UTI - Again

[healthys]

Hello All,

The culture has come positive again after treatment of the UTI with 7 day course of macrobid. I had the D&C procedure while on treatment for the UTI and they used a urinary catheter during the procedure. The OB wanted to test my urine for cure and now the culture shows I have other different bacteria which are bad news. She called me today saying I need to take cipro even though I am asymptomatic saying that both type of bacteria are suscpetible to cipro only so she wants to give me a 10 course of cipro. I have so far refused the course because I am asymptomatic. I am consulting with my ID doctor. It is needless to say how anxious I am with this development. I feel like the urinary cath gave me this new bacteria and I am livid right now. These are all dangerous, antibiotic resistant bacteria and I have just been crying seeing this report. If I have to treat this, what do I do! I am pretty much screwed with cdiff if I take cipro!

On top of this, I am also having some foul smelling stools which are formed and loose alternatively. I reached out to my gastro who wants to do a fecal fat test to see if I am absorbing fats properly or not. Please advise or share experiences or words of calm. Because I am freaking out. This is so not what I had expected when I tried to get pregnant after getting over major surgery last year and being over 8 months from cdiff. I am at my wit's end today.


Here's the latest urine culture report-

CULTURE, URINE, ROUTINE

Micro Number: 10553598
Test Status: Final
Specimen Source: Urine, clean catch
Specimen Quality: Adequate
Result: Greater than 100,000 CFU/mL of Pseudomonas aeruginosa
Greater than 100,000 CFU/mL of
Raoultella (Klebsiella) ornithinolytica

Ps.aeruginosa R.ornithinolytic
---------------- ----------------
INT MIC INT MIC
AMOX/CLAVULANATE * S <=2
AMPICILLIN * R >=32
AMP/SULBACTAM * S 4
CEFAZOLIN * NR <=4 **2
CEFEPIME S 2 S <=1
CEFTAZIDIME S 4 *
CEFTRIAXONE * S <=1
CIPROFLOXACIN S <=0.25 S <=0.25
ERTAPENEM * S <=0.5
GENTAMICIN S 4 S <=1
IMIPENEM S 1 S 0.5
LEVOFLOXACIN S 1 S <=0.12
NITROFURANTOIN * S <=16
PIP/TAZOBACTAM S 8 S <=4
TOBRAMYCIN S <=1 S <=1
TRIMETHOPRIM/SULFA * S <=20

S=Susceptible I=Intermediate R=Resistant * = Not Tested
NR = Not Reported **NN = See Therapy Comments


THERAPY COMMENTS

Note 1:
For infections other than uncomplicated UTI
caused by E. coli, K. pneumoniae or P. mirabilis:
Cefazolin is resistant if MIC > or = 8 mcg/mL.
(Distinguishing susceptible versus intermediate
for isolates with MIC < or = 4 mcg/mL requires
additional testing.)

Note 2:
For uncomplicated UTI caused by E. coli,
K. pneumoniae or P. mirabilis: Cefazolin is
susceptible if MIC <32 mcg/mL and predicts
susceptible to the oral agents cefaclor, cefdinir,
cefpodoxime, cefprozil, cefuroxime, cephalexin
and loracarbef.


Thank you,

[healthys]

Has anyone taken cipro without relapsing? If yes, what was the regimen of cipro? Thank you!

[beth22]

I got c diff from Cipro twice. The second time was after I had FMT and the doctor did not think it would happen, but it did. I see on your list that TRIMETHOPRIM/SULFA * S <=20 would work if I am reading that correctly. That would be a better choice c diff wise, but run it by your doctor.

[healthys]

Thank you Beth for responding! There are actually two bugs, one is susceptible to macrobid and bactrim etc but the other one is not which is why they are asking me to use cipro as the other one Pseudomonas aeruginosa is not susceptible to our usual UTI abx. I spoke to another OB and my ID doctor and they said if I am not symptomatic and since I am not pregnant anymore, I do not need to treat it. It is a case of asymptomatic bacteriuria and more likely that I am just colonized. So for now, I am praying that it doesn't become symptomatic and goes away. I am taking cranberry pills and d-mannose daily. I know that they might not help much or at all but I will keep taking those alongside my probiotics for now and hope for the best.