Urine infections - dip test positive for infection, lab culture negative. ?

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Can anyone advise? DD is nine and has recurrent urine infections. She's now on the fourth set of antibiotics for this since February.

Each time I've taken a sample into the GP surgery and they've tested it there and then and it's come back positive for infection. It's also generally cloudy and as I understand it that's a clear sign of infection. Plus of course all her symptoms point to infection (painful wee, sometimes fever + vomiting, aches)

The odd thing is I took her on Sunday as the infection seemed to be back (two weeks after the last dose of antibiotics). It was hurting her a lot to wee, pain in her tummy, very pale and achy. Dip test showed up infection immediately. Dr prescribed furantoin (she had previously had trimethoprim). As it was a Sunday, the culture couldn't be sent away so the next day, as requested, I bought in another sample to be sent off to the lab. The odd thing is that the sample has come back clear of infection. Obviously she'd had almost a day's worth of furantoin by then so the infection would have been abating but she was still in pain and still ill (enough to be off school for two days) so presumably something should have shown up? This exact thing has happened twice now (Sunday dip test shows infection Monday lab culture shows none).

I'm having difficulty getting the GP surgery to take this seriously. They see that the test result is clear and so decide no further action is needed. But I am assuming that there is an underlying infection that is never completely going away. Any suggestions?

What exactly was positive on the urinalysis in the surgery? The dip sticks do not give readings that are positive or negative for infection, they indicate the presence of markers such as leucocytes, protein, blood, nitrites, etc which may all be indicative of an infection if they are present but do not give a definite diagnosis. They may be present as only a trace or in higher amounts. Some markers such as leucocytes may be present if the sample is not a clean catch. It is only the lab result that can tell you for certain if bacteria is present in the sample.

The bacteria may well be dead after 24 hrs of antibiotics so the culture would be negative even though she had an infection
Let the doctors know she had had antibiotics before the sample was taken.

What I would also suggest is that you give a repeat sample 48 hrs after last antibiotic to make sure any infection has cleared.

I don't know what the dip test was positive for. I can't ask the dr as they won't call me to discuss and the next appointment available is end of May. They are really hard to deal with.

I've made a private appointment now just to get someone to follow up properly but I would have liked to have gone armed with a but more knowledge about what's already been done. The few samples that have shown something have been positive for E. coli but I don't know if these recent infections were the same or not.

I will try to get another test once she's two days clear of antibiotics but may have to get that done privately as the GP just won't do the follow up.

My dd had a fair amount before her gp referred her for anything further and (not trying to scare) she's suffered kidney scarring as a result of recurrent infections. 4th set of antibiotics since Feb is quite a lot, is this the 1st batch of infections shes had? can you try another gp or try and insist on further testing? Has she had any scans to check she's completely clearing her bladder? Also check she's not being made to 'hold it' at school when she needs to go. A nurse at hospital told me that urine tests after taking antibiotics weren't much good because the medication can mess with the results. would try not to go on a Sunday unless it's to a walk in centre, hospitals will take the sample any day of the week.

Ok so another five days of antibiotics finished. Two days off them, Sunday again and it's hurting to wee again. It's like Groundhog Day. Luckily we have a private apptment on Wednesday.

She has actually had a previous batch of infections (about three years ago) and had a scan but all came up clear. But we are seeing a paediatric urologist and presumably they'll be happy to scan again if necessary.

Good luck for the appointment tomorrow. Hopefully they'll be able to give you some good advice. Hope dd is feeling better, do update with what happens

Thanks for thinking of us! The appointment went really well. We saw Dr Anne Wright at the Portland who was really thorough and attentive. It was very nice to be listened to.

She has referred DD for a Mag3 scan to check for kidney damage, reflux and whether she is fully emptying her bladder. In the mean time she told me to get cranberry tablets from Holland and Barratt and some D - Mannose which I'd never heard of before but have just ordered from Amazon. Apparently it clings to the bacteria so they can't stick to anything internally (that's as far as my understanding went!). It's got really good reviews on Amazon.

Plus more, more, more water, more toilet trips and some probiotics.

DD finishes the current set of antibiotics at the weekend so if the infection comes back yet again we are to request prophylactic antibiotics from the GP. She is writing to the GP to set out exactly what they need to do if this happens.

Feeling much better that we have seen someone who wanted to help us get a solution rather than help us get out of the surgery asap.

Yay, that's good and positive! might need to try the D-mannose for my own dd, hadn't had that recommend before but it sounds very helpful.