Urine bench Urine test for: Sugar It's normal to occasionally have a small amount of sugar in your urine during pregnancy, but if you have elevated levels at a couple of prenatal visits in a row or a very high level at one visit, it could mean you have gestational diabetes. Your practitioner may have you take a glucose challenge test to find out whether that's the case. (Even if your urine test results are normal, you'll have a glucose challenge test between 24 and 28 weeks to check for this relatively common condition.) Protein Excess protein in your urine can be a sign of a urinary tract infection (UTI), kidney damage, or certain other disorders. Later in your pregnancy, it can also be a sign of preeclampsia if it's accompanied by high blood pressure. If you have protein in your urine but your blood pressure is normal, your provider may send a clean catch midstream sample to the lab in a sterile container to test for a UTI. Ketones Ketones are produced when the body starts breaking down stored or ingested fat for energy. This can happen when you're not getting enough carbohydrates (your body's usual source of energy). If you're suffering from severe nausea and vomiting or you've lost weight during pregnancy, your practitioner may check your urine for ketones. If your ketone reading is high and you can't keep any food or liquid down, you may need intravenous fluids and medication. If ketones are found in combination with sugar, it could be a sign of diabetes. Blood cells or bacteria On your first prenatal visit, your urine sample will most likely be screened for bacteria that indicate a UTI through a laboratory urinalysis and a culture and sensitivity test. (The culture shows whether you have a UTI, and the sensitivity test shows which antibiotics can effectively treat the infection.) If this initial test is negative, your risk of developing a UTI later in pregnancy is small, unless you have a history of chronic or recurrent UTIs. You may continue to have dipstick tests during your pregnancy or you may only have one if you show symptoms. The dipstick test checks for a certain enzyme (produced by white blood cells) and nitrites (produced by certain bacteria), both of which signal a UTI. If either of these shows up on a dipstick test, a sterile urine sample will be sent to the lab for a culture and sensitivity test. 1
You usually have to wait about 48 hours for the results of a urine culture and sensitivity test. However, your practitioner may start you on some kind of antibiotics before the testing is complete, particularly if you have symptoms of a urinary tract infection. You'll be tested again after treatment of a UTI and at regular intervals during your pregnancy if your provider feels you're at risk for recurrent UTIs for example, if you have a history of kidney infection or frequent UTIs. While UTIs usually cause painful symptoms when you're not pregnant, it's possible to have a UTI with no symptoms during pregnancy. If left untreated, even a painless, symptomless UTI can progress to a full-blown kidney infection, which almost always requires hospitalization. Types of urine samples: Analysis sample Urine culture sample Analysis and Urine culture sample Pregnant sample we work in samples depend to the type: urine sample If its analysis sample we will use IRIS Machin. If its culture sample we will use CLED media and helping media. If its Analysis and Urine culture sample we will do both way 2
Pregnant sample test putting urine into a special container with an eyedropper You will be looking for a change in color and line, in 2-5 minute. Iris machine: 3
Iris s has chemistry and microscopy systems. The design provides organized, easy to read touch points and messages the machines highly automated work flow. strip loader that offers a window into the machine s internal workings. A vibrant blue band extends from the figure eight-shaped strip loader, illustrating the path that test strips take through the machines. Touch points such as the sand blasted aluminum strip loader handle. 1. Chemistry: PH: A urine ph level test is a test that analyzes the acidity or alkalinity of a urine sample. Kidney stones tend to form in a highly acidic or highly basic (alkaline) environment. Your doctor can use the test to determine your chances of developing them. Protein: High levels of protein in the urine may therefore be due to diseases of the kidney, such as glomerulonephritis. It may also be due to general illnesses that also affect the kidney as in high blood pressure or failure. Infections of the renal pathway such as cystitis or pyelonephritis may cause a high level of protein in the urine. Glucose: High glucose levels often indicate diabetes, a group of diseases that affects the way the body handles glucose. RBC: A higher than normal number of RBCs in the urine may be due to: Kidney and other urinary tract problems, such as infection, tumor, or stones injury, Prostate problems, Bladder or kidney cancer. Ketone: Ketones build up when the body needs to break down fats and fatty acids to use as fuel. This is most likely to occur when the body does not get enough sugar or carbohydrates. This may be due to diabetic ketoacidosis (DKA). DKA is a life-threatening problem that affects people with diabetes. It occurs when the body cannot use sugar (glucose) as a fuel source because there is no insulin or not enough insulin. Fat is used for fuel instead. An abnormal result may also be due to: Fasting or starvation: such as with anorexia (an eating disorder) High protein or low carbohydrate diet Vomiting over a long period (such as during early pregnancy) Acute or severe illnesses, such as sepsis or burns High fevers The thyroid gland making too much thyroid hormone (hyperthyroidism) Nursing a baby, if the mother does not eat and drink enough Lycosyte(WBC): Kidney infections like pyelonephritis can lead to the increase of white blood cells in urine. It's an infection that occurs in the urinary tract and spreads to the kidneys. However, the risk of kidney infection is more common in people who have a weak immune system or among those who have been 4
