nitrites in urine but no leukocytes

Lifestyle changes can help reduce the symptoms of some conditions that cause leukocytes to enter the urine. Advertising on our site helps support our mission. Pregnant people will need a course of antibiotics whether or not they have symptoms. A sample should be sent for urine culture in all women with suspected lower UTI who: Are pregnant. Published 2015 Mar 24. doi:10.1371/journal.pone.01197128. These UTIs don't respond well to standard treatments. When dealt with promptly, UTIs are easily treatable and usually resolve quickly in a couple of days. The most likely reason is pregnancy. Some types of bacteria have an enzyme that converts nitrates into nitrites. These statements have not been evaluated by the Food and Drug Administration. This is highly suspected if there are no nitrites present in the urine at the time. Officials say the antibiotic gepotidacin is performing so well in trials that it may be available sooner than expected for treatment of UTIs. i am having the same problem and there is no information anywhere! If you have nitrituria, your doctor may want to send your urine sample to a laboratory for a urine culture test. Be sure to take all your antibiotics, even if you're feeling better. Leukocytes are also known as white blood cells, which are an important part of your immune system. Without bacteria, nitrites cant form. The amount of nitrites in your urine is always changing based on factors like what you've eaten. Nitrate reduction to nitrite, nitric oxide and ammonia by gut bacteria under physiological conditions. Learn about the differences between kidney infections and UTIs here. Does positive nitrite mean UTI? Not all bacteria result in a positive nitrate result. Nitrite and leucocyte esterase are indicators of urinary tract infection. The urine dipstick was exposed to air for too long. While most cases of pyuria are due to a true urinary tract infection, some cases are observed in patients without an infection. We want the forums to be a useful resource for our users but it is important to remember that the forums are Rachael is a freelance healthcare writer and critical care nurse based near Cleveland, Ohio. jay x Report / Delete Reply Does a positive nitrite test always signal a UTI? Can poor sleep impact your weight loss goals? UTIs usually have symptoms you can notice, such as: Some people wont experience symptoms of a UTI right away. Took copro, bactrim and finally culture for UtI for 3 weeks. Other signs include frequent urination, pain or burning sensation when passing urine, or blood in the urine. What does this mean? Pyuria is a term used to describe white blood cells in the urine. Learn more about the different causes of blood in urine in males and females here. . Nitrites in urine may be a sign of a urinary tract infection (UTI). A test for nitrites can also come back negative if the urine is excreted before the reduction of nitrate to nitrite can take place. But in cases when they are detected in high quantity, it means your body is fighting an infection like bacteria infections.. Then the stinging began, so I drank lots of water which fixed the problem however, my first morning urine is still smelly and always has Nitrites in it! You can still have a UTI even if the urine dipstick test doesnt detect nitrites in your pee. UTIs are caused by different types of bacteria. . When they are found in someone's urine, a urinary tract infection is also most likely the reason. Stopping an antibiotic too soon can allow the infection to return and contribute to antibiotic resistance. Doctors will first order a urine analysis (urinalysis) to screen the urine for abnormalities which may be enough to detect any problems. If your nitrite test comes back positive and your healthcare provider determines you have a mild UTI, you'll likely be prescribed a short course of broad-spectrum antibiotics such as trimethoprim-sulfamethoxazole (TMP-SMX) that you'd take for around three days. Healthline Media does not provide medical advice, diagnosis, or treatment. Kidneys perform essential functions in your body, filtering waste and producing hormones. Is the ketogenic diet right for autoimmune conditions? aafp.org/pubs/afp/issues/2000/0201/p713.html, aafp.org/pubs/afp/issues/2005/0315/p1153.html. MNT is the registered trade mark of Healthline Media. Furthermore, we also studied the growth of the urinary pathogen Escherichia coll in acidified nitrite-containing urine. Nitrate reduction to nitrite, nitric oxide and ammonia by gut bacteria under physiological conditions. A positive nitrite result signifies that bacteria capable of this conversion (eg, Escherichia coli, Klebsiella, Proteus, Enterobacter, Citrobacter, Pseudomonas) are present in the urinary tract. But some people will develop complicated infections that develop outside of the urinary tract, like the kidneys. yes.. they would of picked BV up at smear