Urine tests are often done to check for antibiotic sensitivity. The method is used to diagnose microorganisms in the genitourinary system in order to prevent the appearance of cystitis, pyelonephritis and urethritis in a person.
According to urine tests, one can easily understand the presence of abnormalities in the work of certain organs, the presence of diabetes mellitus, kidney stones, arterial hypertension and liver pathologies.
Antibiotics - scope, possible harm
Antibiotics are drugs of natural, semi-synthetic and synthetic origin, the action of which is aimed at stopping the multiplication of pathogenic microorganisms, at stopping their metabolism. Urine tests for antibiotic susceptibility are taken at any hospital.
These medicines are used to treat inflammatory processes. According to the spectrum of action, antibiotics are divided into:
- destroying the cell wall of bacteria (they will be inactive when interacting with mycoplasmas). Drugs with a narrow specificity affect a small number of gram-positive and gram-negative microorganisms. Broad-specific antibiotics affect large numbers of bacteria;
- antifungal;
- antiprotozoal;
- antiviral;
- antineoplastic.
According to the mechanism of biological action, antibiotics are divided into:
- drugs that suppress the synthesis of the cell wall (Cycloserine, Fosfomycin);
- drugs that disrupt the functions of the cell membrane (Nystatin, Gramicidin);
- drugs that slow down protein synthesis on ribosomes (Macrolides, Aminoglycosides);
- medicines that slow down the synthesis of nucleic acids - RNA and DNA (Nitrofurans, Trimethoprim);
- antibiotics that disrupt the synthesis of nitrogenous compounds and amino acids (actinomycin D, remantadine).
Side effects of antibiotics and possible harm:
- high toxicity (depends on properties, dosage, administration) - hepatotoxic effect (effect on the liver), nephrotoxic (effect on the kidneys), neurotoxic (effect on the nervous system). Hematotoxic (damage to the cardiovascular system), cardiotoxic (damage to the heart) and embryotoxic (effect on the fetus);
- dysbiosis (violation of the normal intestinal microflora);
- allergic reactions;
- decreased immunity;
- endotoxic shock;
- the emergence of drug resistance.
Infectious diseases that can be detected by urinalysis
Urine tests are best able to identify a large number of pathologies. They are used in all medical fields. Experienced experts recommend regularly donating urine to prevent chronic diseases and further complications.
When urine becomes acidic, water depletion in the human body, an increase in blood sugar, and a decrease in potassium in blood cells can be foreseen. If there is a lack of potassium, there is a possibility of the appearance of chronic renal failure, disturbed blood balance, cancer of the genitourinary system.
With an increase in protein in the urine, it is worth thinking about kidney problems, inflammatory processes of the ureter, urethra, and cardiovascular insufficiency.
When the level of leukocytes in the urine rises sharply, there is the possibility of kidney stones and pyelonephritis. Often, tuberculosis of the kidneys or their tumors, prostate cancer develops.
An increased level of red blood cells in the urine indicates nephrotic syndrome and malignant tumors in the kidneys. Bilirubin indicates liver damage, malaria, gallstones, and hepatitis.
Urogenital tract
With the help of urine tests, the following diseases can be detected:
- pathology of the upper urinary tract (pyelonephritis);
- pathology of the lower urinary tract (cystitis, urethritis, prostatitis, problems with the penis);
- symptomatic problems;
- asymptomatic.
There should be no nitrites, protein compounds, sugars, ketone bodies, urobilinogen and bilirubin in the liquid. The white blood cell count must be up to 7. Bacteria must be free.
With a decrease in the weight and density of the fluid, you need to think about the fact that the urinary system is not able to control the process of creating urine. Conclusion: pathogenic substances, salts, toxins remain in the body. This contributes to the development of kidney failure.
Protein compounds in urine indicate the appearance of persistent glomerulonephritis, problems with urination, amyloid in the kidneys and nephropathy in diabetes mellitus. Pus and inflammation in the bladder can increase the level of protein in the fluid. Only the attending physician can decipher the study.
