Gram Stain – Urine:
Why Gram Stain (Urine) Test?
CLINICAL INFORMATION
A urine test is performed along with results from a urinalysis (pus/blood), to diagnose a Urinary Tract Infection (UTI) such as cystitis, and to identify the cause of infectious pathological microbes eg. Staphylococcus, Klebsiella, E.coli, Enterobacter or Proteus etc. Urine culture and sensitivity tests are ordered in patients with UTI when suspected of ascending to kidneys or bladder who manifest with clinical manifestations (signs and symptoms). The urine sample specimen of the patient is added to a suitable culture medium for their microbial growth. The formation of bacterial or fungal colony growth signifies the presence of that microbe as a positive test result. Gram stain test is most often used to find out the causative pathogen such as in bacterial infection. The absence of microbial growth in the urine culture medium is confirmed in the negative test results. These test results help in arriving at diagnosis with confirmatory test results (to rule out a differential diagnosis) and prescribing specific medications against the infectious pathogens, and also in monitoring treatment (prognosis). Some common symptoms include chills and fever, burning pain while urination (burning micturition), pain in the back or lower back, frequent urgency to urinate, cloudy or smelly urine etc. In some suspected cases of sexually transmitted diseases, such tests for Sexually Transmitted Infection (STI) becomes mandatory. Gram Stain Test: This test checks for the presence of harmful pathogenic microbes in suspected infection, for example in the throat, lungs, skin wounds, genitals etc and moreover in body fluids such as blood, urine etc. The two main categories of bacterial infections are gram-positive and gram-negative. This screening for diagnosis is done by the differentiation made, based on how the bacteria react to the gram stain. A gram stain is coloured purple and if the bacteria remain in purple colour it is gram-positive bacteria and incases the bacteria turns red or pink they are gram-negative bacteria. Examples of gram-positive bacteria include nosocomial infection caused by methicillin-resistant Streptococcus aureus (MRSA), Strep infections, toxic shock etc. Examples of gram-negative infections include Salmonella, pneumonia, gonorrhea, UTI etc. The significance of differentiating the nature of bacteria as gram-positive or gram-negative helps the physician to begin the most effective antibiotic therapy for treating it. If the test result shows the presence of more than (≥15) colonies along with the same organism isolated from peripheral blood along with clinical signs and symptoms, then the case is said to be an infected positive case. Other gram stain tests include the Acid Fast Test (eg. For mycobacterium causing TB etc). Clinical manifestations include chills, fever, fatigue, nausea, confusion, increased heart rate, nasal flare due to increased breathing -which may or may not be associated with shortness of breath on physical exertion, inflammation (presenting with cardinal signs of inflammation like – rubor, tumour, calor, dolor and loss of function), blood clots, drop in blood pressure, organ failure, elevated WBCs etc. Once tested positive, then the additional supportive tests are ordered for - Evidence-Based Therapy (EBT) such as CBC, test for the presence of bacterial toxins (release of toxic by-products) eg staphylococcal infection, in case of foodborne-illness/food poison (or their toxins), different sample specimen collected for tests eg. blood, stool, urine culture, sputum test, CSF sampling, ascetic fluid, pleural fluid, pericardial fluid, synovial fluid, complement test (to check for increased levels of C3) etc. Moreover, sensitivity tests (also known as susceptibility testing) are also performed in addition, to appropriate antibiotic treatment & for better prognosis eg. MRSA – Methicillin-Resistant Staphylococcus aureus, VMSA – Vancomycin-Resistant Staphylococcus aureus etc. Other tests other than culture and sensitivity of semen for the source of infection includes microscopic examination and evaluation of semen analysis, blood tests like CBC, differential WBC count (in case of infection), Prostate-Specific Antigen test, testosterone, FSH, ELISA test for Mumps antibodies etc, other hormonal assays eg. pituitary hormones (in case of tumours etc), urinalysis to check for UTI, digital rectal examination to confirm pain and swelling of the prostate, CT Scan, ultrasound (vericocele), genetic tests like DNA etc.
General Instructions:
Sample Requirement: Specimen - urine. Test Preparation: None.
NOTE - Sample for specimen collections may vary based on the patient’s condition/cases according to the patient’s presenting complaints/signs or symptoms:
SPECIMEN REQUIREMENT (Special or Rare Cases) - As instructed and guided by Physician / Clinician / Pathologist / as per Laboratory’s requirements, according to procedures and protocols.
This Multi-Specialty Clinical Referral Laboratory RT DIAGNOSTICS provides precise and accurate tests with an extensive range of testing services to the medical centres to help in the diagnosis and identification of pathology in the test specimens for infectious diseases and also to evaluate the function of organ systems of the patient. It prevents further complications and helps to stabilize and restore health to near normalcy at the earliest without delay.
