Our UTI test collects DNA from any bacteria, yeast and viruses present in your sample.

We then analyse it and use the information to find unique matches to our database of over 4,000 different microbial species including bacteria and yeasts. This allows us to build up a highly accurate list of all the organisms present.

We also use an internal calibrator to estimate how many cells of each species were present in your sample. This gives us a quantitative and highly accurate profile of the full microbiome it contained.'

Our method was developed as an alternative to the way the NHS diagnoses urine infections. This normally relies on dip-stick tests which look at chemical changes in your urine or culturing tests where a lab will try to grow and identify bacteria in your sample. Dip-sticks often miss infections if the chemical changes are not the right type or big enough. Culturing tests, even extended culturing, are limited to growing specific types of bacteria so can miss entire families of microbes that require particular conditions to grow.

There are some commercial services that, like us, test for DNA from microbes. However, these either use a process called PCR, sometimes combined with DNA sequencing, to look at a small part of microbial DNA called 16s rRNA. PCR tests can be sensitive but are prone to reporting contaminants. Most commercial tests are limited to looking for around 20 pre-defined species of bacteria that commonly cause infections. This means they can miss many different types of microbes in a sample. 16s rRNA testing is better at finding unexpected microbes but will often only report the presence of families of bacteria rather than individual species. It also struggles to give accurate quantities for each microbe found.

Our test uses long sequences of microbial DNA taken directly from your sample with no need for PCR. It’s still a sensitive method but is less prone to reporting contaminants. We recover lots of DNA for each microbe so, along with our carefully developed DNA matching method, we are able to give very detailed and confident identifications for any bacteria and yeast we find. Our internal calibration also allows us to provide accurate estimations on how many cells of each microbe are present.

Identifying all microbial species AND accurately reporting their levels is crucial information for health-care providers. Only when they see the full picture can they determine which organism might be causing an infection that requires treatment.

Complete data given in a clear form. That’s what makes our test better than others.

Yes.

Our testing service works well with male urine samples too. If you have symptoms or recurrent symptoms of UTI please send us a urine sample for analysis.

Our test is capable of routinely identifying organisms present at only a thousand cells. This is per mL for a urine test or per swab for others. This is about one hundred times more sensitive than the standard NHS culture tests.

This test is suitable for anyone who is looking to find out the exact identity and quantity of every microbe in their urine or bladder microbiomes.

The test may be particularly useful for those suffering from recurrent UTIs. The NHS and other diagnostic labs commonly rely on dip-stick tests or extended culturing to identify the organism causing infection. These methods often miss entire families of microbes. Identifying all microbial species AND accurately reporting their levels is crucial information for healthcare providers. Only when they see the full picture can they determine which organism might be causing an infection and administer the correct treatment. This is essential to get rid of that infection and to ensure that it does not return.

Additionally, this test is particularly suitable for those with BV, thrush and other genitourinary infections.

We are always happy to receive questions about our service.

All questions, queries and comments can be sent to us using our dedicated contact form and we'll get back to you as soon as possible.

Please note though that we are not medically trained so cannot offer personalised advice about treatment or comment on your treatment histories.

This is why we don't offer a phone contact service.

UTI’s affect people regardless of age, race or social status and we are acutely aware that the cost of our testing system may be beyond the reach of many sufferers.

Our organization is not-for-profit so we have set our price at a level where we can continue to operate but unfortunately new high-tech services such as these are expensive to run.

Hopefully, over-time, the operating costs of our service will reduce and we can pass these savings on to customers.

We are also working hard to try to get to a position where our tests can be available within the NHS or through private health care providers but this process is likely to take a long time.

I’m afraid not.

Our testing service is not currently accredited to work directly with the NHS so it cannot be run as an NHS diagnostic. We are working hard towards getting this to happen though.

In the meantime we provide a method for you to print and share your results with your GP who may, or may not, use the information to guide further tests or treatments at their own discretion.

Until quite recently it was assumed that healthy urine was sterile.

With the advent of DNA based testing it’s now apparent that mixed populations of bacteria, yeast and other small microbes occur naturally in most people’s bladder’s. This collection of organisms is called the bladder or urine microbiome. The vagina has it’s own collection of microbes which are often very similar to the ones found in the urine of the same person; this is the vaginal microbiome.

