What is the significance of mucus and leukocytes (white blood cells) in urine?

From the Guidelines

If you have mucus and leukocytes in your urine, you should see a healthcare provider as this likely indicates a urinary tract infection (UTI) or other inflammatory condition affecting your urinary system. The presence of mucus and leukocytes in urine is a significant finding that requires medical attention, as it can be a sign of an underlying infection or inflammatory process. According to the most recent guidelines, urinalysis, including assessment of white and red blood cells and nitrite, is recommended for routine diagnosis 1.

Key Considerations

• The presence of leukocytes in urine indicates that the immune system is responding to an infection or inflammation in the urinary tract.
• Mucus in the urine can be a sign of irritation or inflammation of the urinary tract lining.
• Other symptoms may include painful urination, frequency, urgency, cloudy urine, or lower abdominal pain.
• If you experience fever, back pain, or blood in urine, seek immediate medical attention as these may indicate a more serious kidney infection.

Treatment and Management

• Treatment typically involves antibiotics, but the choice of antibiotic should be based on local resistance patterns and optimized 1.
• Fluoroquinolones and cephalosporins are the only antimicrobial agents that can be recommended for oral empiric treatment of uncomplicated pyelonephritis 1.
• While waiting for medical care, drink plenty of water to help flush bacteria from your system.
• Don't delay treatment as untreated UTIs can spread to the kidneys and cause more serious complications.

Diagnostic Approach

• Urinalysis and urine culture should be performed to confirm the diagnosis of UTI 1.
• A urine culture and antimicrobial susceptibility testing should be performed in all cases of pyelonephritis 1.
• Imaging studies, such as ultrasound, may be necessary to rule out urinary tract obstruction or renal stone disease 1.

From the Research

Mucus and Leukocytes in Urine

• The presence of mucus and leukocytes in urine can be an indication of a urinary tract infection (UTI) 2
• Leukocyturia, or the presence of leukocytes in urine, is often associated with bacteriuria, or the presence of bacteria in urine 2
• The most common cause of leukocyturia is an infection of the urinary tract, and it can be differentiated into neutrophil or eosinophil granulocytes or lymphocytes 2

Diagnosis and Treatment of UTIs

• Urinary tract infections can be diagnosed and treated with various antimicrobial agents, including trimethoprim-sulfamethoxazole, nitrofurantoin, and fosfomycin 3, 4
• The choice of antimicrobial agent depends on the severity of the infection, the presence of underlying medical conditions, and the susceptibility of the causative organism to different antibiotics 4, 5
• Resistance to certain antimicrobial agents, such as trimethoprim-sulfamethoxazole, is a growing concern and can affect treatment outcomes 5, 6

Risk Factors for Antimicrobial Resistance

• Prior use of antimicrobial agents, such as trimethoprim-sulfamethoxazole, can increase the risk of resistance to these agents 6
• Prior urinary infection or colonization with resistant organisms can also increase the risk of resistance 6
• Patient-specific risk factors, such as age and underlying medical conditions, can also affect the risk of antimicrobial resistance 5, 6