Bacterial Presence in Urine: What 3+ Means for Your Health - Urology

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Urinary bacteria


Hello Doctor, this week I went to the clinic for a urinalysis and the bacterial count was 3+, while all other parameters were normal, including leukocytes which were 0-2, and Leukocyte Esterase was negative.
I recently had a kidney ultrasound, and both the kidneys and bladder appeared normal.

1.
Recently, I have been using progesterone vaginally every day, which causes some discharge and residual progesterone to come out.
Additionally, during the urine collection, I collected the midstream portion.
Could these factors have contributed to the bacterial reaction in the urine?
2.
Is a bacterial count of 3+ considered serious? Is there a need for further testing? Thank you, Doctor, for taking the time to respond.

Niming, 20~29 year old female. Ask Date: 2022/05/14

Dr. Du Shixi reply Urology


Hello:
1.
Recently, I have been experiencing discharge due to daily progesterone insertion, and there is residual progesterone that is also coming out.
Additionally, during my recent urine collection, I obtained a sample from the latter part of the stream.
Could these factors have contributed to the presence of bacteria in my urine?
2.
Is a bacterial count of 3+ considered serious? Is there a need for further testing? Thank you, doctor, for taking the time to respond.
Generally, if there is an infection, there would also be the presence of white blood cells and urinary symptoms.
If those are absent, it is possible that the urine sample was contaminated.
A repeat urinalysis may be warranted.
Wishing you good health.

Reply Date: 2022/05/14

More Info


When interpreting urine test results, particularly the presence of bacteria, it is essential to understand the implications of a "3+" bacterial count. In your case, the urine culture showing a bacterial count of 3+ indicates a significant presence of bacteria in the urine. However, the context of this finding is crucial for determining its clinical significance.

1. Understanding the 3+ Bacterial Count: A 3+ result typically suggests a moderate to high level of bacterial growth. In a healthy individual, urine should be sterile, meaning it should not contain any bacteria. The presence of bacteria can indicate a urinary tract infection (UTI) or contamination during the urine collection process. Given that your white blood cell count is normal (0-2) and leukocyte esterase is negative, this may suggest that there is no active infection, as these findings are often associated with inflammation or infection.

2. Possible Contamination: You mentioned that you have been using progesterone vaginally, which can lead to discharge that might contaminate the urine sample. Additionally, collecting urine from the midstream can sometimes introduce bacteria from the skin or vaginal area, leading to a false positive result. This is particularly relevant if you collected the urine sample from the latter part of urination, as this can increase the likelihood of contamination.

3. Next Steps: Given the context of your symptoms and the urine test results, it may be prudent to repeat the urine culture to confirm the presence of bacteria and rule out contamination. If the repeat test shows a similar result, further evaluation may be necessary. This could include a more detailed assessment of your urinary symptoms, a physical examination, and possibly imaging studies if indicated.

4. When to Seek Further Evaluation: If you start experiencing symptoms such as burning during urination, frequent urges to urinate, or lower abdominal pain, it would be essential to follow up with your healthcare provider. They may recommend additional tests, such as a urine culture with sensitivity testing, to identify the specific bacteria and determine the most effective antibiotic treatment if needed.

5. Conclusion: While a 3+ bacterial count in urine is noteworthy, the absence of other indicators of infection (like elevated white blood cells or leukocyte esterase) suggests that it may not be clinically significant, especially if contamination is suspected. Monitoring your symptoms and possibly repeating the urine test will help clarify the situation. Always consult with your healthcare provider for personalized advice and to discuss any concerns you may have regarding your health.
In summary, while a 3+ bacterial count warrants attention, the overall clinical picture, including your symptoms and other test results, will guide the need for further investigation or treatment.

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