Scientific research is still investigating what effect having different types of microbes, their abundance and the overall make-up of communities have on bladder or vaginal health. Some are thought to be harmless, some actively help protect against infection whilst others may cause symptoms. Bladder microbiomes will be different from person to person and may change over time.

The female bladder microbiome is heavily influenced by the vaginal and gut microbiomes. For individual microbes it seems that location is important; bacteria that have an important job in one location can be problematic if accidentally introduced into a different space. This is especially true of urine infections which often involve the unintentional spread of a bacteria from the gut, e.g. E coli, where it might be doing useful work, into the bladder where it can cause harm.

The science of microbiome analysis and the role they play in health is still new and there is a lot yet to understand.

We have done experiments that suggest most bacteria are in the heavier material contained in the wee.

This is most likely to be chunks of bacterial biofilms or sloughed skin cells from the bladder lining. Skin cells are naturally lost and replaced in a healthy urinary tract. This process can be increased in response to an infection where the cells may now have bacteria living inside them or attached to their surfaces (see FAQ : Do bacteria that cause infections just float in the urine?).

Our process breaks open and degrades the skin cells to release any bacteria ready for testing.

Yes, it is quite common and perfectly natural to see bacteria, yeast and even some viruses in the vagina. This is known as the vaginal microbiome.

There seems to be a high degree of overlap in the vaginal and urine microbiomes of the same person suggesting that a constant exchange of organisms is normal between these two locations.

This science is still new and a greater understanding of this relationship will likely be useful to improve outcomes when treating a suspected bacterial infection in either bladder or vagina. For example, due to the close relationship of these locations, bacteria from an infection can often be seen in both the vagina and urine. Only treating the infection at a single location may lead to an increased chance of it returning.

Different species of bacteria and yeast have different characteristics.

Some will exist floating freely but many of the bacteria known to cause UTIs use a type of 'glue' they produce to attach themselves to the cells lining your bladder. This glue can also be used to stick the bacteria to each other and encase themselves in larger protective capsules called biofilms.

Other bacteria are known to invade, live and grow within the bladder lining itself.

These methods allow bacteria to thrive inside the highly challenging environment of the urinary tract where there is a constant risk of being flushed out.

Yes. Although this means the sample will be in the post for longer.

We add preservatives to the sample tubes to prevent microbes growing during transport so this should not be a problem.

However, to be safe we recommend that, if possible, you wait until the start of the week or if you’ve already taken your sample, package it up and store it carefully in the fridge over the weekend until posting.

We are now able to serve customers in over 27 countries across the EU.

Kits purchased by international customers will be charged an extra £25 at checkout to cover shipping.

Once purchased, we use the FedEx International Priority service to ship your sample kit direct to your address. This normally takes 2-3 working days and you will be sent tracking information by email to follow it's progress.

Once you have collected your samples we then use the same service to return the package to our lab. This is already paid for by the extra shipping costs and you do not need to pay again.

Once you are ready to return the sample there are 3 options:

1. Simply contact FedEx directly to arrange a pick-up from your address using the information emailed to you.

2. Contact us and we will arrange the pick-up for you.

3. Drop the package at a FedEx drop off location (please make sure they accept international parcels though).

All the paper work to get the sample through customs (both on the way to you and on the way back to the lab) is already attached electronically to the shipping labels so you don't have to fill out any annoying paperwork or pay import duties.

When the return package is picked-up you will receive tracking updates by email to follow it's journey to the lab. You will also get an email confirming safe arrival of the samples.

Typically it takes 2-3 working days to return to us from anywhere in the EU. We use preservatives to protect the samples during transport so they arrive in our lab ready to process, even if there is a delay.

Like our samples in the UK though, it's always better to return the sample on a Monday as weekend's can slow things down.

Once we receive the samples your results will normally be available next working day.

Yes, they can do.

However, we use chemicals in our collection tubes for urine and swab samples that minimised onward-growth.

Not all testing services use preservatives which can allow the make-up of the microbes in the sample to change before they are tested.