yes.. Hi! did you find a diagnosis / resolution? The following can also cause raised levels of leukocytes in the urine: Leukocytes in the urine cause different symptoms depending on the cause. Martina Franz, Walter H. Hrl, Common errors in diagnosis and management of urinary tract infection. Involvement of NLRP3 and NLRC4 Inflammasome in Uropathogenic. Just like with the LE test, false-negative nitrite results can occur and can be influenced by the following: Bottom line is a negative nitrite value does not necessarily mean there is no infection present. People who suspect leukocytes in the urine provide a urine sample that their doctor can analyze in three ways: Visual exam, dipstick test, and microscopic exam. Total leukocyte count of 11,210 70 Views Does a total leukocyte count of 11,210 cells/cumm indicate . In many cases, your UTI symptoms should begin to improve within a few days of starting antibiotic treatment. Exp Ther Med. Read More Policy. When they are found in someones urine, a urinary tract infection is also most likely the reason. Bono MJ, et al. Antibiotics kill the bacteria causing the infection. As already discussed, this could be caused by improper storage of the dipsticks or urine or could happen if the patient is immunocompromised. The doctor on duty tested my urine and found that there were leukocytes present but no nitrates. 2006 Jun;274(3):150-4. doi: 10.1007/s00404-006-0149-8. Leukocytes can be noted in the urine for the following reasons: 1. and transmitted securely. NO was also released from acidified control urine if nitrite was added, and this release was greatly potentiated in the presence of vitamin C. Furthermore, the growth of E. coli was markedly reduced by the addition of nitrite to acidified urine. Would be really helpful. Pregnancy physiological changes can result in pyuria (leukocytes in urine) In pregnancy we treat asymptomatic bacteruria. The usefulness of the nitrite test is limited, however, as nitrite production is not associated with other urinary tract pathogens such as Pseudomonas or even enterococci. Neutrophils (one of the types of granulocytes) are the first cops on the scene in an immune response, and their presence will be detected by an LE test even before you start to experience noticeable symptoms. Other reasons for nitrite urine tests include: Your healthcare provider will likely recommend a urine culture to identify the type of bacteria thats present in your urine. I have noticed for the last 3 months my urine has been smelly in the morning and thought nothing of it. No nitrates does not always mean no uti, especially Enterococcus is not making nitrates. You may also get a urinalysis if you have UTI symptoms. Leukocyte esterase shows leukocytes (white blood cells [WBCs]) in the urine. In the case of an active infection or leukocytes in your urine, you should not have sex until completely cleared. did you find out what it was? Effects of pH, nitrite, and ascorbic acid on nonenzymatic nitric oxide generation and bacterial growth in urine. What bacteria cause nitrites in urine? Carlsson S, Govoni M, Wiklund NP, Weitzberg E, Lundberg JO. Urinary Tract Infection Facts and Statistics: What You Need to Know. Didnt seek treatment, didnt increase water intake or buy OTC UTI medicine. 4. You can also take oral supplements. Some bacteria, for example, Enterobacteriaceae, convert nitrates to nitrites. Analysis of the sample. Methods of quantitative analysis of the nitric oxide metabolites nitrite and nitrate in human biological fluids. In the absence of bacteria, nitrite is not found in urine. Most species of bacteria that colonize in the urine cause nitrates, which are derived from dietary metabolites, to be converted to nitrites. Leukocytes can sometimes show in urine tests. Normally no nitrites are detected in the urine. What does excess white blood cells in urine mean? Nitrates are excreted in urine and are reduced to nitrites through the action of the enzyme nitrate reductase. A nitrite urine test isnt always accurate, so your provider will check for other signs of a UTI. A urinalysis may be done for a variety of reasons, including: Before a urinalysis, inform your doctor of any medications, vitamins, or supplements youre taking. Free U.S. shipping & money back guarantee. Some of. General Medicine 4,496 satisfied customers UtI for 3 weeks. 2015;10(5):e0127490]. respect of any healthcare matters. This can be caused by certain obstructions by tumors, stones or in men by enlarged prostate. This mechanism might explain why urinary acidification and vitamin C may be effective in the treatment of bacteriuria. In the meantime, when there are changes noted to a urine . He sent my urine to the lab to be tested further and gave me some antibiotics to use in the meantime. Large amounts of NO were released from infected nitrite-containing urine after mild acidification. and Privacy Policy and steps will be taken to remove posts identified Epub 2019 Dec 3. This happens when there is physical damage to the urinary tract, as is the case when kidney stones are passed. Ghosh R, Gopalakrishnan S, Savitha R, Renganathan T, Pushpavanam S. Sci Rep. 2019 May 27;9(1):7896. doi: 10.1038/s41598-019-44455-1. The old and damaged WBCs tend to get eliminated from the body in small amounts along with urine. 