Other infectious pathologies
According to the indicators and norms of urine, it is possible to identify the development of infections in the human body. The color of urine can change with many medications. If the density of the liquid becomes more than 1.025 g / l, it means that the person is tormented by gag reflexes, bouts of nausea, diabetes mellitus, flatulence and dehydration. Indicators below 1.008 g / l indicate an excess of water in the body, getting rid of edema, diabetes insipidus.
Usually the urine environment is acidic. The appearance of a weakly acidic and alkaline environment indicates the development of inflammatory processes. A strongly acidic environment occurs during fasting and fevers.
There are a lot of protein compounds in the liquid for nephropathy in pregnant women. Bile pigments often appear in hepatitis, liver cirrhosis and poisoning.
The presence of epithelial cells in the urine indicates the presence of stones and sand. There should be no fungi in the urine, their appearance indicates the development of candidiasis.
About the examination procedure and material sampling
All indicators should always be normal. Good Results Table:
| Index | Norm up to 1 year | Norm for babies after 1 year | The norm for adults | ||
| Erythrocytes | — | Up to 2 | Until 3 | ||
| Leukocytes | < 3 | Until 6 | Until 6 | ||
| Bilirubin | — | — | — | ||
| Urobilinogen | — | 6-11 mg / l | 5-10 mg / l | ||
| Protein compounds | Up to 0.002 g / l | Up to 0.036 g / l | Up to 0.04 g / l | ||
| Acidity | 4,6-7,8 | 4,6-8,1 | 6-7 | ||
| Density | 1,002-1,006 | 1-3 years old (1.005-1.007), 3-6 years old (1.013-1.021), 6-13 years old (1.013-1.026) | 1,013-1,026 | ||
| Ketone bodies | — | — | — | ||
| Nitrite | — | — | — | ||
| Glucose | — | — | — | ||
| Colour | yellow | yellow | light yellow | ||
Rules for taking material from adults, children and pregnant women
Materials are taken for research in the laboratory according to the following rules:
- collect a portion after waking up;
- do not eat before the morning toilet;
- do not pour over the edge - start emitting into the toilet, after a few seconds substitute the container for the liquid, after filling it, continue the process of getting rid of the liquid into the toilet.
To collect a portion of liquid from a little girl, you should keep the labia in a divorced state, let the girl let the urine pass by for the first seconds, then direct it to a special container.
To take tests from boys, you should remember the correct sequence: keep the foreskin in the abducted position, allow a few seconds to release the liquid past the jar, then direct it to the container.
A pregnant woman needs to give urine early in the morning. Pre-wash the container, fill it to 125 ml, then close the container tightly. Do not allow the analyzes to be overcooled, so that the results will not be distorted.
Bacterial urine culture
Bacterial culture is carried out only in complete sterility. The process is necessary if:
- suspicions of pathology in the genitourinary system;
- control over the effectiveness of antimicrobial treatment of diseases of the urinary system;
- pregnancy.
The specialist applies drops of liquid to the nutrient medium. Then they are located in a thermostat. A day later, the doctor takes out a Petri dish and carefully examines the nutrient medium. The development of the infectious process occurs only if the human body has:
- saprophytic staphylococcus;
- proteas;
- colibacillus;
- Pseudomonas aeruginosa;
- Klebsiels.
What is an antibioticogram
An antibioticogram is a study in which doctors determine the sensitivity to various antibiotics. The procedure is carried out in a special laboratory. Experts sow on a nutrient medium to identify pathogenic organisms. This will allow doctors to further implement the antibacterial program.
When bacteria are identified, doctors transplant them to another nutrient medium to see their further development. Next, special paper disks are applied, which are pre-soaked in antibiotics. Those microorganisms that are most sensitive to this type of drug will not multiply and grow, while others will continue their vital activity. The concentration of MIC is capable of suppressing bacterial development.
Decoding the results
The provided fluid is not sterile. If it contains less than 1000 bacteria, there are no infectious processes in the body. The questionable result would be when more than 10,000 infectious agents are present in the urine. From 100,000 bacteria in the liquid indicates that a person is sick with genitourinary diseases.
The patient can find out the results within 6 days. They will indicate the presence of pathogenic organisms in the urinary system, but will not specify exactly where they are located, in which organ. Only doctors can figure this out.
