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Part II: My Very Worst Urinary Tract Infection

Posted Sep 22 2012 12:00am
Having complications of seemingly simple issues seems to be the story of my life. 

I can't just have a tonsillectomy, I have to have complications that send me to the hospital.  I can't just have typical side effects to Trileptal, I have to have an anaphylactic reaction that sends me to the hospital.  I can't just have a simple urinary tract infection, I have to end up in the hospital on IV antibiotics. 

Obviously, I've given away the ending to my UTI story. 

Most UTIs are caused by Escherichia coli (E. coli).  Since I can't seem to do anything the easy way, my infection was NOT caused by the usual bacteria.  Instead, the bacteria I had was an antibiotic-resistant Klebsiella pneumoniae.  And, of course, it was completely resistant to the the antibiotic I had been prescribed (Macrobid/Nitrofurantoin).  See below for my urine culture results
RESULT: Greater than 100,000 CFU/mL of Klebsiella pneumoniae
K.pneumoniae
----------------
INT MIC
AMPICILLIN R > = 32
AMP/SULBACTAM R > = 32
CEFAZOLIN S < = 4
CEFEPIME S < = 1
CEFTRIAXONE S < = 1
CIPROFLOXACIN S < = 0.25
ERTAPENEM S < = 0.5
GENTAMICIN S < = 1
IMIPENEM S < = 1
LEVOFLOXACIN S < = 0.12
NITROFURANTOIN R 128
TOBRAMYCIN S < = 1
TRIMETHOPRIM/SULFA R > = 320
Legend S = Susceptible  I = Intermediate   R = Resistant  NS = Not Susceptible
You'll notice that there is a big R next to Nitrofurantonin, which indicates the bacteria I had was resistant to the antibiotic I had been prescribed.  The reason I did not feel better over the weekend was because my antibiotic was doing nothing!  Fortunately, the urine culture results came in on Monday, so the PA prescribed a new antibiotic that the bacteria was supposed to be susceptible to (and that I was not allergic to).

Unfortunately, I did not feel any better on the new antibiotic (in fact, I was feeling worse; pain had started to spread to my lower back), so I made an appointment with a doctor for that Thursday -- exactly one week after my symptoms started.  The doctor decided that I was not on a strong enough antibiotic, so she changed my antibiotic.  By the following Monday, my symptoms had not improved. I felt a constant cramping feeling in my lower pelvis and back; I was nauseated and running a 100-degree temperature.  By now, I'd been sick for about a week and a half. 

I called the doctor's office, and they instructed me to go to an Emergency Room rather than come into the office.  The ER?  I felt awful, but I didn't feel THAT sick.  Oh well, what could I do but follow the doctor's orders.  And just like that, my very first UTI became my very worst. 

As my husband was driving me to the Emergency Room, I commented to him that I hoped we'd be back home in time for dinner.  I figured the ER would give me some IV antibiotics and send me home that day with a new prescription.  No such luck. 

While the ER doctor did order IV antibiotics, he also wanted to keep me in the hospital overnight.  Really?!  I told the ER doctor that I felt sick, but not that sick.  He smiled and said they wanted to keep me overnight for additional tests and observation.  I thought he was speaking in code and really meant "we just want your money." 

While in the hospital, I had a CT of my abdomen and was poked and prodded by numerous doctors (Residents) throughout the night.  I had multiple blood tests, a urine test, and two IV antibiotic treatments over the course of 24 hours.  The hospital I happened to be in was a teaching hospital, so I also kept having to repeat my medical history over and over.  I got very little sleep during my stay (my snoring roommate didn't help).  I was glad that I would be going home after just one night.

Before I could leave the hospital, the Attending Physician (i.e., the senior doctor in charge of the Residents) had to review my case.  I assumed I would be prescribed some sort of antibiotic to take home.  I was right, but I was surprised by the prescription. 

I'll write more about my unusual prescription in my next post. 
 
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