What Does The Following Urine Culture Report Indicate?

Posted on Thu, 4 May 2017

Question: I have conducted a urine culture and recent routine today only and just to clarify that i am not on antibiotics currently but drastcally my pus cells has been reduced which were 10-15 earlier (13/04/2017) , i am surprised by this . please review my reports and advise, what is the next step.

Answered by Dr. Dr. P. T. Patil (7 hours later)

Brief Answer:
Urine culture still reveals E-Coli infection.

Detailed Answer:
Hello
Thanks for query .

Pus cells in urine are dead White Blood cells that are being passed out in urine .Sudden decrease in pus cell count even when one is not taking antibiotic is common and it just indicates their absence in that particular sample of urine but does not rule out infection .The only test to trace out or rule out infection is culture and sensitivity test.

Your recent culture report has revealed UTI due to E-coli bacteria which are sensitive to Piperacilin and Imepenum and intermediate sensitive to combination of Amoxicilinand Claulanic acid
.
Both Piperacillinand Tazobactum and Ertapenum are available only in injectable form and very expensive and has to administered through intravenous route
twice daily Normally we recommend these antibiotic only in hospitalized patient with severe infection

Culture report has revealed intermediate sensitivity to combination of Amoxicilil and Claulanic acid. I would suggest you to take Augmentin which is combination of these drugs available in XXXXXXX market and is available in oral form and economically cost effective .You can take it twice daily for a week .

Thanks and Regards.
Dr.Patil.

.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. P. T. Patil (2 hours later)

Thanks so much for your response Sir. There is one page is missing from the urine culture report hence i have attached now for your review. After looking at this report the urologist, i am seeing currently has suggested Niftas 100 mg twice daily for 10 days and then 1 tablet daily for 1 month. He has also suggested to take Cranpac d for 1 month twice daily for 1 month. Do you agree with this?

There is one question in my mind about the statement made in the urine culture report:
Proteus rettgeri may develop resistance during prolonged treatment with third generation cephalosporins.

What does this bacteria means? Is it treatable?

Even i am on strict diet control but sometimes i feel very irritable and itching feeling in my anus.

Please advise.

Answered by Dr. Dr. P. T. Patil (1 hour later)

Brief Answer:
You can continue Nitrofurantoin twice daily

Detailed Answer:
Hello
Thanks for uploading rest of the report .

Your urologist has rightly advised to take Nitrofurantoin .It is very safe and effective in UTI. Continue taking it as suggested by him .

As regards your doubt about developing resistance to Cephalosporin .It is known fact that bacteria which cause infection can become resistant to antibiotics to which they were once sensitive to.I would give one example (Mosquitoes which were very sensitive to DDT are now resistant to it ) same is applied here .It is a natures law of survival for fittest.

In such situation one has to repeat culture and switch to antibiotic to which they are reported to be sensitive.

Thanks and Regards.
Dr.Patil.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. P. T. Patil (1 hour later)

Thanks sir for your response. can you please provide your view on my situation which I did mention previous as well but looks like skip while reviewing. I will close the question once you provide your expert view on my below condition:

Even i am on strict diet control but sometimes i feel very irritable and itching feeling in my anus.

Answered by Dr. Dr. P. T. Patil (33 minutes later)

Brief Answer:
could be due to Acute Fissure In Anus .

Detailed Answer:
Hello
Thanks for follow up .
Irritation and itching in anus could be duet Acute Fissure in Anus ,However it can be confirmed only on clinical examination by a qualified General surgeon .

Applying local anesthetic jelly like Xyloaine will give relief .

If stools are hard take stool softener like Naturolax granules every day at night

Thanks and Regards.
Dr.Patil.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar