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Thread: Are there any success-stories involving Klebsiella Pneumoniae?

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    Senior Member Tufelhunden's Avatar
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    Are there any success-stories involving Klebsiella Pneumoniae?

    Hey! Hope everyone is doing (relatively) well! Long story short...

    Early July, I came down with symptoms of a UTI, which for me included feeling miserable, leakage, and a bit of a temp. About 4 hours after coming down with symptoms, checked into the ER (Kaiser, Norcal) and gave a urine specimen, which tested positive for a UTI. I was given a ten day course of Cipro. 3 days later, heard back from the ER doctor that the bug grown was Klebsiela Pneumoniae and it was sensitive to everything, including the Cipro. I followed up with my urologist, and she wanted to ultrasound my bladder to check to see if I empty. The ultrasound looked good and I empty very well. Once the 10 day course of antibiotics was over, approximately 4 days later, I came down with similar symptoms of a UTI. Went back to the ER and once again tested positive for yet another UTI, to which I was prescribed another course of Cipro. This time the culture later came back with no bacterial growth, but my urologist stated that this was most likely due to the fact that I had just gotten off the first course of antibiotics. I can't be 100% positive, but due to the basic symptoms I am having, the rapid recurrence (I usually get UTIs an average of every 7 - 8 months; this one came back in 4 days) and the scent of my urine, I think it's the same bug: Klebsiella Pneumoniae. My current course of Cipro is finishing this Monday; however, I am still experiencing bladder spasms and occasional leakage and a slight smell to the urine - all symptoms which have cleared up for me after the 3-4th day of antibiotic treatment in the past. My temp is normal (mid 98s) but will occasionally rise (99.4).

    I did some reading on this forum and have been in correspondence with my Uro regarding the potential that stones (struvites) were interrupting the antibiotics. The urologist didn't see any stones in the original ultrasound (after the first infection), so I had her order an x-ray, as I read on here that struvites may not actually show up on a sonogram/ultrasound. The x-ray didn't show any stones. I have also read that people have had some success with Vetericyn, so after consulting with a senior member on this forum regarding their regimen, ordered some Vetericyn spray to instill and Vetericyn VF hydrogel to use as lube instead of surgilube. As I understand what I've read (please correct me if I am wrong) Vetericyn (like D-Mannose) is a preventative, not a UTI treatment.

    I would basically like to know if anyone here has successfully eradicated this bug, and by what means. Basically, I am welcoming any success stories for both an emotional boost and information. My plan is to continue with the second course of antibiotics until Monday when they run out, but I have this dreadful anticipation that this bug is just going to come back yet again right after the antibiotics are done. Is there anything else I should be doing which I have overlooked? Is Klebsiella typically a bug which shows sensitivity on a C/S only to be able to actually fight back?

    Apologies - now looking at this post, I tried making a long story short, but didn't do too well.
    No one ever became unsuccessful by helping others out

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    My urologist prefers not to use the same antibiotic twice in a row for a recurrent urinary tract infection, if there is another antibiotic that is effective. Cipro is a broad spectrum antibiotic and may well be used to treat Klebsiella, but there may be more targeted antibiotics a doctor could try first and then use Cipro as a last resort. A 12-14 day course may be more effective than 10 days.

    Vetericyn is generally used prophylactically. That said, I have heard, anecdotally, of one case where an individual cured a urinary tract infection (I don't know the bacteria) using 60cc Vetericyn every 3 hours round the clock for about 4 or 5 days. This method is pretty expensive and there have been no studies to substantiate the ability of Microcyn/Vetericyn to cure a UTI. Vetericyn is known as an antimicrobial, not an antibiotic. When I have had infections I take antibiotics and instill Vetericyn concurrently (using about 30cc Vetericyn twice a day).

    All the best,
    GJ

  3. #3
    I battled klebsiella pneumoniae for a long time.

    We'd try some antibiotic that it was supposed to be resistant to based on the C&S, take it and the symptoms would be alleviated, then five days after the antibiotic was stopped the symptoms would start to recur, and would turn serious about a week later. This cycle was repeated over and over, for over six months, I was at wit's end. Wound up in the hospital at one point, and saw an infectious disease doc who helped a lot.

    in my case, a long course of Levaquin kicked it. It's been a while but I think it was actually a six week course. At least two weeks anyway. That messed up my bowels for a while though, use a lot of probiotic if you take antibiotics in my experience.

    Note that Vetericyn can also interfere with C&S, which is important.

    The thing about Levaquin, my urologist told me, is that it is so powerful he likes to hold it in reserve and only use it when absolutely necessary, since if you develop resistance to that they start to run out of drugs to treat you. He called it the nuclear weapon of antibiotics. The infectious disease doctor said Levaquin is more penetrative to kidney tissue than other antiobiotics.