5 years ago, 2. Nitrites. This method of testing for a UTI does have its limitations, however, since nitrites give little information about what type of bacteria is causing the infection. This urine test identifies the specific bacteria causing the infection, enabling your provider to select the most effective medication. I have noticed for the last 3 months my urine has been smelly in the morning and thought nothing of it. Both of these substances are indicators of infection. Nitrite-positive urine (pee) is a sign of a possible urinary tract infection (UTI). Wear cotton underwear and avoid tight-fitting clothing. Urinary tract infections typically cause cloudy or foul-smelling urine. It's also possible to have a UTI without having nitrites in your urine. As a result, you develop a urinary tract infection (UTI). Given the low prevalence of enterococcal UTI, the absence of . Because of the role bacteria plays in transforming nitrates into nitrites, the nitrite levels in your urine are sometimes used to help diagnose bacterial infections, specifically in the urinary tract. He also said this could be a sign of a bladder infection. Urine is the liquid the kidneys produce to expel useless waste from the body. Overactive Bladder vs. Urinary Incontinence and UTI: Whats the Difference? A block in urine flow can result in presence of blood in urine. Delzell JE, et al. The bacteria may travel to your bladder (the organ that holds urine), causing bladder inflammation (cystitis). Leukocyte negative means that the amount of white blood cells in your urine are low and not secreting leukocyte esterase, which is a compound white blood cells excrete when they're activated, or fighting off an infection. However, for many of us, weve had the experience of being uncertain about our test strip findings do I really have a UTI? BMC Infect Dis. Negative nitrite and low leukocytes indicate positive test for infection. Leukocytes in Urine - No Nitrates Health Destination 8.04K subscribers 34K views 3 years ago The video explains what leukocytes in urine means. Urinary tract infection in adults. Only culture testing can tell if a bacteria is present. government site. High leukocyte levels in the urine may indicate a urinary tract infection or other underlying inflammatory medical problems. This article reviews all you need to, Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. October 2017;17(1):670. doi:10.1186/s12879-017-2785-y. (https://www.uspharmacist.com/article/interpretation-of-urinalysis-and-urine-culture-for-uti-treatment), (https://medlineplus.gov/lab-tests/nitrites-in-urine/), (https://www.womenshealth.gov/a-z-topics/urinary-tract-infections), (https://www.urologyhealth.org/urology-a-z/u/urinary-tract-infections-in-adults), Visitation, mask requirements and COVID-19 information. Bacrea A, Fekete GL, Grigorescu BL, Bacrea VC. I am a 32 year old woman. Methods: When nitrites in urine cause a UTI, you may experience these symptoms: Your healthcare provider orders a urinalysis to test for bacteria and nitrites in urine. Chu CM, Lowder JL. A urine culture usually takes about two to three days to be completed, sometimes longer depending on the type of bacteria. Leukocyte dipstick test:White blood cells (leukocytes) are found in the urine. UTIs are the second most common type of infection in the body (after the common cold). Dr. Evan Altman answered Psychiatry 21 years experience Leukocytes = WBCs: White blood cells in the urine indicate that an inflammatory or immune system reaction is taking place. Federal government websites often end in .gov or .mil. PMC Nitrituria by itself may not mean you have a UTI. As always, consult with your doctor to see what reference ranges were used for your test and be sure to voice any concerns you may have. The presence of leukocytes in urine indicates inflammation of the urinary tract. Change your underwear and clean your genitals on a daily basis; in some cases, washing your undergarments and towels with a disinfectant will be needed as well. Leukocytes, also known as white blood cells, are a central part. Nitrites in the urine are diagnosed with a test called a urinalysis. This time I caught it early (a few days ago) and immediately started guzzling water when I became suspicious. Through the outward expulsion of urine, it's possible to filter the blood. This test is usually performed at the same time of the nitrites in urine test. Kidney disease causes itchy skin, known as pruritis, most often in the advanced stages of the disease. This information will allow them to