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Dr. Andrew Rynne

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What causes the presence of nitrites in urine?

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Dr. Klarida Papaqako

General & Family Physician

Practicing since :2010

Answered : 1605 Questions

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Posted on Wed, 25 Apr 2018 in Urinary and Bladder Problems
Question: I had an uncomfortable bladder, so I tested first void. It tested positive for nitrite and trace leucocyte. I used a second strip to be sure and again nitrite appeared positive. I had a cystoscopy scheduled for the morning anyway but when I gave them a sample before procedure it tested negative for nitrite and positive for trace leucocyte. Dr did the procedure anyway. So what caused the positive nitrite?
doctor
Answered by Dr. Klarida Papaqako 2 hours later
Brief Answer:
Nitrites are sign of bacteria which cause UTI

Detailed Answer:
Hello,

Thank you for using HealthcareMagic to post your health query.
I read carefully your question and I understand your concern.

Nitrites are a secure sign of a urinary tract infection which can explain the symptom of an uncomfortable bladder.

Leukocytes alone though can also be a sign of UTI if the sample of urine is taken in the right way.

So the positive nitrites are caused by the bacteria that cause a urinary tract infection, but maybe the concentration of bacteria was not that high to be detected the last time.

Anyway, the symptoms you have are evident enough to proceed with the procedure (which I believe your doctor did already).

Hope this is helpful.
Let me know if you need more clarifications.

Regards,     
Dr. Papaqako

Above answer was peer-reviewed by : Dr. Arnab Banerjee
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Follow up: Dr. Klarida Papaqako 1 hour later
Thanks. I guess my question should have been, can two dipsticks in a row on the same sample be false. Dr took urine from the bladder through the cystoscope and the preliminary results were no bacteria growth after 24 hrs.
doctor
Answered by Dr. Klarida Papaqako 14 hours later
Brief Answer:
Same sample, should show same results of dipstick, with smaller changes.

Detailed Answer:
Hello,

Thank you for the follow up question.

2 dipsticks show different results when done is the same sample, if one of them either is not applied how it should, or if one of them is expired or gone bad. But if applied how it should, in general it should give the same result.

But if the samples are different, and taken in different times of the day, then the dipstick can be different. But we take as the right one, the one that is positive- because if it is positive at least once, means that there were bacteria there, and it is not good to be treated, or to wait until it gets worse.

I hope this is clear.

Kind regards,
Dr. Papaqako
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Klarida Papaqako 34 hours later
I'm sorry, I still didn't word my question right. It was two dipsticks done on the same sample in which both tested positive for nitrites. However the urine sample at the urologist only showed positive for trace leucocytes. The procedure was done, another sample was removed from the bladder by way of cystoscope and that showed no bacteria. So maybe the sticks were both bad. I did get one antibiotic capsule after the procedure and all seems well, so thank you.
doctor
Answered by Dr. Klarida Papaqako 19 hours later
Brief Answer:
Urine taken from urinary bladder is not contaminated.

Detailed Answer:
Hello,

The both sticks weren't bad. It is more possible for a dipstick to result positive when you take them yourself, because the urine may be contaminated from the external urinary ways, like urethra and the vagina.
But if your doctor took it directly from the urinary bladder, then it is more accurate. In this case it showed negative, but since you had symptoms and since it has showed twice positive, I guess the doctor has preferred to be sure and treat you rather then risking for the infection to spread.

I hope this is more clear now, but feel free to ask again if still need more clarifications.

Kind Regards,
Dr. Papaqako
Above answer was peer-reviewed by : Dr. Raju A.T
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