Infectious Disease

Recurring UTI

“I tested positive for a UTI, then got treatment but my symptoms didn’t go away. Now my urine culture is negative and my doctor says I don’t have an infection. What can I do? I still feel like I have a UTI.”

These questions highlight something that science has now proven many times over: the standard UTI test is inaccurate in as many as 50% of cases. 

• Multiple rounds of antibiotics, with UTI symptoms always returning
• Negative urine test results despite symptoms of a UTI
• UTIs as frequently as every month, regardless of home remedies or medication
• An escalation of symptoms over time, and a fear that there is no solution
• Constant pain in the urinary tract, with little or no relief

Traditional Testing

At the heart of it, the standard urine culture is incredibly inaccurate for a test that is so heavily relied on and considered the gold standard.  And this isn’t just our opinion. Studies show that standard urine culturing may miss more than 50% of infections, leaving many people with false negative results.

If you experience UTI symptoms but have received negative culture results:

• The standard urine culture was developed in the 1950s, but was never intended to be used in the diagnosis of lower urinary tract infection. It has not been updated since.
• Standard culture is typically conducted over no more than 24-48 hours. This is insufficient as many bacteria take up to 5 days to grow, and some fungi more than 20 days.
• Some bacteria, such as anaerobes (bacteria that will only grow in an oxygen free environment) will not grow at all unless an anaerobic culture is requested.
• Results are often biased towards easy to grow microorganisms, while others are completely missed.
• Uncommon microorganisms are often considered contamination rather than potential causes of infection.
• Bacteria that have been living in a biofilm, are less likely to grow in a culture than free-floating bacteria.
• Antibiotic susceptibility testing conducted via the standard method looks at isolated bacterial strains, rather than at the bacterial community as a whole, and therefore ignores the possibility of shared antibiotic resistance. This is where Capital Health’s Antibiotic resistance may provide an advantage.

Can Viruses and Sexually Transmitted Infections Cause UTI Symptoms?

Viruses are identified in around 20% of the UTI samples. At this stage, the clinical significance of these viruses is not completely understood. It may be the case that a virus is a contributing or causative factor for UTI symptoms in some people.

Some Sexually Transmitted Infections are known to cause UTI-like symptoms, so it’s often a good idea to rule this possibility out. Capital Health offers add-on tests for this purpose:

• Chlamydia trachomatis
• Neisseria gonorrhoeae
• Trichomonas vaginalis