prescribe a more targeted antibiotic. This site needs JavaScript to work properly. Best Pract Res Clin Gastroenterol. Posted (2022). PLoS One. These infections can affect any part of the urinary system, including the bladder, urethra, and kidneys. Negative nitrites and leukocytes indicate presence of no bacteria. Karwowska M, Kononiuk A. Nitrates/Nitrites in Food-Risk for Nitrosative Stress and Benefits. Rachael is a freelance healthcare writer and critical care nurse based near Cleveland, Ohio. Testing urine for nitrites is a quick way to screen for a UTI, but other tests like urine cultures can provide more detailed and accurate information. Communication is most important! Egton Medical Information Systems Limited. I have had a UTI before once, but I was kind of an idiot about it and did nothing to make it better. Also is this maybe something my body is trying to flush out? Send urine for culture to confirm diagnosis. So, as with everything, check with your doctor about what standard reference ranges are being used to determine any abnormal presence. But what happens if you have been told by your physician that you have leukocytes in your urine but no nitrates? In the urine, it is much lower, between zero and five WBCs per high power field. read more Diana General Practicioner Physic. 5. Note that the body converts nitrates to nitrites and even . A bladder infection is a type of UTI, which refers to infection in the bladder, kidneys, ureters, or urethra. . Bacteria responsible for an infection feed on this waste . Always speak to your doctor before acting and in cases of emergency seek Discover 10 ways to prevent kidney stones here. appropriate medical assistance immediately. 2019 Sep 3;10:2020. doi: 10.3389/fmicb.2019.02020. A false-positive result can be caused by various factors including: A dirty catch urine sample may also contaminate a specimen with leukocytes from the vagina, which is why you may be asked to clean yourself and catch urine midstream; however, the current scientific evidence suggests that cleansing procedures may not be necessary as they have not been shown to decrease urine contamination significantly. Today I bought an OTC UTI test strip, the results of which say I have nitrites in my urine but no leukocytes. This is because granulocytic cells all have esterases in them. WBCs in the urine may mean a UTI is present. Leukocytes are white blood cells that help your body fight germs. Your age and overall health factor in. Cystitis, or inflammation of the bladder, is another possible cause of leukocytes in urine. A UTI is diagnosed if there are nitrites or leukocytes present in the . Registered number: 10004395 Registered office: Fulford Grange, Micklefield Lane, Rawdon, Leeds, LS19 6BA. Coming to a Cleveland Clinic location?Hillcrest Cancer Center check-in changesCole Eye entrance closingVisitation, mask requirements and COVID-19 information, Notice of Intelligent Business Solutions data eventLearn more. Keep in mind that not all bacteria are capable of converting nitrate to nitrite. does anybody know why this is? Leukocytes in urine but no nitrates 07-01-2010, 03:28 AM. What does it mean if you have leukocytes and nitrite in your urine? Am J Obstet Gynecol. We link primary sources including studies, scientific references, and statistics within each article and also list them in the resources section at the bottom of our articles. In normal circumstances, small amounts of leukocytes are found in urine. NITRITES Nitrites normally are not found in urine but result when bacteria reduce urinary nitrates to nitrites. A test strip will be dipped into your urine sample; it changes color based on the chemicals found in your urine. Harmful bacteria find their way into the urinary tract and reproduce rapidly. Your symptoms should begin to improve within a few days of starting treatment. What antibiotics treat nitrite positive UTI? Learn more about the differences between bladder infections and UTIs here. They may prescribe antibiotics to treat the UTI. The exact type of antibiotic youre prescribed will depend on what kind of bacteria is in your urinary tract, your medical history, and whether youre pregnant. Nitrites can form naturally in your body when the foods you eat are digested. Remember, nitrituria without other symptoms of a UTI may not indicate an infection. What is the latest research on the form of cancer Jimmy Carter has? Nitrate reduction to nitrite, nitric oxide and ammonia by gut bacteria under physiological conditions [published correction appears in PLoS One. Conversely, a false-negative result may also occur on occasion. It is uncommon to have high levels of leukocytes passing into the urine. Maintain a good ingestion of vitamins such as C and B to boost your immune system; these nutrients can be found in foods like cranberries, oranges, tangerine, lemon, lime, ginger, arugula, among others. as being in breach of those terms. Urine