    But repeated UTIs can be from a bunch of things including stones. In my case they did a bunch of tests, CT scan, cystoscopy, ultrasounds to rule out those.

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    Senior Member Tufelhunden's Avatar
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    Thanks for the information, gjnl.

    That is quite the story, xsfxsf...glad to hear you got over it, though.

    I have to ask; is it typical for this bacteria (or any) to display sensitivity to a certain antibiotic, and then manage to actually fight it off? If so, this may be a question for a microbiologist, but what is it about this bacteria that enables it to do this?
    No one ever became unsuccessful by helping others out

  5. #5
    Super Moderator Sue Pendleton's Avatar
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    Quote Originally Posted by Tufelhunden View Post

    I have to ask; is it typical for this bacteria (or any) to display sensitivity to a certain antibiotic, and then manage to actually fight it off? If so, this may be a question for a microbiologist, but what is it about this bacteria that enables it to do this?
    Evolution! A bacteria that manages to adapt enough to ward off an incoming battery of tested sensitive to antibiotics is a first generation resistant bacteria. This is why with any complicated UTIs, and all catheter users are complicated, need 10 to 14 days instead of 3 to 7 days of an antibiotic showing that the bacteria is sensitive to it. Normally a lab will list several antibiotics and their degree of effectiveness. I've never has a problem with k. pnuemonia on a 14 day course.

    I think the best way to see bladder stones is by cystoscopy and kidneys by contrast CT. I could be wrong so I hope the nurses chime in.

    Do you get rid of all equipment after about day 3 and again around day 7 if you have a 10 day regimen or day 10 if you have a 14? I mean get rid of catheters used, connecting tubes and bags. If you can't afford that then change to new ones and soak the bags and connecting tubes in a heavy bleach solution and air dry.

    Lastly, why the ER? Many docs who practice out of smaller medical centers have labs and xray in house. Your doc should be able to give you sterile cups and send an order to his/her lab for the ua and c&s. Much cheaper and you build a relationship with one doc who knows you.
    Courage doesn't always roar. Sometimes courage is the quiet voice at the end of the day saying, "I will try again tomorrow."

    Disclaimer: Answers, suggestions, and/or comments do not constitute medical advice expressed or implied and are based solely on my experiences as a SCI patient. Please consult your attending physician for medical advise and treatment. In the event of a medical emergency please call 911.

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    Quote Originally Posted by xsfxsf View Post
    Note that Vetericyn can also interfere with C&S, which is important.
    If you are using Vetericyn daily, you can still submit a specimen for analysis, just be sure the urine you are submitting doesn't contain any instilled Vetericyn. I've not read anything about how Vetericyn may affect a specimen of urine, but it makes sense that you want to submit a specimen of just urine.

    All the best,
    GJ

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    Senior Member Tufelhunden's Avatar
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    gjnl- I just re-read your post and have a question that you or someone else may be able to answer. I have read some random threads regarding Vetericyn where some individuals have successfully eliminated their colonization in their bladder over time using the instillations. If Vetericyn cannot really "cure" a UTI, how does it manage to even come close to decolonizing someone?

    xsfxsf (or anyone who can answer)- How long between finishing your course of antibiotics and giving a specimen which successfully grows? The nightmare scenario I'd like to avoid is that I finish this course of Cipro, then I wait...then it comes back, so I wait some more to try to ensure that I get a specimen which isn't screwed up because of the Cipro I just took. Then I either can't wait anymore so I give a specimen and get on some antibiotics to avoid getting this in my kidneys, or I end up in the hospital with this in my kidneys and a skyrocketing temperature and again get on some antibiotics; to only be informed that the damn specimen I gave didn't grow anything...but now I'm three days into a course of antibiotics (which may not be the exact ones I need). Is this possible?