In what cases are decryption errors?
Errors in decoding urine analyzes are affected by the following situations:
- staff;
- the patient himself;
- methods of conducting;
- special devices;
- technology of carrying out.
Conclusion
Urinalysis to determine antibiotic susceptibility should be performed in order to prescribe the correct treatment. It is important to understand the classification of drugs, side effects, therapeutic effects. Self-medication is contraindicated. Infectious diseases can be detected by urinalysis.
To determine the inflammatory processes, it is recommended to use other analyzes. Only experienced specialists can decipher them, but they sometimes make mistakes. For reliable results, it is important to correctly collect materials, to culture urine on nutrient media. An antibiogram will allow you to determine the sensitivity to drugs in the best way.
Urinalysis for culture is of great importance in the effective diagnosis of diseases of the kidneys and urinary system. At first glance, the urinary system is a rather simple process: urine is formed in the kidneys (this is a type of excrement, a waste product of animals and humans), which then enters the bladder and is excreted from the body through the urethra. This process is so commonplace for a person that the latter does not attach importance to it until a certain moment. The value increases only if this process fails (with kidney disease), and then a person turns to all kinds of medical research.
OAM (also called clinical urinalysis) is a laboratory study that evaluates the physical and chemical characteristics of urine and sediment microscopy. Physical characteristics include the amount of urine, its color, clarity, reaction (pH), specific gravity (relative density). Chemical characteristics include protein, glucose, ketone bodies, bile pigments. Well, microscopy of the sediment is the amount of hemoglobin, erythrocytes, leukocytes, epithelial cells and cylinders. Diagnoses after this study can be varied, for example, leukocyte esterase. If the test is positive, then this means the presence of leukocytes in this type of excrement. Otherwise, leukocyte esterase casts doubt on the infection in the urine and suggests the need for other types of research.
This analysis is one of the most used (they begin to identify a particular disease most often from it), which helps to detect abnormalities in the work of both the urinary system and the kidneys.
Urine analysis according to Nechiporenko (the idea of this study belongs to the Soviet doctor A.Z. Nechiporenko) is a laboratory study, which consists in determining the content of leukocytes, erythrocytes and cylinders in 1 ml of urine. This type of research has become widespread due to its relative simplicity and broad information content. The purpose of this study is to identify a latent inflammatory process in the urinary system or kidney dysfunction, and, as a rule, it is carried out when abnormalities in the OAM are detected. The following proportions are considered normal limits:
- Leukocytes - up to 2000 (in men), up to 4000 (in women).
- Erythrocytes - up to 1000.
- Cylinders - up to 20.
A urine culture is a laboratory test that detects the presence of microorganisms in the urine. The main task of the analysis (urine culture for sterility) is to prove the etiological (causal) role of microorganisms in the development 
diseases (their type, the degree of bacteriuria (the presence of bacteria in the urine), as well as the frequency of excretion of bacteria). In a healthy person, this species is sterile, that is, it does not contain any bacteria, otherwise it indicates the presence of an infection in the urinary system. Sowing urine for flora is prescribed after the presence of deviations in the OAM and urine analysis according to Nechiporenko.
These symptoms occur in people susceptible to the following diseases: acute and chronic cystitis, urethritis, pyelonephritis, as well as diabetes mellitus and immunodeficiency.
Deciphering the analysis of urine culture for microflora
The result of the study is indicated in the presence or absence of bacterial growth, the degree of urine for bacteriuria, expressed in CFU / ml, the name of the pathogen, sensitivity to antimicrobial drugs (determined with bacteriuria in a titer of 10 * 4 CFU / ml). So, when analyzing urine on a seeding tank, the concentration (number) of microorganisms in one unit of biomaterial volume is set on colony-forming units (CFU).
A CFU is a single living microbial cell (or group of cells) that causes a visible microbial colony to grow. If the detected number of bacteria in the urine is up to 1000 CFU / ml, then this means that the bacteria got there randomly, for example, from the external genital organs, which does not require treatment.
But if the number of microbes is equal to or exceeds 100,000 CFU / ml, then in this case there can be no question of any bacteria accidentally caught: this is an infection, and you need to consult a specialist for treatment.
