Recurring Urinary Tract Infections Vex Readers

Cece Turner, 30, who described herself as a “healthy mum” from Scotland, wrote that she had learned the hard way to seek a culture after a harrowing first experience with a U.T.I. two years ago.

She said that she “blindly followed orders, taking drug after drug with no reprieve.”

“I ended up being severely ill with a multi-drug resistant infection,” she continued. “Having tried 6+ different courses of antibiotics over the course of 4 months, my U.T.I. was eventually ‘cured’ in July by a 2 week course of antibiotics.”

Less than a year later, she got a second U.T.I. “This time,” she wrote, “I was a bit more savvy and demanded a culture immediately.”

Doctors and researchers interviewed agreed that in an ideal world, it would be great to culture each infection for possible infection. But that is far from realistic because cultures cost money and take time, discouraging doctors, labs and insurance providers, and also because the usual practice is to quickly treat urinary tract infections with antibiotics.

Dr. Eva Raphael, a physician at San Francisco General Hospital who does research on U.T.I.s, said cultures should be taken more often. “Yes, it takes manpower to send a urine culture, plate it, identify the colonies,” she said, but she added that she believes it’s worth doing “if we’re going to be judicious about the use of antibiotics.”

It might hearten some readers to know that the rise in resistance has spurred policymakers to think about whether to make getting cultures more standard. Dr. Drekonja, who is involved in discussing those kinds of issues with the Infectious Disease Society of America, said: “I suspect it will be addressed in the next version of U.T.I. guidelines,” although it is not clear when those will come out or what they will say.

Many readers who responded to The Times query were woman in their 50s or older. Women who are postmenopausal are particularly susceptible to urinary tract infections because their falling levels of vaginal estrogen can interfere with the body’s ability to fight off bladder infections.