Urine Culture with E. Coli: Meaning, Results and Treatment

Different microbes such as viruses, fungi, and bacteria can cause a urinary tract infection. Bacteria are the most common culprits even though your body has a natural defense system to throw these bacteria out of your body when they enter your urinary tract. But, sometimes, your natural defense fails, giving bacteria the chance to cause an infection in the urethra (urethritis), bladder (cystitis), or kidneys (pyelonephritis). To confirm your symptoms are due to a urinary tract infection, your doctor will ask for a urine test in which they will look for E. coli.

E. Coli in Urine Culture – What Does It Mean?

When your lab assistant tells you that they have found E. coli in urine, it usually means you have a urinary tract infection and your doctor may ask for other tests to confirm what type of infection it is. Under normal circumstances, your urine in the bladder contains no bacteria or other organisms, but that's not the case when bacteria enter your urine through the urethra. Escherichia coli or E. Coli is among the most common causative agents of UTIs. Your doctor will confirm the presence of these bacteria in your urine through a urine culture test, but they will also look for the presence of any red blood cells, while blood cells, or bacteria.

Your lab assistant may ask you to wipe clean your genital area before the test to avoid any contamination. They will then analyze your urine and if they find something specific, they will proceed with a urine culture test to confirm an infection. This test will help confirm the types of bacteria causing infection in your case – this will also help identify the best medicine for the infection.

How to Understand the Urine Culture Test Results

As mentioned already, a urine culture is a test that helps detect and identify the type of organism that's causing a UTI. It usually takes a couple of days to get your urine culture results, but some organisms don't grow that quickly in the culture, so you will have to wait longer for your result.



No bacteria or other organisms grow in the urine culture. The test will be NEGATIVE.

Bacteria grow in the urine culture within the testing time. The test will be POSITIVE.

  • If the test finds more than 100,000 bacteria in a milliliter of urine, it usually indicates an infection.
  • If there are bacteria in your sample but the count is between 100 and 100,000, this may be due to infection or contamination of the sample in which you will need another urine culture.
  • The infection isn't present usually when the count is 100 or less

Also, if different types of bacteria grow in a culture, it usually happens due to contamination. It means your doctor may ask for a repeat culture on a sample for confirmation. Additional testing is usually required when significantly higher count of bacteria is present. Your doctor may also ask for a susceptibility test to identify the best antimicrobial treatment.

More about UTI

The presence of E. coli in urine usually indicates a urinary tract infection, but it may not always cause visible symptoms. When symptoms appear, they may include a burning sensation while urinating, a strong urge to urinate, passing small amounts of urine, passing strong-smelling urine, and urine that appears cloudy or red. Women may also experience pelvic pain around the area of the pubic bone.

Taking Antibiotics

When there is E. coli in urine culture, it is important to identify the best treatment option. Antibiotics usually work well to treat urinary tract infections. If you have a simple infection, your doctor may prescribe Trimethoprim, Nitrofurantoin, Fosfomycin, Levofloxacin, Ciprofloxacin, Doxycycline, and Ceftriaxone. Your symptoms will go away after taking these drugs for some time, but you may have to continue taking these for another week or so to complete the entire course. It is usually enough to take antibiotics for a couple of days only to treat an uncomplicated UTI. Your doctor may also give you a pain medication to numb your bladder and urethra. This will help relieve the burning sensation while urinating. You will notice your urine turn red or orange when using urinary tract analgesics.

For Recurrent UTIs

Your doctor may adapt a different approach when you have frequent UTIs. They may prescribe low dose antibiotics that you have to take for six months or longer. They may prescribe specific antibiotics that you have to take after a sexual encounter – this is usually the case when your UTI is related to sexual activity. Vaginal estrogen therapy may also help if you're postmenopausal. A severe UTI usually requires a hospital stay with treatment involving intravenous antibiotics.

Lifestyle and Home Remedies

You may benefit a bit if the number of E. coli in urine culture is on the lower side. It is usually a good idea to take antibiotics and follow your doctor's instructions while taking the following steps as well.

  • Drink as much water as you can because this will help dilute your urine and relieve burning sensation as well.
  • Don't drink beverages that may irritate your bladder. You should avoid alcohol, coffee, and soft drinks that contain citrus juices.
  • Applying a heating pad directly on your abdomen will also relieve bladder pressure and discomfort.

Alternative Medicine-Cranberry Juice

You also consider using alternative medicines to treat your UTI after you've found E. coli in urine culture. Drinking cranberry juice is one of many things you can do for pain relief. The juice has infection-fighting properties. There are chances that cranberry juice won't work for you, but if it does, there's no harm in drinking plenty of it. You should avoid drinking cranberry juice though if you're already taking blood-thinning medication such as aspirin or warfarin. 

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