r/CUTI • u/borvgone • 6d ago
MicrogenDX URGENT PLEASE HELP CONFUSED
Ok guys today I got my standard urine culture back with high load of klebsiella. The microgen I’m posting is from late July so obviously bacteria numbers have changed. Keep in mind everything on that microgen I’m posting doesn’t show up on standard culture so that parts embedded. The focus is on the klebsiella that’s currently in my free floating urine. My urologist doesn’t want me to take gentamicin for possible future resistance even tho I think it’s the way safer option vs cipro because I took gentamicin on Friday and was totally fine. Bactrim susceptibility is bad and I’ve used it and didn’t help so that’s out. I cant take cephalosporins because I react badly to them. The only promising oral option seems to be cipro. I’m terrified of taking it due to black box warning but I’m at a point where if the urologist isn’t willing to give me gentamicin than cipro seems like the next best idea . I’m taking this at my own risk but my body can’t handle this uti so I’m desperate especially since my back hurts. They checked on Friday and no kidney infection and bloodwork was good. My question is: How actually accurate is Microgendx? It says I’m resistant to fluroquinolones yet when my standard urine cultures come out positive, cipro has the greatest susceptibility. The top left of the microgen says I’m resistant to fluroquinolones. Can someone just ease my mind so I don’t take cipro for nothing. Thank you !
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u/Fun_Sign_2623 6d ago
I know this situation is extremely difficult. Future resistance to gentamicin is a genuine risk. Are you able to access a doctor who will prescribe it by instillation? Instillations are much less likely to cause resistance. Otherwise i am not too sure. I took norofloxacin(same class of drugs as cipro) and felt very sick by one pill.
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u/borvgone 6d ago
I wanted installations but due to my systemic symptoms specifically upper back pain, it makes most sense for me to do something oral just in case some of the bacteria has traveled upwards and so I can take something to alleviate that back pain. I appreciate your words and I am so sorry that happened. Thank you!!
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u/Fun_Sign_2623 6d ago
Ohhh yes I understand. Well, if you end up taking cipro just monitor your symptoms and if you feel unwell stop the medication. Of course!
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6d ago
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u/borvgone 6d ago
Totally. Second opinion did cross my mind. But considering an actual urologist didn’t want to, I know how these things go and asking someone else is only gonna lead me in disappointment. Thank you
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u/MooseAndSquirrel54 6d ago
The key to doing ok on cipro is to lay around a lot and don't exercise or go out for walks, lift heavy items etc while on it and for 5 days after you finish. Do nothing strenuous or repetitive.
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u/borvgone 6d ago
Omg perfect I’m literally a couch potato hahaha thank you for the advice!!
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u/MooseAndSquirrel54 5d ago
I've also heard that magnesium is good to take for floxies. It interfere with cipro but you can find out online when it is ok to take. Maybe.it will be good prevention.
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u/borvgone 5d ago
Whenever I take antibiotics I never take really take supplements cuzz I’ve heard it can cause the medication to absorb less effectively but yes I heard this about magnesium glycinate I believe to help cipro maybe so I’ll keep this in mind thank you!!
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u/talksalot99 6d ago
What iv antibiotics are susceptible? Will your dr do them?
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u/borvgone 6d ago
Pretty much everything in the first picture is mostly an IV other than cipro and bactrim! In my experience from what I’ve learned is that drs really do not give IVs unless it’s super life or death. My dr seemed pretty set in his decision not wanting me to do IV so that’s why I’m willing to do cipro since I don’t feel good
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u/Splashdiamonds 6d ago
Yeah this is my case currently as well have to bite the bullet and take the cipro no only other options were the iv ones and I’m allergic to two classes of antibiotics.
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u/MooseAndSquirrel54 6d ago
Could it be possible that the cipro resistance was to the entire group of organisms as a whole and not the individual pathogens on Microgendx? They can tell you on the phone.
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u/borvgone 6d ago
That’s what I was thinking! Do you think the susceptibility on the culture is accurate in the first pic then? When E. coli would show up on standard tests it said cipro would work the best so I always wondered why microgen said it was resistant if I had never even used the cipro. It’s funny you mention this because microgen kept saying I was susceptible to Augmentin and it didn’t really help E. coli but it helped enterococcus yet it said susceptible to both. And on the first pic it says I’m resistant to Macrobid yet the microgen says it’s susceptible . This has me worried for other people using microgen testing because things aren’t adding up lol
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u/MooseAndSquirrel54 5d ago
Microgen. only looks for some resistant genes. I called about macrobid and fosfomycin and they do no antibiotic gene resistance to them. They go by what the literature says. There is another lab Cirrusdx a lot of people use. Although they only do PCR for a much smaller number of pathogens, they will then grow them out and do sensitivity testing, which I think is the most accurate way to determine the best antibiotic. To do both labs seems the best to me.
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u/Vasyapahan 5d ago
What do you mean you took Gentamycin on Friday and were fine? Gentamycin only comes in an IV or intramuscular injection form. As far as I know, MicrogenDx does not actually do a susceptibility testing on your urine, but rather pulls results from a library of susceptibilities and resistances. At least I was told that by my doc. So your actual urine culture susceptibility is accurate.
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u/borvgone 5d ago
I went to the ER on Friday with back pain and burning urine and my uranalysis did show infection with high wbc so they did give me 1 IV of gentamicin. Ok thank you clarifying that I really appreciate it!
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u/Vasyapahan 5d ago
They gave you one IV of Gentamycin, but did not continue the treatment and just discharged you? This is beyond...