With an intermediate result of 10-1000 CFU / ml, the analysis is considered doubtful and must be retaken. But, in spite of everything, do not try to decipher this or that analysis on your own (deciphering by a non-specialist leads to ineffective treatment). Contact your doctor directly for this.
How to take a bacteriological test: the rules for taking
Rule 1. Biomaterial (urine) is usually collected in the morning after sleep. But there are also individual emergency cases in which the collection of material for research is collected 2-3 hours after the last urination.
Rule. Hands and genitals should be washed immediately before urine collection. This measure is necessary to prevent false microbes from entering the biomaterial, which may lead to a distortion of the final analysis result.
Rule 3. The excrement should be collected in a special and, which is very important, sterile container (they can be purchased at pharmacies). In addition, it is necessary to collect exactly the middle portion of urine, that is, the first and last drops should not fall into the container. This is necessary so that the bacteria in the urine analysis are concentrated in the maximum amount (if, of course, they are in it).
After direct collection of urine, the analysis is delivered to the laboratory, where there are various nutrient media, on which a certain amount of material is applied. Observing certain favorable conditions for each type of bacteria, their colonies are grown. Based on these data, the result of the analysis is made about the microbe that caused the disease. To determine the sensitivity of bacteria to antibiotics, several such drugs are applied to their colonies, so that there is some choice in the selection of a drug to fight the disease. The analysis of urine for the culture tank is prepared from 1 to 10 days (depending on the type of bacteria).
The calendar method of contraception has been used by women as contraception for many years. This way to avoid unwanted pregnancy is free and convenient for both partners. And a woman is only required to closely monitor the menstrual cycle and, preferably, her feelings.
So, how are safe days calculated, what is needed for this? Know the length of your menstrual cycle. Moreover, it is desirable to take the average indicators. To do this, calculate the sum of all days of menstrual cycles for the last 6 months and divide by 6. The resulting number, usually 26-35, divided by 2. Thus, you can get the approximate day of ovulation. Well, since sperm cells live in the female genital tract for up to three days, three days before ovulation are also dangerous. But to be sure to protect yourself, it is better to abstain for three days after ovulation.
If you decide to use the calendar method of contraception and want to calculate ovulation, then the days most favorable for conception will help you calculate the calendar that the program will calculate specifically for you. And your task will only include remembering the first day of the last menstrual cycle and its (cycle) duration.
Interruption of intercourse as a method of contraception is often used in conjunction with the calendar. It increases its efficiency. But it will be even better, in addition to the calendar, to be guided by your feelings. Many women have learned to feel they are ovulating. Thus, you can more accurately "adjust" the safe days. So, what are the signs of ovulation, the day when in no case should you have sex without a reliable contraceptive, if pregnancy is not included in the plans.
1. Pain. Pulling or stabbing from the side. Not strong, do not require pain relief, do not worsen well-being.
2. Increased sex drive.
3. Abundant mucous vaginal discharge, less often bloody.
4. A sharp increase in basal temperature (by about 0.4-0.6 degrees).
After ovulation, women feel soreness in the area of the mammary glands. There may be swelling in the evenings. And a little later, signs of premenstrual syndrome appear.
Prevention of pregnancy by natural contraception is considered more reliable if ovulation is determined using special tests sold in pharmacies. However, this method is very costly.
Modern means of contraception against unwanted pregnancy are divided into the following types of contraception: hormonal tablets and injections, barrier contraceptives, like a condom , intrauterine devices or "spiral" , natural contraceptive methods, including the calendar method of contraception, chemical agents prevention of pregnancy, and surgical methods of contraception.
Contraception (from Lat. "Contraceptio" - protection, prevention of conception) - prevention of unwanted pregnancy with the help of various contraceptives.
As is often the case, the most reliable contraceptives either have undesirable side effects, are difficult to use, or cause irreversible consequences. Therefore, despite its lower reliability, a simple and understandable calendar method of contraception, when used correctly, gives good practical results. What is it?
This method is based on the fact that the maturation of the egg or ovulation occurs in a woman's body in a strictly defined period of the menstrual cycle. With a 28-day cycle, the follicle in the ovary matures on day 14, counting from the first day of menstruation.
