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Does my mother have urinary tract infection?

Q: My 46 years old mother's routine urine analysis report is as follows:

  • Quantity: 20 ml
  • Colour: P. yellow
  • Appearance: Turbid
  • Spec. Gravity: 1.015
  • Reaction: 6.0
  • Albumin: Trace
  • Sugar: Nil
Microscopic examination
  • Pus cells: 1-2
  • RBC cells: Nil
  • EP cells: 2-3
  • Custs: Nil
  • Crystals: Nil
  • bacteria: Nil
  • Others: Nil
Her culture report is as follow:-
  • Type of culture: urine
  • Organism involved: E. coli
  • Colony count: 45000/ml
  • Levofloxacin Le: R
  • Augmentin Ac 30: S
Is everything fine with my mother's urine report? The doctor has asked her to have tab Jidox 200 mg and cap LB gut 100 mg for two weeks. He has also asked her to take Tab RB Tone forte and tab Drofem during her periods. Why has she been asked to take so many medicines?

A:You have not mentioned whether your mother has any symptoms. Apparently she is asymptomatic and her routine urine tests have been done for some unrelated problem. Her routine urine examination is normal. Her urine culture shows "insignificant bacteriuria". It is not uncommon to have the urine sample getting contaminated with bacteria from the perineal skin. If the urine has a growing organism in the bladder, the colony count of the offending bacteria in the culture is likely to be 100,000/ml or more. The contaminating bacteria, on the other hand, are in contact with urine for much lesser time and hence have a colony counts of less than 100,000/ml on urine culture. The latter contaminating bacterial count is called "insignificant bacteriuria", as in your mother's case. Unfortunately, it is not uncommon to see antibiotics being prescribed at the slightest provocation. In fact, the consensus recommendations are that all asymptomatic patients irrespective of the bacterial count, and patients with contaminating "insignificant bacteriuria" should never be treated with antibiotics. Such usage results in resistant strains of bacteria, difficult to treat when the real situation arrives.

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