Urine Test Strips

Trust is good, control is better.

Whether a bladder infection is on its way or already in progress, you can find out easily from home using urine test strips. Very often, the first thing a GP does when you visit with symptoms of a urine infection is exactly the same test.

In a quick urine test, a test strip is dipped into the urine and then compared with the colour fields on the packaging. In a nutshell:

  1. Urine sample: Collect midstream urine in a clean cup. Start by urinating a small amount into the toilet, then collect the urine in the cup - this is what is referred to as midstream urine.
    Important Note: Avoid squeezing to stop the flow before collecting the sample.
    Tip #1: The first-morning urine is the most informative.
    Tip #2: Vaginal bacteria can contaminate the urine sample. To avoid this, clean the area around the vaginal opening and urethral entrance with water before the test.
  2. Dip the test strip: Briefly dip the strip in the urine for about 1 second, then wipe off any excess urine along the edge of the cup.
  3. Wait 60 seconds for the test result to appear.
  4. Compare the test result with the print on the packaging (or leaflet), document, and evaluate.

Note: Test strips are not always reliable and can sometimes give false results (e.g. with an extremely high intake of vitamin C).

If you want to learn more, check out a video by a urologist on the topic of quick urine tests.

Interpreting Parameters in the Test Result

If the following parameters are outside the normal range specified in the package leaflet (indicated by the colour change on the test field), this may indicate a UTI :

  • Leukocytes: A key indicator of inflammatory diseases of the urinary tract and kidneys, usually with bacterial cause.
  • Nitrite: One of the main indicators of bacterial UTIs, e.g. caused by Escherichia coli. Note: If nitrite is not positive in the morning urine, it is likely the UTI is not caused by E. Coli bacteria .
  • Erythrocytes (Haemoglobin): Blood in the urine may indicate a disease of the kidneys and urogenital tract.
  • Protein: Elevated protein levels may indicate kidney inflammation.
  • Glucose: Glucose in urine does not indicate a bladder infection but is almost always a sign of diabetes mellitus (diabetes) and should be checked by a doctor.

Note: Taking antibiotics can lead to inaccurate results (especially for leukocytes and nitrite). An antibiotic treatment should, therefore, be completed at least three days prior.

My Insider Tips

Here’s how I used the test strips:

  • Is something on the way? Testing your urine at home can catch your UTI in an early stage, allowing you to take preventive action immediately.
  • Monitoring progress in a simple bladder infection: Am I on the way to recovery, or is it time (e.g. if there’s blood in the urine) to visit a doctor?
  • Anti-hypochondriac measure: I often imagined the worst because my focus was constantly on my bladder. A clear test result immediately put my mind at ease and freed me from the nagging worry cycle.

If leukocytes and nitrite are negative, the likelihood of a urinary tract infection is low.

Urine test strips are there to support you, but please don’t turn into a control freak by testing your urine daily or every time you feel a slight twinge in your lower abdomen.

FAQ

Test Strips for Bladder Infections

Urine test strips analyse the chemical composition of your urine. You can easily perform the test at home: briefly dip the test strip in mid-stream (morning) urine => read result and compare with the colour scale. In the case of a bladder infection, one or more test fields (leukocytes, nitrite, blood) are usually abnormal. Read more ...

According to the package insert (e.g. Combur 5 Test® Hc Test Strips*). Generally, it works as follows:

  1. Collect mid-stream urine
  2. Briefly dip the test stick
  3. Wait 1-2 minutes
  4. Evaluate test fields with the colour scale

There’s more to know in detail. Read more ...

Mid-stream refers to the middle part of the urine stream when emptying the bladder. So, urinate a bit into the toilet first, then collect. Read more ...

This urine is more concentrated and is therefore suitable for detecting bacterial urinary tract infections or kidney disease. Read more ...

Urine test strips are really easy and very quick to use, but up to 1/3 of tests can be false negatives. This means that even though you have a UTI, the test strip might show normal results. Read more ...

Generally, products with 5 parameters (leukocytes, nitrite, erythrocytes, protein, glucose) are sufficient, e.g. Combur 5 Test® Hc Test Strips* Read more ...