It is quite physiological if the moment of ovulation deviates from this period by 1-2 days. A mature egg retains the ability to fertilize for about one day, after which it dies. Sperm can be in the female genital tract for 3-4 days. Therefore, the most dangerous period for unwanted pregnancy or favorable for conception is 9-16 day of the cycle.
Temperature method of contraception
For a more accurate determination of the day of ovulation, especially if the cycle is irregular, you can use the temperature method - keeping a chart of basal temperature. The temperature method is based on a sharp change in the hormonal ratio in a woman's body and a jump in basal temperature at the time of ovulation. The essence of the method is clear from the figure:
Measurement of the concentration of luteinizing and follicle-stimulating hormones in morning urine most reliably determines the moment of ovulation. But it requires the use of either less accurate tests or more accurate laboratory tests.
What methods of contraception are used in an emergency
Emergency contraception is used after unprotected intercourse, unsuccessful or inappropriate use of contraceptives, or after sexual assault. There are two such methods:
- Emergency contraceptive pills
- Copper-containing intrauterine devices
It should be remembered that they are effective only before pregnancy, within 24 hours or even hours after intercourse.
Contraception after childbirth or abortion
The relevance of contraception for women after childbirth, caesarean section, miscarriage or abortion is due to the fact that the ability to conceive can recover quickly, but the uterine lining is injured, and the woman's body is under stress. Therefore, during this period, pregnancy is not just undesirable, but contraindicated!
Lactational amenorrhea method
This physiological method of contraception after pregnancy and childbirth is based on the absence of ovulation during breastfeeding. Its deep natural meaning lies on the surface: feed the baby first, and then think about the next pregnancy. The method is effective no more than 6 months after childbirth, subject to constant and exclusive breastfeeding without interruption.
The best and safest contraceptive
New methods of contraception appear every year. And each has advantages and disadvantages, different degrees of reliability and availability. Some of them are preferable for girls just entering life, others are suitable after the age of 40.
Yet the most effective contraceptive is common sense, mutual respect for partners, and an understanding of the physiology of sexual relations. Only in this case, both the calendar method of contraception and the latest methods of preventing pregnancy and family planning will lead to the desired result.
Calendar method without formulas and calculator
The safest time for pregnancy is the first 2-3 days after your period and 3-5 days before your period!
The most favorable time for conception is the middle of the cycle.
Text: Olga Lukinskaya
Illustrations: Dasha Chertanova
It is generally accepted that the calculation of "dangerous" and "safe" days- one of the most unreliable methods of protection. It cannot be denied, however, that this method will certainly not cause side effects, unlike hormonal or barrier drugs - moreover, it is extremely cheap or even free of charge. We tried to figure out whether it is worth believing the calendar at all, whether it is possible to increase the reliability of this method and how the “contraceptive” application for a smartphone works.
How it works?
Although the menstrual cycle usually lasts about a month, pregnancy can only occur within a couple of days after ovulation. If you add a few days during which the sperm remain active, you get six to seven fertile (i.e. fertile) days. The difficulty is that you can see ovulation only with an ultrasound examination, and it is impossible to predict its date with absolute accuracy. True, you can focus on the length of the monthly cycle and use formulas to roughly determine the fertile period.
The classic calendar method is the calculation of "dangerous" and "safe" days based on the length of the cycle. With a serious approach, you need to start with keeping a menstrual calendar for at least eight months, or better a year. After that, the first fertile day is calculated from the duration of the shortest cycle, and the last day is calculated from the duration of the longest. During fertile days, the chances of pregnancy are high, which means that you should either avoid sex or use condoms.
It is clear that the accuracy of calculations and the effectiveness of such contraception leaves much to be desired, especially with an unstable menstrual cycle. To determine the fertility period more reliably, you can measure basal temperature, that is, body temperature early in the morning, immediately after waking up. The fact is that it decreases slightly the day before ovulation, and then rises by 0.3-0.6 degrees.
Special thermometers for determining basal temperature differ from ordinary ones in that they measure with an accuracy of two decimal places. After waking up, you need to measure the temperature under the tongue, and then enter the result into a special schedule.