using a urinary catheter for a prolonged time. Bladder infections or cystitis (an inflammation of the urinary tract and ureters) can also lead to excess secretion of leukocytes. A blockage in the urinary system can also result in hematuria (blood in urine). Obstructions can be due to trauma, pelvis tumor, kidney or bladder stones, prostate hypertrophy, or unwanted foreign bodies in the urinary tract. Presence of protein and leukocytes in urine during pregnancy is quite common. During pregnancy, it is possible that the WBC levels in urine increase and there is a possibility of protein contamination from the vagina. Another cause for leukocytes in a patient's urine is sexual intercourse. The bacteria may get transferred to the urethra which may further cause infection. Holding urine for too long can cause overstretching of bladder which weakens the bladder. This can make the bladder incompetent to empty itself completely. This left over urine can lead to bacterial infection. Nitrate: he nitrite TESt of urine has been used as a rapid screening test for significant bacteriuria. However, its potential ability to predict the microorganism causing urinary tract infection (UTI) has not been studied. It is well known that some organisms are more likely than others to reduce nitrate to nitrite. Whereas members of the family Enterobacteriaceae (Escherichia coli and Proteus sp) do so, streptococci and Candida sp do not. These observations may have clinical utility in being able to "rule out" UTI caused by some organism classes. A particularly important application may be to rule out UTI caused by enterococci, an emerging class of nosocomial pathogens with a unique susceptibility pattern. The goal of our study was to test the hypothesis that a positive NT excludes enterococcal UTI. Urobilinogen: Urinary urobilinogen may be increased in the presence of a hemolytic process such as hemolytic anemia. It may also be increased with infectious hepatitis, or with cirrhosis. Urobilin: his test screens for bilirubin in the urine. Bilirubin is not present in the urine of normal, healthy individuals. It is a waste product that is produced by the liver from the hemoglobin of RBCs that are broken down and removed from circulation. It becomes a component of bile, a fluid that is released into the intestines to aid in food digestion. In certain liver diseases, such as biliary obstruction or hepatitis, excess bilirubin can build up in the blood and is eliminated in urine. The presence of bilirubin in urine is an early indicator of liver disease and can occur before clinical symptoms such as jaundice develop. The results of this test will be considered along with the result of urobilinogen (below). If positive, the healthcare practitioner will likely follow up with other laboratory tests, such as a liver panel, to help establish a diagnosis. 5
SARAH AL-FAIFI 2. Microscopy: Bacteria urinary tract infection WBC kidney infection RBC infection, tumor, or stonesnjury, Prostate problems, Bladder or kidney cancer 6
SARAH AL-FAIFI Epithelial cell bacterial infection Yeast: usually occurs in patients with urinary catheters Crystal: kidney stone disease 7
media culture: 1. Main Media CLED Agar is an abbreviation for Cystine Lactose Electrolyte-Deficient Agar. It is a type of differential medium recommended for diagnostic urinary bacteriology. The medium supports the growth of all urinary potential pathogens and provides distinct colony morphology. CLED Agar also supports the growth of a number of contaminants such as diphtheroids, lactobacilli, and micrococci. It is electrolyte deficient to prevent the swarming of Proteus species. Enzymatic Digest of Casein, Enzymatic Digest of Gelatin, and Beef Extract provide the nitrogen, vitamins, and carbon in CLED Agar. L-Cystine is added as a growth supplement for cystine-dependent coliforms. Lactose is the carbohydrate. Organisms capable of fermenting lactose will lower the ph and change color of the medium from green to yellow. Bromthymol Blue is the ph indicator. Agar is the solidifying agent. 8
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Organism Escherichia coli Klebsiella species Colony Morphology yellow, opaque colonies with a slightly deeper coloured centre about 1.25 mm diam. (Non-lactose fermenting strains blue colonies). yellow medium. extremely mucoid colonies varying in colour from yellow to whitish-blue. yellowish medium. Proteus species translucent blue colonies usually smaller than Escherichia coli. bluegreen to blue medium. Salmonella species Pseudomonas aeruginosa Enterococcus faecalis Staphylococcus aureus negative staphylococci flat blue colonies green colonies with typical matte surface and rough periphery. Sweet odor. Blue-green agar yellow colonies about 0.5 mm diameter. yellow medium deep yellow colonies about 0.75 mm diameter, uniform in colour. yellow medium pale yellow or white, more opaque than Enterococcus faecalis, often with paler periphery Corynebacteria very small grey colonies Lactobacilli 2. Helper media: similar to corynebacteria but with a rougher surface If there is high white blood cell or nitrate because of bacterial infection MacConkey agar: for negative gram bacteria. Blood agar: for gram, positive and hemolysis. Sabouraud dextrose agar : for yeast grout. 10