    Sue- Thanks for your experienced insight. Couple of comments and questions; According to what you have written, I am still not sure of the mechanism of how Klebsiella P. managed to "fool" the first C/S. I originally went in (before taking any antibiotics) and gave a specimen. The C/S returned stating that it was very sensitive to Cipro, but you're saying that it was actually ("first-generation") resistant? Why would it then indicate itself to be sensitive? That seems impossible. When you say you've never had a problem with Kleb P. with a 14 day course, it sounds like you've (unfortunately) had some experience with it. Do you recall the exact antibiotics you were prescribed? Do you recall if you originally had a 10 day course which was later upgraded to 14? Feel free to tell me to move this to PM at any point, by the way. I'm just trying to formulate a plan, as I am on my second to last day of the Cipro and I still have a tightness near my bladder and my pee still smells a little (at least in the morning when I first get up), which tells me this thing will rear its ugly head and I'm in the middle of teaching summer school to a bunch of overachieving undergrads (yippee). I read on here that a sonogram with an x-ray should be enough to rule out stones??...I truly hope that is correct. I got my x-ray results back today and there are no stones. I have never heard of the ditching of equipment while fighting a bladder bug. I don't have a bag - I use a clean intermittent catheterization routine I was taught in rehab @ Kaiser. I cath about 10 - 12 times per day @ exactly 210cc every time into a urinal using Purell to disinfect everything and surgilube for lubrication (I've been blessed with a walnut sized bladder and I drink a lot of water); I have two sets of caths...after use, I place them in a mild antibacterial soak for a whole day; the following day, they are taken out and hand-dried and then allowed to dry the entire day (while I use the other set; I switch sets every day). I've sorta always either gone to the ER or to my primary's office, depending on where I'm at when my symptoms show up. I suppose I could just go to my primary's office (I actually have done this before), but I haven't really been instructed differently. I will probably stop by my primary's office tomorrow morning and ask.

    Should I be doing anything else? Apologies for the length of this - as you can imagine I'm a bit flustered waiting for this thing inside me to explode whenever it chooses to. I think I will probably see if I can get a referral to see an infectious disease doctor as well.
    No one ever became unsuccessful by helping others out

  8. #8
    Tufelhuden, did you have studies to look for stones in other parts of your urinary tract other than just your bladder? Stones in your kidneys or stuck in your ureters could also be repeatedly seeding your urine with Klebsiella, which is common in struvite stones especially.

    In addition, have you been evaluated for possible chronic prostatitis? This can also be a source of chronic repeated UTIs with the same bug, and often difficult to diagnose and treat. Often a 6 week course of antibiotics is needed to treat it.

    Have you seen an infectious disease physician for an evaluation?? This is invaluable when you have highly resistant strain of bacteria, and a repeated infection with the same bug over and over.

    Although it is probably not a factor, try not reusing your catheters. Medicare pays for a new catheter each time, and many other insurances have followed their lead. Your method of cleaning your catheters for reuse is also not what is generally recommended if reusing is necessary.


    (KLD)

  9. #9
    Super Moderator Sue Pendleton's Avatar
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    Yea, Purell works well on viruses but no so well on nasty bacteria. This is why bleach is recommended. It has been killing both for several decades.

    The bacteria didn't fool the test. Think of the black death in the middle ages. The bubonic plague wiped out about half of the humans in Europe. Some survivors lived in isolated areas and were never exposed to it. Others got the plague and their bodies managed to create enough white cells and other helper cells to fight off the infection. Maybe they had a better diet or suffered fewer parasites and other problems than those who died. But once fought off they were the resistant ones during the next out break. They were immune.

    So your bacteria told the test that in small amounts this, this and that antibiotic were highly effective against it while, say, 2 others were only marginally effective and the last one didn't work at all. If you were given a long enough course of one of the first three and there was nothing in the body like a catheter or other artificial device to cling to and no place where it could hide in a pocket of the bladder or in a stone where blood doesn't circulate well...then they died. But if there is a place to grow hidden from the antibiotic...there you go. Your bacteria survived or at least a few did to come back and make you sick again. And since they were exposed to that antibiotic they may be immune to it or need a longer course to kill them-in other words they evolved. Not a great example because people who fought off the plague never got it again. With catheters where you are constantly adding new bacteria there is always a chance you won't flush out enough enough and the bacteria multiply and make you sick again.

    I don't remember what I took for klebsiella but I always ask what bacteria I am dealing with in case I see the same bacteria over and over and that's when an infectious disease doc can really help.
    You might try looking up MRSA in Wikipedia to see if they explain resistance better.
    Last edited by Sue Pendleton; 08-04-2014 at 08:27 AM.
    Courage doesn't always roar. Sometimes courage is the quiet voice at the end of the day saying, "I will try again tomorrow."

    Disclaimer: Answers, suggestions, and/or comments do not constitute medical advice expressed or implied and are based solely on my experiences as a SCI patient. Please consult your attending physician for medical advise and treatment. In the event of a medical emergency please call 911.

  10. #10
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    Quote Originally Posted by Tufelhunden View Post
    gjnl- I just re-read your post and have a question that you or someone else may be able to answer. I have read some random threads regarding Vetericyn where some individuals have successfully eliminated their colonization in their bladder over time using the instillations. If Vetericyn cannot really "cure" a UTI, how does it manage to even come close to decolonizing someone?
    Anecdotally, I have heard of an individual who cured a urinary tract infection by instilling 60cc Vetericyn every 3 hours round the clock for 4-5 days. Unfortunately, there are no studies to prove and verify how Vetericyn/Microcyn work in the urinary tract.

    All the best,
    GJ

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