Even during the monthly cycle, the consistency of the mucus covering the cervix changes; these changes are also sometimes taken into account in conjunction with counting days and measuring temperature to better distinguish fertile days from "safe" days. True, not everyone is ready to closely examine the consistency of mucus, and the changes are not always obvious to a layman. Nevertheless, the method is often recommended, only not for contraceptive purposes, but vice versa - for those who are trying to get pregnant.
Advantages and disadvantages
The main advantage of calendar or temperature contraception is the absence of side effects. Although they are being improved every year, sometimes their selection takes an agonizingly long time, and the ideal one may never be found (especially considering that about ten times less of such drugs are registered in Russia than in the United States). It has recently been confirmed that hormonal contraception, including pills and intrauterine devices, increases the likelihood of increased depression by 40%. On the other hand, hormonal drugs are indicated for many women to correct excess androgens (male sex hormones), to treat acne or painful and difficult menstruation.
The calendar method of contraception is also called "natural family planning" and "the method of intermittent abstinence", and these terms describe its features well, which are not suitable for every couple. If you do not want to get pregnant, you will have to use or refuse sex on your fertile days. If pregnancy is not specifically planned, but also does not frighten (“if I get pregnant, I will give birth”), then it would be good to normalize the lifestyle, cure chronic diseases, if any, and increase physical activity. In any case, the calendar method requires concentration and good sleep patterns; it is hardly suitable for those who fly on business trips every week (try getting enough sleep and remember to carry a thermometer with you).
Measuring temperature, counting days, and keeping a calendar requires more discipline than, for example, taking a daily pill. Spontaneous sex is poorly combined with the calendar method, even in a long-formed couple, let alone new partners (however, in such cases, you always need to use condoms to protect yourself not only from pregnancy, but also from infections). And yet, the main problem of the calendar method is low reliability: its Pearl index is from 9 to 40, that is, pregnancy can occur in 40 women out of 100 (almost half!) Within a year. But it looks like this situation is starting to change thanks to smartphone apps.
Can reliability be improved?
There are many menstrual tracker and ovulation calculator apps out there, but they are usually designed to determine the best days to conceive, not the other way around. The applications aimed at preventing pregnancy were mostly limited to pill reminders and trackers telling you when it was time to change your hormonal vaginal ring. But in February 2017, Natural Cycles became the world's first smartphone app to register as a contraceptive medical device; the basis was the results of two full-fledged clinical studies.
The "contraceptive" application for a smartphone uses the calendar-temperature method (also called symptothermal). Users do not have to draw graphs - they just need to measure the temperature under their tongue with a sensitive thermometer every morning and enter it into the application, and it will do the rest by itself using mathematical algorithms.
According to the creators of the application, the percentage of fertile days mistakenly called safe does not exceed 0.5%, that is, with ideal use, the method is very reliable. It turns out that, thanks to a complex algorithm, the effectiveness of the calendar method of contraception approached that for hormonal drugs. On the other hand, in a study of the actual use of this application among more than 4,000 women, the Pearl index, which determines the effectiveness of contraceptive methods, was 7%.
This means that pregnancy occurred in 7 women out of 100 per year, but most often it was not an application error that was to blame, but a human factor, for example, unprotected sex during the fertile period or inaccurate temperature measurement. Factors such as colds, hangovers, or lack of sleep affect its accuracy. Sleeping too long (two hours longer than usual) also reduces the accuracy of the thermometer, so it's not clear what to do with the habit of getting enough sleep on weekends. Of course, like any other method of contraception, this one is not for everyone; on the one hand, it is devoid of side effects and is now surprisingly accurate, and on the other, it requires a stable lifestyle, discipline and certain restrictions.
Considering that the trend towards the use of "natural" and "organic" has not slowed down for a year, and the registration of Natural Cycles in Europe as a medical device has become a sensation (the application is used by more than one hundred and fifty thousand people), it is possible that other similar ones will appear. Relative cheapness (65 euros per year, including a thermometer) can be a plus for many, eliminating any inconvenience. In the end, the more options there are, the more likely each woman will choose the option that best suits her.
