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Thread: Recurrent UTI Symptoms

  1. #1

    Recurrent UTI Symptoms

    Over the past month and a half, I feel like a slave to my bladder issues. I'm a C7 quad and I intermittent cath. Here is what has been going on:

    -I went in at the end of January to the hospital for 3 days of IV antibiotics for a UTI. When I left, I finished my round of antibiotics and life was good.

    -About a week later, I started feeling like I was getting another infection. I was pretty sure I was because of cloudy urine and more urggency to pee. I sent a urine sample in and my doc called in a round of Macrobid while waiting on the culture. The nurse called three days later and said the urine culture was negative and that they normally would not prescribe any antibiotics for this but the doc wanted me to finish out the week long prescription of Macrobid. I think I finished those about 2 weeks ago or so.

    -Since then, I've had periods of cloudy urine and feeling a bit "UTI"-ish. I have been trying to take cranberry and vitamin-c pills to help fight it off. It has seemed that I have a bug in me that is so ready to jump on any slight mistake I make and make me feel horrible and leak in bed. A few days ago, I didn't drink my normal 2-3 liters of water, and my urine got cloudy and I felt bad. The way my body felt, I thought for sure I was getting a UTI. The next day, I got back on the cran/vit-c and I have felt pretty good the past few days.

    -I had a doc visit two days ago and requested another culture, so we'll see. I feel like I always give samples after taking cran/vit-c and drinking a lot of water, so my samples always look very clear and normal. I worry that I'm giving misleading samples, but I don't know how the cultures really work and hope that if there was a bacteria infection that it would show up on the culture results anyway.

    I gotta run so can't type more, but I hope I gave enough info for someone to give some advice. I think my doctor is very good, even though not real SCI-experienced.

    Thanks for reading!

  2. #2
    Go to this thread and follow the link to Bladder Management for Adults with Spinal Cord Injury. It's excellent.
    Remember, bugs in the pee do not a UTI make. So a positive culture (bacteriuria) does not mean you have a UTI, although a culture of course is useful for finding the appropriate antibiotic when you have a real UTI.
    You have a UTI only if the bacteria are living in the tissue, not just the urine. Symptoms of that are fever, etc. I'd say "feeling bad" could be a symptom of a UTI, but that probably varies between individuals.
    How much cranberry / vit C do you take to get clear urine? My wife's is still cloudy, although maybe it's a bit less now that she's been taking 4 grams or so of cranberry extract a day.
    - Richard

  3. #3
    Senior Member
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    I have been using uraquid and 500 mg vit C for the past few years with great results. Might want to check it out.

  4. #4
    Cranberry & Vit C won't affect the organism if it is there on the culture, they are more a preventative measure. On the other hand if the cultrue shows there is an organism but you feel just fine and having no symptoms then you probably don't need the medicine- this is colonization. You sound like you are having symptoms, if the cultrue comes back clear maybe it s avirus or something else making you not feel good. I would keep doing what you our are doing and wait for results of the culture.

    CWO

  5. #5
    Have you been evaluated for stones recently? Prostatitis? Both can cause recurrent infections with the same bug. Is your urologist doing these annual tests? Is he/she a specialist in neurologic urology?

    (KLD)

  6. #6

    Recurrent UTI's

    Hello Everyone,
    Its my first time to join here today. I believe all you guys are and will be a tremendous blessing to me, and as well to everyone.
    I am 5-yrs. post, C6-C7 Quadriplegia-complete; fell asleep while driving. Since after my accident, I've been using a supra-pubic catheter for bladder management. It went fine for more than 3yrs without any uti. Come June of 2008, I was hospitalized with asthma and bronchitis. I had my catheter changed since its already due. I was about to be discharged when I developed a fever and chills. They found MRSA in my urine!
    From then on, my uti's are catastrophically recurrent. It has been 1.5 yrs since it started, and I still have them now! It always would be MRSA, then they treat it, i'll be good in a week or so after treatment, uti comes back, now its Pseudomonas!; they treat it again, I'll be ok in a few days; then will get another one, and now its MRSA again; and back and forth!
    Unfortunately, its not only colonization since I have uti symptoms everytime; all the time. I tried taking unsweetened cranberry juice and caplets regularly, together with 1000mg of Vit. C every day. My fluid intake is approx. 2-3 liters a day. I tried all of those anti-infection silver-coated tipped catheters with no success; not to mention that every procedure/change in done with utmost caution to maintain sterility. My urologist ordered a UDS-(Uro Dynamics Study) of my bladder and found it very spasmic, thus thought urine refluxes back to my kidneys causing the infection; even though I did not agree much with him since I have a supra-pubic catheter which drains all the time, thus eliminating pressure build up in the bladder to cause urine reflux. He prescribed Vesicare for my bladder spasms. I took them regularly with no success. Finally, he recommended that I resort to Sphincterotomy (cutting of the urinary sphincter) for free urine drainage with texas or condom cath to catch the urine; or; a urostomy; both of which would be my last resort. Both of these procedures are irreversible! My gastroenterologist ordered both abdominal x-rays and CAT-Scan of the abdomen with contrast; results of both went back normal! Both my urologist and my infectious disease doctors and pushing me to each other. They're tired of me I guess!
    One and a half years of continuous back-to-back uti's are killing me! I'm really tired of it! Is there anything more I can do? I really need your help guys...
    I live in Orlando, FL. and my physiatrist is referring me for a third opinion to the doctors at Shands Hospital in Gainesville here in Florida.
    I dont know what to do anymore! I really need you inputs, suggestions and/or recommendations ASAP...