Having Leukocytes Without Nitrates: Causes and Treatments. Plasma- and urine concentrations of nitrite/nitrate and cyclic Guanosinemonophosphate in intrauterine growth restricted and preeclamptic pregnancies. Is it normal to have crystals in urine? July 2018;219(1):40-51. doi:10.1016/j.ajog.2017.12.231. Urinary tract infection. National Library of Medicine Having leukocytes in the urine without nitrites can also lead to a false-positive result that points to a bacterial infection when there is none. Seek emergency help if you have any of the following symptoms, as they could mean an infection has spread to your bladder or kidneys: If you experience any of the above symptoms or any other symptoms of a UTI, you should seek a doctors care as soon as possible. Emerg Med News. You may start to feel better after just a few days of antibiotics. If the dipstick test reveals abnormal results, the urine sample may be sent off to a laboratory for further testing and microscopic evaluation. Pregnant women suffer more from this due to the physiological changes during pregnancy, and as the foetus grows, it puts more pressure on the kidneys further increasing chances of infection. Cleveland Clinic is a non-profit academic medical center. Leukocytes, also known as white blood cells, are a central part of the immune system. Leukocytes in Urine (No Nitrates) Even in healthy persons, the body is continually fighting pathogens that try to invade it. 2005-2023 Healthline Media a Red Ventures Company. Urine Having Leukocytes Without Nitrates: Causes and Treatments When nitrates are positive in your urine, it probably means that a urinary tract infection caused by gram-negative bacteria is present. Most of the time, nitrates pass through our bodies without causing problems. Sometimes we will advise them if a specimen is properly sampled and tested to perform a culture. Symptoms include severe abdominal or lower back pain, confusion, and fever. In most cases, there are warning symptoms that allow knowing the presence of an infection, such as fever , general malaise, vomiting, abdominal pain or urination , as well as burning, which is very uncomfortable. That explains why regular urinal discharge has traces of leukocytes. If your doctor tests your urine and finds too many leukocytes, it could be a sign of infection. Sterile pyuria is the persistent presence of white blood cells in the urine without a bacterial cause. For this reason, healthcare providers will sometimes use urine dipstick testing for nitrites to diagnose urinary tract infections (UTIs). Many gram-negative and some gram-positive organisms are capable of this. Jamin Brahmbhatt, MD, is a board-certified urologist and Chief of Surgery at Orlando Health South Lake Hospital. 6 users are following. One tested positive for nitrites the other tested negative for luekocytes. When you have leukocytes in urine but no nitrates, it may also indicate a urinary tract infection. Leukocytes are white blood cells that help your body fight germs. leukocytes every time i go to get my pee tested at the doctors i have high wbc/leukocytes but no infection. Use of the forums is subject to our Terms of Use Occasionally, bacteria from other body parts reach the kidneys through the bloodstream. Nitrites in urine show a UTI is present. Read our. eCollection 2019. Accessibility Thus, their presence is abnormal. A false-positive nitrite result (one that says nitrites are present when theyre not) is less common. 2004-2023 Healthline Media UK Ltd, Brighton, UK, a Red Ventures Company. Leukocytes can be present in urine for many, many, reasons. They help the body defend itself against pathogenic microorganisms (such as viruses, bacteria, fungi and parasites), foreign particles and potentially harmful abnormal cells in the blood and tissues. doi:10.1093/ofid/ofu019. But nitrite tests aren't foolproof; false positive and false negatives are both possible. Your provider will perform other dipstick tests and check for high white blood cell counts, which may indicate infection. doi:10.1371/journal.pone.0119712. In some cases, leukocytes can be found in a urine sample without actually having a urinary tract infection, which may be due to an incorrect technique or bad hygiene when collecting the sample. You may still have it if your leukocyte test turns positive. Your provider inserts a special test strip called a urine dipstick into the sample to test for nitrite-positive pee. We avoid using tertiary references. Leukocytes in urine no nitrates does not immediately discard a urinary tract infection. Who should be tested for nitrites, and how. Protein, urine casts (especially red blood cell casts), red blood cells, or white blood cells in the urine can indicate serious kidney involvement; leukocyte esterase may indicate a bladder infection. 