Urine culture with antibiogram: what is it, what is it for and results

Urine culture with antibiogram, also called urine culture with antibiogram, is a laboratory test requested by the physician, which aims to identify the microorganism causing a urinary tract infection and also to determine its sensitivity and resistance profile to the antibiotics that are normally used to treat the infection. Therefore, based on the result of the test, the physician can indicate the most appropriate antimicrobial drug for the person. 

Generally, the performance of this test is indicated when the person presents signs and symptoms of urinary infection; however, it can also be requested when in a general analysis of urine bacteria and numerous leukocytes are identified in the sample, since these alterations indicate this type of infection, being important to determine which is the microorganism responsible. 

Urine culture with antibiogram: what is it, what is it for and results

What is the antibiogram urine culture test for?

The antibiogram urine culture test is used to identify the microorganism responsible for the urinary alteration and also to know which antimicrobial drug can be used most effectively to combat it. 

Mainly, this test is indicated in case of urinary tract infection, and can be requested after having the result of a general urine test, or when the person presents signs and symptoms of urinary tract infection, such as frequent urination and pain and burning when urinating. Learn how to identify the symptoms of a urinary tract infection. 

This test is used to identify the presence of certain microorganisms and their susceptibility to antimicrobials, the main ones being:

  • Escherichia coli;
  • Klebsiella pneumoniae;
  • Candida sp. ;
  • Proteus mirabilis;
  • Pseudomonas spp. ;
  • Staphylococcus saprophyticus;
  • Streptococcus agalactiae;
  • Enterococcus faecalis;
  • Serratia marcenses;
  • Morganella morganii;
  • Acinetobacter baumannii.

    • The identification of other microorganisms that could also be related to urinary tract infection, such as Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma spp. and Gardnerella vaginalis, for example, in most cases is not performed by urine culture, being usually requested a vaginal or penile secretion sampling to be carried out the identification of the microorganism and antibiogram, or a urine analysis by molecular methods. 

    How to interpret the result

    The result of the urine culture with antibiogram is included in a report indicating whether the test was negative or positive and, if so, the microorganism identified, its quantity in the urine and the antibiotics to which it was sensitive and resistant. 

    The result is considered negative when a normal growth of microorganisms that naturally form part of the urinary system is determined; on the other hand, the result is positive when there is an increase in the quantity of any of the microorganisms that form part of the normal microbiota or when the presence of an unusual microorganism is determined. 

    In relation to the antibiogram, apart from informing whether the microorganism is sensitive or resistant to antibiotics, it also indicates the minimum inhibitory concentration (MIC), which corresponds to the minimum concentration of antimicrobial that is necessary to inhibit the growth of the microorganism; this being, therefore, very important information for the physician to be able to indicate the most appropriate treatment. 

    Urine culture with antibiogram for Escherichia coli

    Escherichia coli, also known as E. coli, is a bacterium frequently associated with urinary tract infections. When the urine culture is positive for this bacterium, it is indicated in the medical report the amount in which it is found in the urine and to which antibiotics it is sensitive, usually being fosfomycin, nitrofurantoin, amoxicillin with clavulanic acid, norfloxacin or ciprofloxacin. 

    In addition, the MIC is indicated, which in the case of Escherichia coli, for example, is determined to be susceptible to the antibiotic ampicillin when the MIC is less than or equal to 8 µg/mL for this drug, thus recommending its use for treatment; while values equal to or greater than 32 µg/ mL indicate that the bacterium is resistant to this antimicrobial. 

    Thus, according to the results obtained in the urine culture and in the antibiogram, the physician mayto indicate the best treatment for the infection. 

    How it is performed

    Urine culture is a simple test that is performed from a urine sample, which must be collected and stored in a suitable container provided by the laboratory. It is important to keep in mind that the sample should be taken from the first urine of the day; and to carry out the collection, it is first necessary to clean the intimate region with soap and water and then discard the first stream of urine and only take the intermediate stream. 

    It is important that the specimen is taken to the laboratory up to 2 hours after collection so that urine culture and antibiogram are feasible. In the laboratory, the sample is placed in a culture medium that favors the growth of microorganisms normally present in urine. After 24 to 48 hours, it is possible to determine the growth of microorganisms and thus perform microbial identification tests. 

    Likewise, from the moment in which the growth of microorganisms is observed in the culture medium, it is possible to determine the amount of microorganisms, which may indicate that it is a colonization or infection; in addition, it is also possible to perform the antibiogram, in which the microorganism is tested with different antibiotics, determining which ones it is sensitive or resistant to. Learn more about the antibiogram. 

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