    Thank you all and Godbless!
    Last edited by darbelbar; 12-21-2009 at 01:52 PM.

  7. #7
    With an indwelling catheter, you should be drinking at least 3-4 liters daily, ideally water. You will be colonized pretty much all the time. You say you have constant UTIs. Is this fevers and chills all the time? Have you been tested for stones? You can reflux with an indwelling catheter in place if you have high bladder pressures, and use of an anticholenergic is highly recommended if that is the case. It will also help prevent bladder shrinkage, AD related to your catheter, and leakage. We rarely do urodynamics for someone with an indwelling catheter unless they plan to change to a different bladder management method, as it really does not help with management decisions.

    While an indwelling catheter will increase your risks for colonization and UTIs, there is certainly no guarantee that switching to reflex voiding would help with this, as often this voiding is done with high pressures and with significant residual urine, which can cause UTIs. This can occur in spite of having a sphincterotomy (which will also make it difficult to use a urethral indwelling catheter or intermittent cath again without leaking). Reflex voiding would also mean having to wear a condom catheter (ECC) 24/7. In addition, many men find that eventually their bladder decompensates with this method and requires indwelling or intermittent cath to empty anyway.

    Once you have MRSA, you are unlikely to get rid of it, and it is usually futile to try to eradicate it with antibiotics. It will invaribly come back, and often even more resistant.

    At C6-7 you should be able to do intermittent cath, but with a long-term use of indwelling catheters, this would generally require at least Botox if not a bladder augmentation to do.

    (KLD)

  8. #8
    Thanks. I usually only have mild fever (99.5-101 po, ax or tym), but with mod-severe chills. KUB and x-rays did not reflect presence of any stones. Abdomen CAT-scans revealed normal results of all organs. I am having Vesicare as my anticholinergic med. I agree with you in regards to reflex voiding and its repercussions. Unfortunately I am not able to self-cath due to a lot of tendon release and tendon transfers done on both L and R elbows and wrists due to severe contractures and sublux of my R ulna which they also resected. I am not able to weight bear nor do transfers with them as well.

    Would urostomy be the last and radical attempt to decrease uti's in my situation? Would getting rid of a very hyperactive and colonized bladder guarantee lesser episodes of uti's? I will try my best to use and exhaust other methods first before doing so, especially if urostomy would or could not guarantee less uti's. I am currently finishing a 7-day oral Doxycyline for MRSA. After which, when the culture comes back clean, I will immediately start Uroquid with 2grms of Vit. C, cranberry capsule 1000mg and 3-4liters of water as you suggested.
    Your input is very valuable. What further things am I suppose to do? Thanks and Godbless!

  9. #9
    No, a urostomy is no guarantee that you would have any fewer UTIs. You of course would need to be able to maintain the appliance, changing it every 3-4 days, and pay meticulous attention to the peristomal skin care required. Strictures of the ureteral connections to the conduit are also fairly common, and stones can be common as well.

    A 7 day course of antibiotics would rarely be sufficient for a complex UTI, esp. one that is highly resistant like MRSA.

    (KLD)

  10. #10
    Thanks!
    Should my urine c/s go back negative, would the Uroquid be effective enough in preventing reinfection with MRSA and Pneudomonas? or it is only good for the lesser resistant bugs or for only those who self-cath?
    A friend also told me to minimize use of antibiotics, and if the symptoms are not that severe, not to treat it but instead do the conservative measures; (drinking lots of water, vit. C, cranberry juice, etc). However, I'm also concerned that if I will leave it alone and wont treat it, the infection will ascend to my kidneys and destroy it as well, opening the possibility of dialysis if that happens. What do you think is best to do? Thanks and Godbless!

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