Metabolic . Patient guide
Urinalysis and urine culture (Urine MC&S) Blood Test
Also known as: Urine dipstick + MSU culture, Mid-stream urine, Urine microscopy, culture and sensitivities
What is Urine MC&S
Urinalysis combines a chemical dipstick (looking for blood, protein, glucose, ketones, leukocytes and nitrites) with a urine culture if infection is suspected (a mid-stream urine sent for microscopy, culture and antibiotic sensitivities). It is the standard first-line test for urinary tract infection, suspected kidney disease, and unexplained blood or protein in the urine.
This biomarker entry is being clinically reviewed by our team. The factual content draws on UK guidance (NICE, NHS, Royal Colleges and the relevant speciality society where cited).
Reference range
Reported in qualitative (dipstick + culture). Final reports always carry the issuing laboratory's range, which is what your clinician will interpret against.
| Group | Range | Note |
|---|---|---|
| Leukocytes (dipstick) | Negative is normal | Positive suggests UTI, usually combined with nitrites |
| Nitrites (dipstick) | Negative is normal | Positive is more specific for UTI than leukocytes alone |
| Blood (dipstick) | Negative is normal | Positive needs context: menstruation, recent exercise, UTI, stones, or rarely cancer |
| Protein (dipstick) | Negative or trace is normal | 1+ or higher persisting needs quantification by urine albumin-to-creatinine ratio (ACR) or protein-to-creatinine ratio (PCR) per NICE CKS CKD |
| Glucose (dipstick) | Negative is normal | Positive raises suspicion of diabetes; cross-checked against HbA1c and fasting glucose |
| Ketones (dipstick) | Negative is normal | Can be normal in fasting or low-carb diets; significant in uncontrolled diabetes |
| Urine culture (MC&S) | No significant growth | Traditionally >=10^5 colony-forming units / mL, but lower counts (>=10^3 CFU/mL) can be significant in symptomatic patients per UK Standards for Microbiology Investigations |
What it is
Urinalysis is a multi-parameter test on a single mid-stream urine sample. The chemical dipstick gives a colour-change result for around eight markers, including leukocytes and nitrites (suggesting urinary tract infection), blood (haematuria), protein (proteinuria, a kidney marker), glucose (poorly controlled diabetes), ketones, urinary pH and specific gravity. If clinically indicated, the same sample is sent for microscopy, culture and antibiotic sensitivities to identify the bacteria responsible for a UTI.
Why a clinician would order it
Urinalysis is requested in symptoms suggestive of urinary tract infection (dysuria, frequency, urgency, suprapubic pain), in any unexplained loin pain or fever, in suspected diabetes (glucose and ketones), in pregnancy, in unexplained fatigue or oedema (looking for proteinuria), in haematuria work-up, and as part of comprehensive general wellness screening. It is also offered as an add-on to the WMG Health custom panel.
If your level is outside the range
Symptoms of low Urine MC&S
- A negative urinalysis with no growth on culture is the reassuring normal result. No symptoms attached.
What low can indicate. A clean urinalysis makes UTI, significant proteinuria and overt diabetes less likely at the point of testing, but a negative dipstick does not exclude UTI in a symptomatic patient (NICE CKS UTI advises sending a urine culture if symptoms persist). It also does not exclude all kidney disease, where a blood test for creatinine and eGFR adds further information.
Symptoms of high Urine MC&S
- Positive leukocytes and nitrites with bacterial growth: dysuria, frequency, urgency, cloudy urine, suprapubic pain (UTI).
- Persistent proteinuria: usually asymptomatic, picked up on routine testing.
- Persistent haematuria with no infection: needs urology review to exclude stones, structural abnormality, or rarely malignancy.
- Glycosuria: may be the first sign of undiagnosed or poorly controlled diabetes.
What high can indicate. Urinary tract infection (positive leukocytes, nitrites and culture); diabetes (glucose, ketones); kidney disease (proteinuria); kidney stones or bladder pathology (haematuria); pregnancy in some cases (urinary HCG is a separate add-on). Persistent abnormal findings are always interpreted alongside symptoms and blood results.
Testing tips
Provide a mid-stream urine sample: pass the first part of urine into the toilet, then catch the middle portion in the sterile container. In women, clean the area first with the wipe provided. The sample is more accurate when not heavily diluted by recent fluid intake. Menstruation can cause a false-positive blood result and the test is best deferred where possible.
Related markers
Sources
UK guidance our clinicians use when interpreting this marker.
- NICE CKS: Urinary tract infection (lower) - women
- NICE NG2: Bladder cancer - diagnosis and management
This page is general patient information, not personal medical advice. A GMC-registered clinician will review your results and tailor any interpretation to you. See our Editorial Policy for how we write and review content.
Common questions about Urine MC&S
What is a normal Urine MC&S range?
Leukocytes (dipstick): Negative is normal (Positive suggests UTI, usually combined with nitrites). Nitrites (dipstick): Negative is normal (Positive is more specific for UTI than leukocytes alone). Blood (dipstick): Negative is normal (Positive needs context: menstruation, recent exercise, UTI, stones, or rarely cancer). Protein (dipstick): Negative or trace is normal (1+ or higher persisting needs quantification by urine albumin-to-creatinine ratio (ACR) or protein-to-creatinine ratio (PCR) per NICE CKS CKD). Glucose (dipstick): Negative is normal (Positive raises suspicion of diabetes; cross-checked against HbA1c and fasting glucose). Ketones (dipstick): Negative is normal (Can be normal in fasting or low-carb diets; significant in uncontrolled diabetes). Urine culture (MC&S): No significant growth (Traditionally >=10^5 colony-forming units / mL, but lower counts (>=10^3 CFU/mL) can be significant in symptomatic patients per UK Standards for Microbiology Investigations). Always interpret your own results against the laboratory range printed on your report, since assay-specific reference ranges vary.
What does a low Urine MC&S result mean?
A clean urinalysis makes UTI, significant proteinuria and overt diabetes less likely at the point of testing, but a negative dipstick does not exclude UTI in a symptomatic patient (NICE CKS UTI advises sending a urine culture if symptoms persist). It also does not exclude all kidney disease, where a blood test for creatinine and eGFR adds further information.
What does a high Urine MC&S result mean?
Urinary tract infection (positive leukocytes, nitrites and culture); diabetes (glucose, ketones); kidney disease (proteinuria); kidney stones or bladder pathology (haematuria); pregnancy in some cases (urinary HCG is a separate add-on). Persistent abnormal findings are always interpreted alongside symptoms and blood results.
Do I need to fast or prepare for the Urine MC&S blood test?
Provide a mid-stream urine sample: pass the first part of urine into the toilet, then catch the middle portion in the sterile container. In women, clean the area first with the wipe provided. The sample is more accurate when not heavily diluted by recent fluid intake. Menstruation can cause a false-positive blood result and the test is best deferred where possible.
Can I order a Urine MC&S blood test privately in London?
Yes. WMG Health offers Urine MC&S as part of bespoke panels and several pre-built panels at our 134 Harley Street clinic. Results are clinician-reviewed by a GMC-registered doctor within 4 hours for the most common assays. All panels are custom-built around your specific question; bookings via /contact/ or 020 3239 3378.