US Pharm. 2010;35(11):80-81.

Urinary tract infections (UTIs) account for approximately 8.3 million doctor visits each year.1 Approximately 7 million episodes of acute uncomplicated UTI occur annually in the United States.2 It is estimated that at least 20% of women can expect to have a symptomatic UTI in their lifetime, occurring a majority of the time in women who are between 20 and 56 years of age. Women are more prone to infection than men primarily because women have a shorter urethra.3 In fact, one in every five women who contract a UTI will eventually have another. Further, women acquire three or more UTIs a year more than men. Repeat infections are commonly seen in patients with diabetes or those who have difficulty upon urination, such as patients with urinary incontinence and benign prostatic hypertrophy.4

Pathophysiology

Some components of the urine include water, metabolic waste, glucose, nitrates, and urea. Urine is sterile under normal circumstances, and the presence of bacteria is highly unlikely. However, a UTI occurs when bacteria adhere to epithelial cells of the bladder wall or the opening of the urethra, colonizing the lower urinary system. Further, approximately 80% of uncomplicated UTI manifestations are caused by Escherichia coli.5,6 Additionally, there is a wide array of other causative bacteria, including klebsiella, enterococcus, and proteus. 

How to Detect a UTI

Symptoms associated with a UTI include dysurea, urgency, frequency, and abdominal pain. Patients generally suspect an infection when urine appears cloudy, bloody, or foul smelling.  Since these symptoms can be indicative of other conditions, a urinalysis is needed to confirm the presence of a UTI. Nitrites and proteins in the urine are often confirmatory and are reliable markers for diagnosis.

To mitigate painful urinary symptoms, early detection is vital. To aid in early detection, Woman's Wellbeing developed the UTI Home Screening Test Stick. This product, which is now available OTC as the vH essentials UTI Home Test (FIGURE 1), has been shown to identify approximately 90% of infections occurring in women who suffer from recurrent UTIs and in women who are at risk owing to sexual activity.2  

How the UTI Home Screening Test Works

The vH essentials UTI Home Test is a quick and simple test that detects urinary nitrite and the presence of protein in the urine. Subsequent to the application of urine, color differentiation determines whether the test is positive or negative. For example, a color change from white to pink and from yellow to green develops when nitrites and proteins are detected, respectively. A deeper color signifies higher concentrations of proteins and nitrites.

The accuracy of this test is limited by certain circumstances that may skew the results. For example, false-negative results may be observed following high consumption of ascorbic acid, antibiotics, or fruit juices, or if the urine is not in the bladder for at least 4 to 6 hours. False positives may present if the urine specimen appears red due to any cause; for example, recent ingestion of common UTI pain relief medication containing phenazopyradine dye or contamination with menstrual fluid. In the event of a positive nitrite or protein result, patients should contact their primary health care provider. And even if both nitrites and proteins are negative, patients with persistent symptoms need to see a health care provider for further evaluation. Patient instructions may be found in TABLE 1

Analytical Studies

This product was compared to another commercially available UTI test strip. During the study, 100 negative urine samples were spiked with sodium nitrite and 50 were utilized as placebo. Each specimen was tested with the commercially available UTI test strip and with the UTI Home Test. Results demonstrated a comparative sensitivity and specificity of 99.3% and 98%, respectively (TABLE 2).7 Only one false negative and one false positive were observed. 

Warnings and Precautions

The manufacturer of the UTI Home Test cautions that it is for in vitro diagnostic use only, and that a person who is color-blind should not make the visual color comparison.3 In addition, the manufacturer warns that unpredictable, inaccurate results can occur if the colors are read too early or too late or if lighting is poor, and that the UTI Home Test should not be stored with household chemicals since they may cause the test to be ineffective.3 The UTI Home Test should also be kept away from small children.3 

Conclusion

Performed in the convenience of the patient's home, the vH essentials UTI Home Test is an affordable procedure with simple instructions that provides accurate results in less than 2 minutes. For more information on the UTI Home Test, visit www.vhessentials.com or call 1-800-635-3696.

REFERENCES

1. Urinary tract infection. National Guideline Clearing House. www.guideline.gov. Accessed October 10, 2009.
2. Bishop M. Uncomplicated urinary tract infection. EAU. 2004:143-150.
3. vH essentials UTI Home Test package insert. Jackson, WI: Lake Consumer Products, Inc; 2010.
4. UTI (Urinary Tract Infection) Home Care Kit. TestMyHormones Web site. www.testmyhormones.com. Accessed October 1, 2009.
5. Krieger J. Urinary tract infections: what's new? J Urol. 2002;168:2351-2358.
6. Persaud K, Pisanelli A, Evans P, et al. Monitoring urinary tract infections and bacterial vaginosis. Sensors and Actuators B. 2006;116(I-2):116-120.
7. Women's Wellbeing UTI Home Test Stick. Clinical studies data.

To comment on this article, contact rdavidson@uspharmcist.com.