Expanded Urine Culture for Chronic UTI: Dr. Cat Anderson (Part 4)

In this video, Dr. Anderson explains current standard diagnostic techniques for UTI testing, and emerging technologies.
Standard urine culture is based on criteria developed in 1956 by Kass et al. The study, aimed at preventing pregnancy loss, accessed a small number of pregnant women with kidney infections. They chose a rate of 100,000 bacteria per milliliter of urine - 10 to the 5 per milliliter - to indicate an infection. Though developed for a niche group, it has since been applied to all urine testing.
In 1981, Stamm et al reported that the standard should not be applied to all patients because the threshold excludes symptomatic patients. A result of “no significant infection” is often misinterpreted as having no infection. Although Stamm et al recommended that the outdated standard be scrapped, it is still used today.
Samples go through particulate recognition in which the number of pus cells, red blood cells and bacteria per microliter are measured. The majority of patients with recurrent and chronic UTI will not reach the standard thresholds. Often, because patients find relief from drinking extra fluids, urine is diluted making counts lower. This is not taken into account during standard testing.
Dr. Anderson’s laboratory achieves more accurate results by seeding into liquid broth cultures. To do this, a clean, midstream urine specimen is required of both the first and second urinations of the day. With chronic recurrent UTIs, the first catch contains the highest concentration of bacteria, and the second has the highest concentration of shed bladder lining cells.
If patients are experiencing UTIs after sex, a test can detect if one partner is passing organisms to the other during intercourse. For male partners, if a foreskin swab delivers the same organisms as those in the female partner’s sample, the male can be treated topically. In addition, Dr Anderson has partnered with a molecular laboratory to assess the urinary microbiome and identify organisms that require treatment with antibiotics.
About Dr. Cat Anderson, MBCHB, BSC(HONS), MRCGP, DFSRH, Certificate in Menopause Care
Before returning to university to study medicine, Dr. Anderson used her undergraduate degree in medical microbiology and biochemistry to work as a research scientist in the pharma industry. This likely underpinned her interest in some of the more challenging cases of long-standing microbial infections, including UTIs. Motivated by her interest in this area and frustrated by the lack of educational resources, she looked to key opinion leaders around the world, where she studied the etiology of recalcitrant/fastidious bacterial infection and how therapies used in these infections have successfully helped a wide range of patients.
A true portfolio GP with postgraduate qualifications, expertise in women’s health and urogenital infection, Dr. Anderson divides her time between NHS and private practice. She runs a specialist service dealing with recurrent and chronic UTI, vaginal problems and menopause in North Staffordshire, UK and has a branch clinic in London.
With a wealth of experience in these areas of medicine, she is well placed for designing personalized treatment plans. She uses a variety of established treatments and complements them with naturopathic remedies and lifestyle measures to optimize outcomes as quickly as possible. The majority of patients (70%), report symptomatic improvement within 6-8 weeks of starting treatment, more complex cases can benefit from on-going investigations if needed.
Check out the playlist: www.youtube.co...
Why is my UTI Test Negative? The Science Behind UTIs: • Why is my UTI Test Neg...
Which UTI Test is the Most Helpful: • Which UTI Test is the ...
Testing and What to Treat: Recurrent UTI: • Testing and What to Tr...
UTIs after Sex, Partner Testing and Other Risk Factors: • UTIs after Sex, Partne...
Read more about the issues with UTI testing: liveutifree.co...
Learn more about chronic UTI: liveutifree.co...
More on recurrent UTI in males: liveutifree.co...
If you are a clinician, you can learn about joining our clinician referral network here: liveutifree.co...
About Live UTI Free
Live UTI Free is a patient advocacy and research organization. We do not endorse specific treatment approaches, clinicians or diagnostics methods. The content of this video does not provide medical advice. It is intended for informational purposes only. The medical and/or nutritional information is not a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen. liveutifree.com/
Post-production: Melissa Wairimu / kreativlee_