UTI but lab keeps saying sample is clear

[Shonla]

I have all the symptoms of a UTI. When my urine is dipped it shows positive for leukocytes and nitrites, which indicates an infection. I get prescribed nitrafurantoin, which eases my symptoms but never quite knocks it on the head. So my sample gets sent away to the lab, and the result comes back saying it’s clear.

How am I supposed to get the correct antibiotic when the lab keeps saying it’s clear? The doctor is adamant that my sample can’t possibly be clear with that dipstick result, but the lab keeps saying it is.

Anyone? 😩

Are you giving a sample before you start antibiotics?
Important that this is the case.
How long has this been going on for ages how many courses of nitrofurantoin have you had?
How old are you?

Every single time my sample is dipped it shows a clear infection (leukocytes and nitrites). So then they send it to the lab to find out what sort of antibiotics I need, and it comes back clear. That includes the first sample which was sent away before I started antibiotics.

It’s been going on for about 3 weeks and I’ve had 3 days on nitrafurantoin, one day off, then another 2 days of nitrafurantoin, I have one day left to take and my symptoms have massively eased but I’m not cured. I think I must need a different antibiotic, but I can’t find out which one because my result keeps coming back clear!

I’m 44 and this episode was triggered by sex, it started hurting shortly afterwards. I’m prone to UTIs after sex. The doctor swabbed me and ruled out STIs and thrush. I used two thrush pessaries just in case but it didn’t fix the problem. It’s clearly a UTI, if it wasn’t then the nitrafurantoin wouldn’t ease the pain?

A dip is non specific in a way, as nothing is coming back on culture then you won't be able to find a specific antibiotic as you can't get antibiotic sensitivities without a cultured bug.
The GP could try another antibiotic.
You could try something that alkanises the urine, to help symptoms. Also drink tonnes of water.
I would also think about whether you have dryness of the vagina due to peri, might be worth trying vaginal oestrogen.

I don’t think I have peri. I was absolutely fine until I had sex, then these symptoms started a few hours later. I don’t think sex causes peri? It does however cause UTI, and it feels like every other UTI I’ve ever had. Peri doesn’t cause nitrites in your urine either - UTI does.

I would love the GP to try another antibiotic. They won’t give me one because my test is coming back from the lab as clear.

No it's just that the dry vagina of peri and menopause make UTIs more likely, especially after sex. Vaginal oestrogen and hrt act as a preventative as they keep the vagina moist.

44 is primo age for peri changes though so if it's clear it's most likely to be that. I had all sorts of issues - and it took ages to sort out. Look for the similarities not the differences like AA 😂

I don’t get why it’s clear though? The dip test shows white blood cells and nitrites. Only a UTI causes nitrites.

My daughter has had this. She had a run of recurrent obvious to me utis, with dip signs, but clear lab results. Her paediatrician (she was under the hospital) kept then ruling out utis. It went on for ages, then eventually resolved. Then this year, it happened again. Gp said that he was sure it was a uti despite lab, and that he had seen this happen before, and extended antibiotics to be sure infection was gone. It worked - and it didn’t come back.

Are the office and lab samples both midstream?
most post sex UTI’s are e-coli.
you can have natural flora that’s out of balance that causes UTI like symptoms but it’s not a bacterial infection.
no advice as to how to fix, have you tried D-Mannoose?

It’s the same sample. She dipped it in the office and it looked infected. Then sent away the rest of the bottle and the result was clear.

If it wasn’t a UTI the nitrafurantoin wouldn’t improve the symptoms. It just isn’t clearing it. The problem is the GP won’t give me more antibiotics because the test is clear.

Ovestin cream is your new best friend.

OP my sister had real issues with this, something to do with the NHS lab tests not being sensitive enough to pick up an infection. Her UTI’s were recurrent but this service was amazing: https://www.chronicutiinfo.com/treatment/conventional-medicine/uk-treatment/prof-malone-lee/
This is the private clinic but they also see patients on the NHS. This may not be needed in your case but it’s useful to have the information should you need it. She also found D-Mannose helpful.

It could be that you have the UTI initially, it is cleared and then the other symptoms are perimenopause related.

I was your age when these kinds of issues started (plus thrush), it could be vaginal atrophy which is likely to cause recurring UTIs until your hormones are more level.

HRT has resolved things for me.

If the urine is sent when the antibiotics are still in your system, the urine will not grow bugs, Despite a positive dip stick.
You need to be off antibiotics for more than a few days.

Exactly. Why do the doctors not appear to know this? They’re saying a clear test means there’s no infection and there never was.

You can order UTI meds yourself online from UK regulated pharmacies: https://www.healthexpress.co.uk/cystitis

D-Mannoose changed my life! After 10+ years of UTIs, negative tests, antibiotics that didn't work etc.. I was at my wits end and drinking loads of water just made everything worse.
Now, the second I feel the slight familiar twinge 'down there' I take two d-mannoose tablets with a mug of water and its sorted.

I kind of suspect that the reason d-mannoose isn't suggested by GPs is because big pharma companies can't make lots of money out of it, so no one is funding research or marketing.

A close relative of mine was seriously ill and had several courses of antibios over a year and like you always showed infection with the dip stick but the hospitals got to the point that there is perhaps a residual infection which wasn’t harming him as such so to stop the antibios to give him time to recover. I researched everything and put him on D-MANNOSE daily. After 3 months tests all clear. He took for 6 months and again 3 years later when another UTI crept up.

There's a whole, long thread on this. Let me see if I can find you the link.

It's called 'UTI symptoms not going away and scared'.

UTI Symptoms not going away & scared www.mumsnet.com/Talk/general_health/4850557-uti-symptoms-not-going-away-scared

Have a read of that. There's all sorts of good advice in it.

I had this. In the end I asked why they hadn’t done a blood sample. So they did one. That showed I was fighting an infection and I got an urgent referral to urology. The urologist said he sees this all the time. I was put on 6 months worth of antibiotics and never had a problem since.

Check that they are not saying it’s “mixed growth” which sometimes they say means it is clear because there isn’t one specific bacteria they can target. This happened to me and I had to resend sample several times to find out what it was that was growing.

You need to start your Ovestin cream now. Peri changes the whole makeup of your pelvic floor.

I used to get lots of UTIs in the past and have taken lots of antibiotics until about 8 years ago. I now use D Mannose daily which fingers crossed generally keeps it at bay.

Recently I had a UTI. Initially went to the chemist who gave me nitrofuriton which has worked well for me in the past, but was only given 3 days worth of drugs. This is apparenlty now a standard timescale from the NHS for this drug (when I last had an infection and used this a standard prescription was 5/7 days). I was pretty dubious but told it was researched etc. After 3 days it was a lot better but not 100% gone. Tried to ignore it, but 2 days later it came back worse than when I first went in. Went to the GP, urine dip showed traces of blood but no infection, argued the case for 7 days course as I had had successful treatment in the past, which I was reluctantly given. After 5 days it was much much better and by the 7 days it was gone.

Nitrofuriton manufactures guidelines for length of treatment is for up to 7 days. I’m guessing the NHS is trying to cut costs by reducing this timescale but it doesn’t work for everyone. I’d ask for a longer course of tablets.