Our shipping method ensure that the levels of microbes we see in the lab are much closer to the levels found in the fresh samples.

Yes please.

We prefer the first wee of the day as it should contain an over-night build-up of sloughed skin cells and bacteria that makes identifying problems easier.

However, we recognise that for some people the first wee of the day doesn't really exist. If you are suffering symptoms that keep you up all night with constant visits to the loo then any wee sample taken at any time should be sufficient.

Please also catch the first part of the wee too. Some testing systems prefer a 'mid-stream' collection where you discard the first part of the wee but we really like that bit so please include it !

Ideally we’d prefer for you to wait until your bleeding has stopped before you use the swab although small amounts of blood are not a problem.

We provide an intimate wipe with our kits. We recommend using it to carefully clean around the urethra, the bit where the wee comes out, before collecting your sample. This brand of wipes has been chosen carefully to be as delicate as possible as we appreciate that having an active infection can make the vulva highly sensitive.

Please use the pop-up cardboard ‘PeeCanter’ container to collect your sample before decanting it into the sample tube to keep it as clean as possible.

We currently check each sample for over 4,000 different species of bacteria, 11,000 different viruses and 21,000 different plasmids. Plasmids are small circles of DNA that bacteria can share between them. Some allow them to become resistant to different antibiotics so tracking them can be important. We normally don’t include viruses and plasmids in your standard report but can show them to a health-care professional if asked.

All detected organisms are reported to species level. Our report will never list unknown members of a particular bacterial family.

For some species, such as E coli, we can report to even more detailed levels. We predict which serotype the E coli in your sample is likely to be and which strain it most closely resembles. This information can be very useful to your health-care provider.

Unlike most other testing systems, we can easily differentiate between species of Shigella vs E coli and other very closely related organisms such as Lactobacillus gasseri vs Lacrobacillus paragasseri.

Yes, but only viruses that use DNA as their instruction manual. Most of these viruses only infect bacteria. Yes, unbelievably bacteria catch colds too ! Hence, not only can we can find bacteria that might be causing symptoms, we can also see what bacterial viruses, or bacteriophages, might be infecting them in turn.

Many viruses that cause serious human health issues, such as HIV and Coronavirus, are RNA based and we cannot currently detect these. However, we can detect some human viruses such as Epstein-Barr virus that commonly cause glandular fever.

We currently offer advice on antibiotic sensitivity profiles for any bacterial species that are known to cause UTIs, but only if they appear in your results at significant levels. We can supply these profiles quickly as they are based on our previous experiments where we grow and test species against our panel of antibiotics in our lab. Although these results are NOT for the exact strain of bacteria that is found in your sample they are for the same species and usually provide a reliable guide.

We are planning a service that allows for bespoke testing of antibiotics on specific species directly from your urine or swab sample. However, this will still require a DNA based test first, to confirm the target microbe is still present in your sample, and that there is enough of it to allow culturing in the lab. This service will be much slower than our DNA based profiling, as culturing and testing can take many days. For this reason, we like to use our current database to supply instant advice that should be highly relevant in most cases. Only if the treatment fails do we then advise a bespoke test such as this.

Some DNA-based testing labs offer advice based on the presence of known genes that can change the response of bacteria to antibiotics. We do screen for these genes, but currently do not report the results as they only represent a fraction of the genes that cause antibiotic resistance, so we don’t feel they give a particularly reliable guide to the behaviour of the bacteria. We find that treatment advice based on our previous antibiotic testing data is much more useful.

If there are significant levels of bacteria causing an infection then we should see them.

However, we have found that if symptoms are very new they may be caused by levels of bacteria too low to register on our UTI tests.

Occasionally we find only high levels of bacteria that are traditionally thought to be benign. In these cases it’s hard to know if your symptoms are caused by something we haven’t detected or if there is a reason why, for some people, a ‘normal’ bacterial species might be causing symptoms.

Yes.

Our UTI testing can find any bacterial or DNA viruses in urine or from swabs if they are present in large enough quantities.

This includes organisms that cause common sexually transmitted infections including Chlamydia, Gonorrhea, Syphilis, Chancroid and Urethritis/PID.

