterial properties. Drink like tea.

Mother-and-stepmother normalizes local immunity, the condition of the mucous membranes, helps to eliminate infection. Apply a decoction (drink 50 ml).

Homeopathy has side effects (allergies, kidney, liver diseases), so it is important to take precautions - always consult your doctor.

• Recipe number 5.

For cooking, take lard, oats, barley (about 100 grams), pour about 500 ml of boiling water, then boil for 10-15 minutes, insist at least 2-3 hours. They eat a glass a day, adding a teaspoon of bitter almonds and a tablespoon of honey. Significantly increases immunity, body endurance, kills bacteria.

• Recipe number 6.

Take chicory and black coffee in equal proportions. Take about 2-3 tablespoons of each component, add 300 ml of bitter radish juice, stir until completely dissolved, insist for at least 1.5-2 hours. They drink 100 ml per day, adding honey to taste.

• Recipe number 7.

Approximately 250-300 ml of sea buckthorn oil is taken as a basis. Then add about a tablespoon of the following components: a head of garlic, grated through a fine grater, egg yolk, mint and ivy herb (a tablespoon). Stir, insist for at least an hour. I drink a tablespoon twice a day.

• Recipe number 8.

Rum (100 ml) is added to milk with honey (500 ml), add a tablespoon of ground ginger, cinnamon. Boil for 5-10 minutes, drink 50 ml before bedtime.

Surgery

Surgical methods of treatment are resorted to when drug therapy is ineffective, and this is very rare. Basically, such a need arises in emergency cases, upon detection of a focus of a purulent-inflammatory process (areas of necrosis, phlegmon). Especially if there is a risk of rupture, infection of the entire abdominal cavity (peritonitis). This can be observed in seriously ill patients, in persons with immunodeficiency, with injuries, injuries.

Prevention

Prevention is based on the elimination of risk factors:

• hygiene compliance
• timely of all foci of infection
• preventive examinations, analyzes.

In addition, you need good nutrition, intake of vitamins, mineral components. You can’t overcool.

Forecast

The course and prognosis depend on the timeliness of diagnosis and treatment. The bacteria in the urine can be treated with antibiotics. But you need to understand that neglected cases cannot be cured - peritonitis, bacteremia, sepsis may develop. Cases of death are known.