The following colours are commonly used:

  • Elevated leukocytes (usually shades of violet, darker indicating higher levels)
  • Elevated nitrite (usually shades of pink, brighter pink indicating higher levels)
  • Elevated erythrocytes (usually green dots or fully green)
  • Elevated protein (usually shades of green): CAUTION Indicator of kidney involvement!!

Read more ...

  • Elevated leukocytes (usually shades of violet, darker indicating higher levels) => Suggests an inflammatory disease of the kidneys or urinary tract
  • Elevated nitrite (usually shades of pink, brighter pink indicating higher levels) => Strong indicator of a urinary tract infection with nitrite-forming bacteria (e.g. E. coli, Klebsiella, Proteus Mirabilis)
  • Elevated erythrocytes (usually green dots or fully green) => Blood in the urine is a warning sign that should always be investigated further.
  • Elevated protein (usually shades of green) => Indicates a kidney disease (e.g. ascending cystitis)

Here you can read what all the parameters mean in detail: What does the urine test strip indicate?

Nitrite positive + Leukocytes positive => Urinary tract infection very likely

Nitrite positive + Leukocytes negative => Urinary tract infection very likely

Nitrite negative + Leukocytes positive => Urinary tract infection likely (e.g. with Enterococci)

Nitrite negative + Leukocytes negative => Urinary tract infection less likely

Read more ...

  • no more than 10 leukocytes/µL
  • no nitrite
  • no blood components

Read more ...

Healthy urine is clear and light to dark yellow. With a urinary tract infection, it may also appear reddish due to blood contamination, cloudy, with a noticeable smell, or foamy. Read more ...

Unfortunately, there are many influences that can lead to incorrect results. A few examples: during and 3 days after antibiotics, menstruation, after intense exercise, contamination (unclean sample collection), diluted urine, test fields read too late, ... Read more ...

The colour can range from orange to reddish, cloudy or flaky, and the urine may foam if there is kidney involvement, with a foul or ammonia-like smell. Read more ...

A urine test strip showing the presence of nitrite in the urine indicates a bacterial urinary tract infection. However, this parameter is not very reliable. Read more ...

This could either be due to contamination or an undiagnosed infection. Read more ...

No, and there can be several reasons for this:

  • 1 in 3 rapid tests are false negatives => the urine is often not sent for a urine culture
  • Too few bacteria in the urine => negative urine culture
  • Bacteria embedded in the bladder lining => bacteria cannot be detected
  • Interstitial cystitis (IC) => a chronic, non-infectious bladder inflammation

Read more ...

No. During antibiotic treatment and up to 3 days after, the rapid test is not reliable, especially for leukocytes and nitrite. Read more ...

Yes, this can occur. If there is a lot of protein in the urine, it may indicate kidney involvement. Read more ...

0-10 leukocytes /µL are considered negative. Read more ...

A positive test result for nitrite indicates that a urinary tract infection is very likely. Read more ...

Leukocytes are always a sign of inflammation. If no bacteria can be detected, there can be many reasons for this.

  • False positive rapid test
  • Urethritis / sexually transmitted bacteria
  • Infection with fungi/viruses/parasites/rare pathogens (requires special tests)
  • Bacteria hiding in the biofilm / bladder lining

Read more ...

A urinary tract infection is likely. Leukocytes always indicate an inflammation. Nitrite is very prone to error, and some bacteria do not produce nitrite (e.g. enterococci, staphylococci). Read more ...

Nitrite is very prone to interference and is often falsely negative (due to too few bacteria, large urine volumes, highly diluted urine, or antibiotics). Additionally, some bacteria do not produce nitrite (Enterococci, Staphylococci). Read more ...

Blood in the urine is always a warning sign (except during menstruation or after intense exercise). In 50% of cases, the cause is an uncomplicated urinary tract infection, but in serious cases, it can also be a tumour. Always have it checked! Read more ...

Diabetes mellitus is the most common cause of glucosuria. From a blood sugar level of about 160 mg/dl, glucose can already be detected in the urine. Read more ...

