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Thread: UTI klebsiella pneumoniae none symptoms

  1. #1

    UTI klebsiella pneumoniae none symptoms

    Hello, thank you in advance for any help, I appreciated any advice
    My short history I?m 46 years old with 22 years SCI C5/C6 complete, my voiding bladder routine have changed with time, the first year after accident intermittent catheterization, next twelve years void by pressure with external cath (two utis in twelve years). Until 2.010 I began to suffer from sphincter dyssynergia and I started to intermittent catheterization for 6 years. (One or two utis per year); In 2010 I asked consult and opinions about sphinctherectomy or suprapubic catheter but my urologist and I decided the shphinctherectomy because for twelve years void my bladder by presure fine and I?m not able to cath myself, the Dr Charles Linne did the procedure at February 2.016 and I was happy with the retake the void by pressure routine with external cath, after shphinctherectomy took one year for my first UTI
    e.coli feb 2017 then eleven months again e.coli Jan 2018 all my utis since my SCI had been by e.coli but in October 2018 I had pseudomonas aeruginosa UTI sensitive to ciprofloxacin and levofloxacin; in October 2018 I took Cipro and didn?t get well in January 2019 I had to take levofloxacin and I could get rid of the bugs, from January I started to void my bladder three times per day, my care giver transfer me to my shower wheelchair I tide de safety bell and with I little push void my bladder 3 or 4 minutes. But even doing that I got another uti now in august 2019 seven months later but this is the first time I?m very concerned, I feel fine with none symptoms but the C&S klebsiella pneumonia > 100.000 cfu but multiresistant only three IV options my blood test was fine tomorrow I have an appointment to kidneys bladder ecography. What would you action recommend??
    Every rose has its thorn
    Just like every night has its dawn

  2. #2
    When you say you void by "pressure", are you straining (valsalva) or using Crede maneuver? Or are you reflex voiding ("kicking off")? Both of these technques are not generally recommended for long term bladder management, as they can increase your risks for reflux of urine up the ureters, can cause high bladder pressures, and potentially lead long-term to a decompensated bladder that no longer contracts sufficient to empty the bladder in spite of having a sphincterotomy. A sphincterotomy can also scar-down and may need to be repeated after some time.

    Have you had recent tests for stones in your urinary tract? Both pseudomonas and Klebsiella are commonly associated with stones, especially struvite stones, in people with SCI.

    If stones have been ruled out, or removed and you still have these types of colonization/infections, then an infectious disease physician should provide your urologist with consultation about treatment (or not).

    (KLD)
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

  3. #3
    Hello FER, I'm 66 with a 33 year history of T2 complete. I started 'tap and express' but this caused reflux and kidney damage so I have been intermittently catherising for 30 years. I have not had a symptomatic UTI for 7 or 8 yars but colonisation at various times by Enterobacter, Pseudomonas, Klebsiella, E. coli and most recently Citrobacter. None of these has got in to my kidneys (nor crossed the bladder wall) and none of them have I treated (except E. coli see below).

    I write just to say that Klebsiella was and still is my favourite. It caused no noticeable reduction in bladder volume and it smells much less than the others. It has also proven quite tenacious (that is not easily displaced by another environmental bacteria). I did, out of curiosity, try and succeed in replacing it with E. coli but E. coli I found intolerable - it causes the worst odour of any of the above colonisers so I treated it with antibiotics. Following successful treatment the next coloniser was the Citrobacter which isn't too bad. Nonetheless I prefer Klebsiella and might yet treat the Citrobacter if I do not get a natural replacement soon.

    There is I suspect a lot of scope in managing UTIs by tailoring the colonising fauna. I also think the 5 species I mention above can be identified by odour - and as I say, the metabolites of Klebsiella are the least offensive. Maybe live with it for a bit and see how it goes? Cheers Paul

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