Cystitis is the inflammation of the urinary bladder that is characterized by frequent and painful urination, low grade fever, discomfort in the pelvic area, nausea, and vomiting. A sample of urine from the patient is the most common specimen. The doctor may prescribe a single clean catch sample of urine or may ask for several urine samples over a period of 24 hours. In hospitalized patients with severe infections, urine sample may be drawn directly from the patient's bladder using a catheter.
Urinalysis
Medline Plus defines urinalysis as the physical, chemical and microscopic examination of the urine. These tests may be performed routinely in a doctor's office. The first step of urinalysis involves visual examination of the urine sample to check for clarity and color of the sample. Uninfected urine is usually clear and pale yellow in color.
This is followed by microscopic examination of the sample in which small amount of the sample is smeared on a glass slide and observed under a microscope for the presence of blood cells, urine crystals, pus, mucus or bacteria.
The third step of urinalysis is chemical analysis during which a special stick, that contains pads of chemicals that change color when they come in contact with the substances of interest, is dipped in the urine sample and changes in color are observed.
Gram Staining
Gram staining is the first test done in a microbiology laboratory and as published in Mackie and McCartney's Manual of Practical Medical Microbiology, this test provides a preliminary identification of the bacteria that is responsible for cystitis. For this test, a small amount of urine sample is smeared on a glass slide and stained with dyes, such as crystal violet and basic fuschin and observed under a microscope for the presence of bacterial cells.
Urine Culture
Urine culture is a confirmatory test that is performed in the microbiology laboratory to confirm the presence of the bacteria and to specifically identify the causative organism. A small amount of the patient's sample is inoculated into growth medium plates, which are gels that contains chemicals that promote the growth of bacteria. These plates are then incubated overnight at 37 degrees Celsius. Mackie and McCartney's Manual of Practical Medical Microbiology informs that if the patient has cystitis, small colonies of bacteria appear on the growth medium plate. These colonies are further identified using microscopy and other chemical tests.
Antimicrobial Assays
Antimicrobial assays are performed to test the antibiotic susceptibility pattern of the bacteria that has been isolated during the urine culture. A small amount of the bacterial colony from the original growth medium plate is smeared on another growth medium plate using a sterile cotton swab. Small paper discs impregnated with antibiotics are placed at different spots on the plate and the plates are incubated overnight at 37 degrees Celsius. A clearing around a particular antibiotic disc indicates that the antibiotic is effective against the isolated bacteria, this according to information published in the Mackie and McCartney's Manual of Practical Medical Microbiology.
Cystoscopy
Cystoscopy is the inspection of the bladder with a cystoscope, which is a thin tube with a light and camera. This test looks for anatomical abnormalities that could lead to cystitis and according to Mayo Clinic, this test is required only for patients with recurring cystitis.
References
- "Mackie and McCartney's Manual of Practical Medical Microbiology"; J. G. Collee, A. G. Fraser, B. P. Marmion and A. Simmons;1996
- MayoClinic.com: Cystitis
- MedlinePlus: Urinalysis