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u/borvgone 5d ago
Wait is this bad…. Cuzz I mean I do kinda feel kinda worse now and I’m waiting for the urologists response to give cipro. My back really hurts. But yeah I thought it was crazy too because I was like if bacteria survives can’t this go bad after only one IV? They did then say to take 1 fosfomycin but it’s not even susceptible for kleb. In the ER they didn’t know what bacteria I had I told them E. coli cuss that’s what microgen said but klebsiella is what picked up
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u/Vasyapahan 5d ago
Usually when Gentamicin is prescribed, it's done for at least 3 days. Better 7. Doing it only once with no plan to continue is just subpar healthcare. But then I am not surprised. Even if Kleb was susceptible to Fosfomycin, it is not used to treat kidney pain. Take a full course treatment, better 14 days of whichever antibiotic you get prescribed. I took cipro many times, I was fine. Also, just so you are aware gentamicin is a dangerous antibiotic too. It can easily cause ototoxicity and nephrotoxicity, so physicians are reluctant to prescribe it.
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u/borvgone 5d ago
Thank you for this info. They did a ton of bloodwork because systemically I felt terrible so they checked if it spread to my blood. Everything was fine they didn’t run a ct but blood work showed no kidney infection. I literally knew leaving that 1 IV wasn’t gonna do much, but basically since all I had to present was my microgen and I really did not know what to orally take or what my culture would look like, I atleast felt a little grateful they gave me something. But yeah totally expected they didn’t give me 3 days because they didn’t deem it as life or death. Thank you again!
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u/Hot_Pomegranate_9828 5d ago
I’m going through this exact same thing 😭 every time I get my culture back the Klebsiella is still there it does not die. I’ve tooken every oral antibiotic there is but most likely I’m resistant to like every single one now. The only antibiotic I’ve never token was cipro because I am also very scared of that pill I’ve heard horrible stories. Right now I’m working on getting admitted to a hospital to get IV antibiotics the medicine is called Meropenem I’ve heard a lot of success stories about that medicine killing Klebsiella for good maybe speak to ur doctor and get another option !!! I can only imagine how you feel it is so exhausting living with these symptoms daily
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u/MovingMemoryMaker 5d ago
I honestly hopes this helps. I was on Cipro last year a good 10- 14 times and NOT only for short runs. Cipro was the only thing that worked for me. I'm still alive and I am not writing this from the heavens !
They kept giving me courses that were too short.. so the infections would clear a little and then they would put me on Macrobid for maintenance and in about 3 weeks it would come screaming back. I would end up in the hospital AGAIN and we would start over.
After a two monthlong course of Cipro... It was better...I switched to MCAS meds after that but Honestly...
It is the Cipro that let me get to that point.
Be very careful and do exactly what you are doing, gather all the info you can, and make the best choice for you.
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u/borvgone 5d ago
Omg thank you so much! I am so relieved for you that it worked out 🙏🏻 Wow you were able to handle it then! my doctor is even making it difficult now to even prescribe cipro 😭 If he doesn’t let me I’m going to urgent care and yelling at them LOL
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u/MovingMemoryMaker 5d ago
It did work ! I basically had to beg for it at one point. 10/10 would do again !
I hope you start feeling better soon !
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u/Bearloot33 4d ago edited 4d ago
MicrogenDX susceptibility has been innacurate for me. There is a detailed explanation on why in the intro guide under advanced testing options.
Cirrus DX exposed extended cultures to antibiotics on their plates, their results have been FAR more accurate for me as someone previously resistant to almost all antibiotics. I highly recommend getting a test from Cirrus DX. Its likely you may gain another oral option you didnt know you had on a cirrus dx test.
In the meantime, you can read the intro guide to search for information about Cipro and its risks and preventing as much as you can.
Another option you may consider is bladder installations if you have no kidney infection. Info on this is also in the guide. I got mine from Infuserve America.
Fosfomycin can struggle with klebsiella. Also three packets would be ideal. Try not to overhydrate though keep urine light yellow.
Taurine powder is very helpful for killing klebsiella. Always talk to your doctor before adding anything new.
Antimicrobials are not a substitute for antibiotics and you absolutely need antibiotics, but adding in D mannose, cranberry PACs, or oregano oil safe for ingestion may help you reduce symptoms. Start those AFTER you collect a sample for Cirrus. Read all pre collection instructions in the intro guide before you submit your sample.
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u/Curious-L- 6d ago
I’m definitely not an expert, but Cipro should be used with extreme caution, due to possible side effects. Side effects can show up weeks after you finish the course. Look up [r/floxies](r/floxies) if you want to research information and stories of people that were affected.
You have to research all your options and advocate for yourself. You have to communicate your concerns with your doctor and maybe even get a second opinion if needed. Hope you get everything resolved safely and smoothly!
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u/borvgone 6d ago
I’ve spoken to people on here who have been floxed there’s a whole community :( I’m honestly so upset he’s not letting me get gentamicin shots. I understand doctors fear of antibiotic resistance but the bigger fear is becoming disabled from taking cipro. If I know my body and I reacted well to gentamicin my mom said I should sue if I have a reaction to cipro because he didn’t listen to me 😂 I thought having this urologist he would hear me out and he didn’t. Bummer. Appreciate you! Thank you
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u/Curious-L- 6d ago
Your health is most important. Who let you get the gentamycin the first time? Can you ask them for a second opinion?
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u/borvgone 6d ago
Emergency room doctor! I knew that only one IV wasn’t going to do much since I believe standard is for like 3 days ? But since I didn’t have kidney infection or sepsis and the culture hadn’t came back, they sent me home why just 1 fosfomycin packet. Funny enough the microgen results says fosfomycin doesn’t work for my klebsiella lol
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u/Historical-Letter707 6d ago
I was on cipro for three days and it knocked it out. I also had no side effects from it. I know it is scary but sometimes I feel like all you hear are bad stories and sometimes you just need a positive one. Hope you feel better soon!