The following products are from well-known manufacturers: Combur 5 Test® Hc Test Strips*, Combur® 9 Test Strips, ELANEE® Urine Control Test, Siemens Multistix®.

There are now also cheaper urine test strips from many other manufacturers, such as: One+Step Urine Test Strips*.

More about this under: Which test strips for bladder infections?

Yes and no. Non-nitrite-producing bacteria (and Proteus Mirabilis) cannot attach to D-Mannose. However, nitrite is a very sensitive indicator, and I know from many fellow sufferers that nitrite never shows up for them, even with an E.coli infection. Read more...

The fresher, the better. A maximum of 2 hours old and always stored at 2-8°C in the refrigerator. Read more...

Quick test negative and no accompanying symptoms or discomfort => probably a contaminated sample (e.g. from vaginal discharge). With correct sample collection: fungal infection, vaginosis, bladder infection, protein admixture, tumours. Read more...

Some bacteria prefer an acidic environment, others prefer alkaline. Depending on the type of bacteria infecting the bladder, you may want to keep the pH level high (alkaline) or low (acidic). Read more...

The pH of urine is usually between 4.8 and 7.6. Read more...

To measure acidity, collect a midstream urine sample and dip a test strip (e.g. inexpensive litmus indicator paper) into it. Read more...

A measurement log should be kept for a week. Urine is considered overly acidic if the morning urine pH is consistently below 6.0 and if the average daily pH is below 6.3. Read more...

A high pH level indicates alkaline urine (pH level > 6.5). The pH level naturally varies with diet, but bladder infections caused by nitrite-producing bacteria also alkalize the urine. Read more...

According to medical guidelines, acidifying the urine (e.g. with Vitamin C* or L-Methionine) can prevent recurring bladder infections. During an acute infection, whether to acidify or alkalise the urine depends on the type of bacteria. Rule of thumb: Acidify for gram-positive bacteria (pH 4-5) and alkalise for gram-negative bacteria (pH 7-8). Read more...

To prevent bladder infections, guidelines suggest acidifying the urine. During an acute infection: Acidify for gram-positive bacteria (pH 4-5) and alkalise for gram-negative bacteria (pH 7-8). Read more...

With each glass of water (250ml), add 2 tablespoons of lemon juice and a pinch of baking soda (sodium bicarbonate). Check with pH test strips each time you empty your bladder. Read more...

A cost-effective alternative to L-Methionine products is high-dose Vitamin C* (= Ascorbic acid). Take 2-3 g of Vitamin C 3-4 times daily and check with pH test strips each time you empty your bladder. Read more...

Just because something tastes acidic doesn’t mean it has an acidic effect on the body. The same applies to alkaline foods. Foods that have an alkaline effect include: many fruits (especially lemons), green vegetables, baking soda, and mineral water. Read more...

Just because something tastes sour does not mean it has an acidic effect in the body. The same applies to alkaline foods. Acidic effect in the body: meat, fish, eggs, grains, alcohol, coffee. Read more ...

Full information on this can be found at When should I make urine alkaline?.

Full information on this can be found at When should I acidify urine?.

They come in two forms: indicator sticks with reaction fields => more expensive, indicator paper without reaction field (the paper changes colour) => inexpensive. Read more ...

A healthy vaginal flora has an acidic environment (pH between 3.8 and 4.4), which also protects against bladder infections. If you experience recurring bladder infections, it is worth keeping an eye on the pH of your vagina (e.g. with ELANEE® pH test). Read more ...

Vaginal pH values in the range 3.8 to 4.4 are in the normal/healthy range. Read more ...

This acidic environment provides foreign germs with poor living conditions and also serves as a protective barrier against vaginal infections and bladder infections. Read more ...

In the more alkaline range (lack of protective lactobacilli), numerous germs find ideal conditions to multiply and cause infections. Read more ...

With vaginal pH test strips, e.g. ELANEE® pH test. If the pH is below 4.5 and you have signs of an infection, it may be a yeast infection. If the pH is 4.5 or higher, this may be due to bacterial vaginosis. Read more ...

Vaginal pH test strips are available in drugstores, pharmacies, and online. A well-known example is ELANEE® pH test. Read more ...