10. Urine dipstick testing has limitations, but is still useful in the ED. They are not usually present in the urine, so when they are present, it can, Nitrites appear in the urine when a person has a bacterial infection in their bladder, ureter, or kidneys. Before A dipstick urinalysis test is easy and offers immediate results, so your healthcare provider may use one to check for nitritesespecially if a UTI is already suspected. Healthy urine contains nitrates, a type of nitrogen chemical. I am a 32 year old woman. The white blood cells are a result of . Some of the most common causes of leukocytes without nitrates in a urine sample are: The treatment will vary, depending on the cause for having an elevated number of leukocytes in your urine. On the other hand, leukocytes are cells of the immune system that respond to a pathologic microorganism. Anaerobic Transcription by OxyR: A Novel Paradigm for Nitrosative Stress. Tests Interpretation Having leukocytes in urine most often indicates that you have a bacterial infection. Simerville JA, Maxted WC, Pahira JJ. When you have more of these than usual in your urine, it's often a sign of a problem somewhere in your urinary tract. Always speak to your doctor before acting and in cases of emergency seek You can take these steps to lower the risk of exposing your urinary tract to nitrite-causing bacteria: You should call your healthcare provider if you experience: You may want to ask your healthcare provider: If you have nitrite-positive urine, it may mean you have a urinary tract infection (UTI). The presence of leukocyte esterase in the urine (leukocyte esterase positive +) usually suggests a urinary tract infection (UTI) or trichomoniasis (an infectious disease caused by the parasite Trichomonas vaginalis). positive leukocytes neg nitrates. Tiso M, Schechter AN. Testing urine for nitrites is a quick way to screen for a UTI, but other tests like urine cultures can provide more detailed and accurate information. When nitrates are positive in your urine, it probably means that a urinary tract infection caused by gram-negative bacteria is present. Leukocyte esterase is a urine screening test that detects a chemical that indicates the presence of white blood cells. 2005 Mar 15;71(6):1153-1162. Development of urinary tract infections are more commonly. Try our Symptom Checker Got any other symptoms? HHS Vulnerability Disclosure, Help Normally, there shouldn't be any nitrites in the urine of humans. Best food forward: Are algae the future of sustainable nutrition? Infected urine may contain considerable amounts of nitrite as a result of bacterial nitrate reductase activity, and detection of nitrite in urine is routinely used in the diagnosis of bacterial cystitis. Bookshelf The length of treatment will depend on the medication used, the dosing and the severity of infection. This product is not intended to diagnose, treat, cure, or prevent any disease. 2020 Apr 20;32(12):803-816. doi: 10.1089/ars.2019.7921. The dead cells are mostly eliminated through urine. 2023 Dotdash Media, Inc. All rights reserved, Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Urinalysis in Acute Care of Adults: Pitfalls in Testing and Interpreting Results. Is it possible to catch a UTI sexually without it being an STD? This is why your doctor considers the result of many tests and any symptoms when diagnosing a UTI. This is usually called a urinary tract infection (UTI). When nitrates are positive in your urine, it probably means that a urinary tract infection caused by gram-negative bacteria is present. i am having the same issue!! You should get immediate results. UTIs are common in pregnancy and are dangerous. Registered in England and Wales. If urine dipstick is negative for all nitrite, leukocyte and RBC, UTI is less likely. Schiessl B, Strasburger C, Bidlingmaier M, Mylonas I, Jeschke U, Kainer F, Friese K. Arch Gynecol Obstet. A UTI can happen anywhere in your urinary tract, including your bladder, ureters, kidneys, and urethra. This is typical of IC. Alterations in intragastric nitrite and vitamin C levels during acid inhibitory therapy. These compounds are found naturally in vegetables and are also added to foods like processed meats to help preserve them. Since the last one worked itself out with none of these precautions or treatment, and this one is still in very early stages and is still very mild, I think I should be able to fight it off on my own without seeing a doc, which for a number of reasons Id like to avoid unless I absolutely have to. Many of these types of bacteria change a normal chemical in your urine, called nitrates, into another chemical, called nitrites. They can lead to high blood pressure and premature delivery if left untreated. We want the forums to be a useful resource for our users but it is important to remember that the forums are Conclusions: If you get frequent UTIs that are difficult to treat, your provider may order a urine culture before prescribing antibiotics.

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