Although our method can detect some DNA viruses, such as Herpes, we currently only report the presence of the bacterial STIs listed above.

Please note: HIV and Coronavirus are RNA viruses and are not detected by our method.'

Yes, we detect yeasts in vaginal and bladder samples.

These are common causes of Thrush and will be reported if present.

Any sample you submit will have some cells from your own body, which in turn will contain your DNA.

Our method works hard to remove your cells from the sample at the earliest stage of processing whilst leaving the microbial cells intact.

This means that the vast majority of DNA sequences we get back are from your microbiome, not from you.

We will never use our method to look at or analyse any of your personal DNA that may remain in the sample.

We are currently able to test urine or vaginal swabs samples.

We hope to launch a new service for fecal samples soon.

If you are on antibiotics or other treatments prescribed by your health-care professional please continue to take them. DO NOT stop taking any treatment without discussing it with your health-care professional first.

If you are on antibiotics, and they are helping, then they could reduce the signal for any bacteria that might be causing you long-term problems. However, if you are still experiencing symptoms then there is a good chance we will still detect it even whilst you are on treatment.

This should not affect our testing.

D-mannose is thought to help prevent some bacteria such as E. coli from attaching to the cells lining your urinary tract, which it needs to do to become a problematic infection.

Our test will see E coli in your wee sample regardless of whether it’s attached to sloughed skin cells or freely floating.

This should not affect our testing.

When your results are ready you will get an email alert. Log into your account to see the results of all your tests, along with your symptom data and any antibiotic treatments you told us about, in one clear, easy to use and secure website.

Each test will list all microbes detected along with their quantity measured in cells per mL (for urine) or cells per swab (for vaginal swab).

We also provide notes and advice about the bacteria detected along with antibiotic treatment options for any that look to be good candidates for causing your symptoms.

You can choose to share your results with your health care professional by printing them or using a link to share them electronically.

If you test with us again then all results will be displayed on the same page allowing you to build up a full testing history in one place.

Occasionally we see samples where no bacteria are detected.

This is especially true in healthy male urine samples where bacterial levels can be very low.

In female urine samples we normally only see this if the sample is excessively dilute or if the donor has used lots of different antibiotics over a long time period leading to loss of their urinary microbiome.

Yes, there is always a chance that something will be missed. No testing systems is completely bullet-proof.

However, we have done everything we can think of to ensure that all organisms present are detected. We also provide you with all the data we get, even if sometimes this can feel a little complicated.

We feel you should see the full contents of your profiled microbiome and then try to support that with notes to help you understand your results, what might be normal and what might be relevant to your condition.

Unlike other testing systems, we do not filter our list to just select organisms we think might be of interest to you as we feel this can heavily bias modern detection methods so that they are not as useful as they should be.

Yes, they should. It could be hard to differentiate a chronic and acute infection from a single test point.

No. You may still have an infection. There are several reasons why we may not have detected it including:

• The sample is excessively dilute.

• You are currently on treatment that’s suppressing the infection.

• The infection is very new and the build-up of bacteria isn’t sufficient yet to see.

• Honestly, we could have missed it. No testing system is bullet-proof and we try our hardest to reduce this possibility but we cannot discount it.

At Digital Microbiology, we find out the exact identity and quantity of every microbe in your sample. Identifying all microbial species AND accurately reporting their levels is crucial information for healthcare providers. Only when they see the full picture can they determine which organism might be causing an infection and administer the correct treatment. We can also determine what antibiotic is most effective against the microbes present. This ensures your treatment plan is more targeted, so you can get rid of the infection for good.

Cytolytic Vaginosis, CV, is a condition caused by over-growth of Lactobacilli in the vagina.

CV can feel like a yeast infection or bacterial vaginosis and is often misdiagnosed as a Candida infection in the absence of culture-able yeast.

Symptoms may include:

• Itching in the vagina or on the vulva, which is the skin outside of the vagina.

• Burning on the vulva, which might get worse when you wee.

• Pain or burning during sex, or a sore feeling after sex.

• Increase in yellowish or white discharge from the vagina.

• Worsening symptoms in the week before your period.

