A urine specimen needs to be left at room temperature for not more than two hours before chemical analysis. If it cannot be performed within the maximum length of time, the specimen should be refrigerated, but not freeze, at 2-8°C to decrease the growth rate of contaminating organisms that could alter the specimen.
An ammonia-like or foul odor associated with the urine specimen often indicates a consumption of food high in protein, dehydration, kidney damage or disease, and ordinarily points out a bacterial infection in the bladder, urinary tract, or kidney.
The chemical strip indicating positive protein, positive nitrite, and positive bacteria, indicates the presence of those substances in the urine specimen, therefore, it somehow confirms the suspicion associated with the odor. As a matter of fact, the presence of nitrite in the urine specimen indicates a urinary tract infection caused by Gram-negative bacteria such as Escherichia coli, and in this case, reduces nitrates to nitrites. The presence of bacteria in the specimen also indicates a urinary tract infection, because urine is usually sterile inside the bladder, and the only way it could contain bacteria, especially Gram-negative rods, is to be infected during its passage through the urinary tract and exiting through the urethra while the proteins in the urine are “common in febrile response or represents presence of protein-containing substance” (Fitzgerald, 2003). The microscopic analysis revealed four bacteria, but no evidence of white blood cells in the specimen; this indicates that after all, there might be no bacterial infection, because white blood cells are usually presented to counter infections inside the body.
The test results on this specimen do not corroborate the previous suspicion associated with the odor, but rather indicate a contaminated specimen that was left at room temperature for too much time. Therefore, those results cannot be trusted.