Broth culture worth getting even when IC confirmed?

[notmybestday]

Hello all --

I'm intrigued by the success people have found with antibiotic therapy. I'm wondering whether a broth culture is worth getting once your IC has been "confirmed" by a urologist. I had a cysto/hydro done two weeks ago, and my uro purportedly found significant inflammation and a severely reduced bladder capacity.

I too went through multiple assumed UTI-antibiotic treatments before being diagnosed with IC (five rounds of Cipro, two rounds of Bactrim, one round of Levaquin). Several times, in-office urine samples showed WBC and twice, a very low-level e. coli infection was found and "treated."

I'm interested in broth cultures because I really can't pinpoint a cause like some of us here can (surgery, chronic UTI's, injury, etc.). I have had IBS for a few years, but the IC symptoms just hit me hard out of nowhere, and I'm desperate for some answers.

The end question being: Should I go ahead with seeking an expensive broth culture?

As always, thank you for your advice.

- S.

[GriffsMommy]

Personally I wouldn't waste the money. That's just me though because my uro did put me on a 6 week course of antibiotics during the diagnoistic process to make sure my problems were not bacterial in nature. The antibiotics didn't help me AT ALL all they did was give me a yeast infection which actually made my IC symptoms worse! BUT, I can see how someone who has had some relief from antibiotics in the past might want to try it. I think that maybe IC could have an infection cause in the fact that maybe an infection caused damage to the bladder and now you have IC but I don't really think it's an ongoing infection or dr's would have caught on by now. Just my opinion though.

[ICNDonna]

Both sides of this issue have been posted for at least several years. There are some who are wholeheartedly in favor of this. Many, if not most, medical professionals will express concerns about inaccuracies due to the potential for contamination, not only from the actual obtaining of the sample, but the delay in beginning the testing until it is received by the lab doing the test.

Most medical facilities have time limits of hours between obtaining the sample and the beginning of testing.

I suggest you review both sides of the issue before making your decision.

Long term antibiotics is also a controversial issue. Some people feel this has been the key to feeling good; others have reported serious problems from the antibiotics, such as developing antibiotic-resistant infections. Again, do your research before deciding. You'll want to consider the fact that antibiotics do have anti-inflammatory qualities, which will in most cases improve symptoms while you are taking them.

Warm hugs,
Donna

[OrlandoP]

Both sides of this issue have been posted for at least several years. There are some who are wholeheartedly in favor of this. Many, if not most, medical professionals will express concerns about inaccuracies due to the potential for contamination, not only from the actual obtaining of the sample, but the delay in beginning the testing until it is received by the lab doing the test.

Most medical facilities have time limits of hours between obtaining the sample and the beginning of testing.

I suggest you review both sides of the issue before making your decision.

Long term antibiotics is also a controversial issue. Some people feel this has been the key to feeling good; others have reported serious problems from the antibiotics, such as developing antibiotic-resistant infections. Again, do your research before deciding. You'll want to consider the fact that antibiotics do have anti-inflammatory qualities, which will in most cases improve symptoms while you are taking them.

Warm hugs,
Donna

And on the other side of this: years ago when I was first having problems, I sent my urine off for a culture with United Medical Labs (the one used by the antibiotic IC camp). It came back negative up to 72 hours.

I think IC is just different for different people. A couple of others and myself on the board are convinced for us it's neuropathic/autoimmune in nature.

[dbritts]

I had IC for 14 yrs. with no evidence of bacteria until 2004. I never imagined that I would end up with a colonized bacterial infection. I had one UTI when I was in my 20s and that's it!! Until 2004! My IC was well-controlled with Elmiron and Zyrtec. It's unfortunate that because 85% of UTIs are caused by e. coli that the majority of urologists miss those of us who develop a gram-positive infection caused by enterococcus or staph. Both of these are difficult to cure and need to be treated under the care of a knowledgeable urologist or Infectious Disease physician. Gram-positive organisms give false-negative results. My infection was caused by Enterococcus Faecalis and MRSE. These are normally "hospital-acquired" infections, but they're on the rise because of overuse of antibiotics in general. There's much information about "superbugs" in the media. Even the antibiotics in food are contributing to the problem. I've been on antibiotics for 4 yrs, by necessity not choice. I've got an excellent urologist but when you're talking about bacteria that affect about 5% of the normal population, this is new territory for them. I'm not "cured" of IC. I can't have the trigger point injections that were helping my levator ani syndrome because of this infection. The side effects of long-term antibiotic therapy are horrible for me. If my enterococcus disappeared tomorrow, I would still have IC. My advice would be to anyone experiencing a change in their IC symptoms to ask your dr. to order a culture that picks up gram-positive bacteria. Every hospital seems to be different, but Quest has a Special Urine Test that your dr. can request. My hospital cultures cost about $8 with insurance. I hope the day comes that it's standard to be cultured for all bacteria because early detection will hopefully make a difference. Enterococcus may turn out to be more of a problem in the IC community than we know right now. My dr. is shocked that I developed an infection like this and he's being more vigilant among his IC patients. I think my IC is autoimmune in nature, and that makes you more susceptible to bacterial infections. I know someone who started having IBS/IC at the same time. Her dr. tested her for bacterial overgrowth in the small intestines. Her test was positive--she's being treated with Rifaxin. She's hoping it will make a difference with her IC, but she's just started treatment so it's too early to know if it's going to help. Wish we had more answers and fewer questions!

Best wishes

[Jamey]

I would recommend getting them done!! For the past two years I've had wbc but "no infection". Every culture I have done comes back as either Staph or Strep. I would do one just to make sure b/c staph can be really hard to get rid of. I have IC to the point that I have hunner's ulcers and major bladder spasms. I thought for many years that I had some kind of infection they weren't finding. Turns out I do. I can't seem to get rid of it either. I used the keyword "staph" and found alot of interesting posts on this site. Hope all goes well.

[notmybestday]

Does the presence of WBC always indicate an infection? I've had WBC in my urine a few times with negative lab results. Could the WBC indicate simple inflammation in the urethra/bladder...or should I be wary of a "hiding" infection?

Thanks for your help. These boards are a godsend.

[MarthaF]

For the present time a broth culture is one way to find out for sure whether the WBC indicates an infection. The usual routine lab culture is not always adequate as many of us have found. As Debbie pointed out Quest has a "Urine culture, special" that is more extensive, and LabCorp has a "Comprehensive urine culture". So you could ask your doctor to order one of these, or on your own you can send a specimen to United Medical Lab and ask for a broth culture (unitedmedicallab.com).

Bacteria has not been researched extensively enough to say that it is not connected to chronic bladder symptoms suffered by many. There are many better tests available now to detect bacteria. It has been published that the EPIC study (Events Preceding IC) being conducted by the U of MD has found that over 50% of the patients participating say their symptoms began with a UTI. Hopefully, they will begin to study a bacterial cause more aggressively than they have in the past. No one has ever been able to rule it out and the one study done by the U of MD in 2000 found 48% improved on antibiotics.

But it is important to find the pathogen and then to use the antibiotic that it is sensitive to. E. coli is not the only kind of bacteria that can cause a UTI; Enterococcus is the second most commonly found.

I recommend getting a more extensive culture from one of the labs above. Or even ask your doctor to have the hospital lab let the cuture grow longer than 48 hours - even a week would not be too long to wait to see if there is any growth.

Martha

[dbritts]

White blood cells may indicate an infection. As Martha pointed out, the office culture doesn't cover all of them. Saw my urologist yesterday--he frequently deals with other bacteria besides e.coli in his entire patient population, not just IC patients. Sounds to me like your dr. might need to do a further work-up.

Debbie