Lactobacilli produce lactic acid as a waste product. Increased quantity of these bacteria can cause vaginal pH to drop to acidic conditions. In some cases this can lead to damage of the vaginal lining causing it to become irritated, inflamed and even degrade and shed. Recent research has suggested that the dominating Lactobacillus species is often Lactobacillus crispatus (Xu et al. 2018)

The Digital Microbiology testing system can detect and accurately count Lactobacillus crispatus on vaginal swabs. This bacterial species is a normal component of many healthy vaginal microbiomes so simply knowing if it is present, which some other testing systems can do, is not enough. Digital Microbiology tests can alert you if your Lactobacillus crispatus:

• Levels are very high, roughly anything above 300 million cells per swab is unusual.

• Has become the predominant species present, normally accounting for over 95% of all bacterial cells detected on the swab.

If either of these is true and you have some of the symptoms listed above then you may have CV and should arrange to see a gynaecologist. They should be able to make a full diagnosis by testing the pH of your vagina and look for evidence of damaged skin cells under a microscope.

Unfortunately there is no known cure for this condition.

The good news is that there are many treatments that help alleviate and manage symptoms. Most aim to try to rebalance the acidic pH directly. These include:

• Sitz Baths.

• Sodium Hydroxide pessaries and douches.

• Using pH balancing vaginal creams or gels such as Pre-Seed.

Please discuss these options with your gynaecologist who should be able to provide more information.

Digital Microbiology is one of the few commercial testing systems that can detect over-growth of Lactobacillus species, including Lactobacillus crispatus.

We feel this is an important condition that is under-reported and under-researched. To complement our testing services we are pushing forward important academic studies in our own laboratories to understand more fully why Lactobacillus crispatus can cause CV in one person, but be part of a normal heathy microbiome in the next.

We are also working with patients and clinicians to try different approaches to reduce the levels of this bacteria in the vagina of CV sufferers. By monitoring these trials with our testing system we are able to provide rapid and accurate real-time feedback on what works and what doesn’t.

It is our sincere hope that our testing system will not only be able to detect this condition accurately, but will contribute towards development of a cure.

Whilst Lactobacillus over-growth in the vagina is associated with Cytolytic Vaginoses, over-growth of the same bacteria in urine has not been widely reported, described or studied.

However, our testing system has revealed that many women with chronic and recurrent UTI symptoms have a significant over-growth of Lactobacillus crispatus in their urine samples.

This may occur in parallel to over-growth of the same bacteria in the vagina causing CV, or in some cases may exist alongside a more ‘normal’ diverse vaginal microbiome.

Similar to CV, Lactobacillus crispatus over-growth in urine samples can dominate the microbiome so that it represents over 99% of all bacterial cells detected. It’s levels can also be unusually high, often reaching over 1 million cells per millilitre of urine.

This picture is very different to a healthy urinary microbiome which will often contain Lactobacillus crispatus but living alongside other species of bacteria as part of a more diverse and balanced ecosystem.

It is not yet understood what causes this bacteria to over-grow in the bladder, or if the increased levels and predominance is the cause of chronic or recurrent UTI symptoms.

At Digital Microbiology we are working hard with global leaders in the field of urogenital microbiome research to understand this phenomenon, and get answers to some fundamental questions such as:

• Is Lactobacillus crispatus simply an innocent bystander?

• Is over-growth the result of numerous courses of antibiotics taken during a long history of UTI symptoms that kill all other species and leaving it as the last bacteria standing?

• Are there some strains of Lactobacillus crispatus that are more aggressive than others and actively lead to over-growth?

• Can some strains dominate a microbiome by making the local environment too acidic for other species to survive?

• Can you change the level of Lactobacillus crispatus in the urine and does it help with symptoms?

This research will take time but is necessary before we can really understand the role of this bacterial species in urine and vaginal pathology.

Xu H, Zhang X, Yao W, Sun Y, Zhang Y. Characterization of the vaginal microbiome during cytolytic vaginosis using high-throughput sequencing. J Clin Lab Anal. 2019 Jan;33(1):e22653. doi: 10.1002/jcla.22653. Epub 2018 Sep 10. PMID: 30203607; PMCID: PMC6430347.'