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 Microgen results and doctor's interpretation. Thoughts? 
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Joined: Mon Dec 31, 2018 10:24 am
Posts: 18
Post Microgen results and doctor's interpretation. Thoughts?
I had previously posted about my case here but thought I'd be better to start a new thread given how confusing it must be to follow all the follow-up posts now:

viewtopic.php?f=2&t=2534

In short, I had nitrites in my urine which was very suggestive of bacterial infection, I was empirically treated by a GP who did not attempt to do a culture, and ever since then we could not get a positive culture. I get chills and malaise (occasional low-grade fever even), suprapubic pain, and the occasional urinary urgency/frequency, with the malaise being the worst symptom, rendering me sick and lethargic all the time.

Symptoms used to go away effectively with antibiotics, and during a 6-week course of levofloxacin I was pretty much completely well, before symptoms returned on the last week of the course. We have tried many antibiotics, including piperacillin-tazobactam at a high dose intravenously for 12 weeks, but the inflammation persists. As of about two weeks ago there were 20+ WBCs in my post-massage urine, and both my urologist and infectious diseases doctor are convinced there's a low-grade infection that's persisting despite treatment, but without a positive culture we have very little to work with.

So I went and got a Microgen DX prostate test and results are as such:

Image


I was somewhat prepared to ask for another course of doxycycline to try in my appointment today (I had previously taken doxy for three weeks or so with no results) - it seemed like the most obvious and best option based off the Microgen recommendations.

But my ID doctor saw the results, and he's fairly certain that the Streptococcus and the Corynebacterium must have been nuked into orbit by the piperacillin-tazobactam (named Zosyn on the Microgen report) I had been on and after some Google searching it does seem to be the case, despite the drug not being recommended for these bugs on the Microgen DX list, and that therefore these four (?) bugs listed must have been from contamination.

The only bug that stood out to him was the Actinomyces neuii, which has been documented to cause prostatitis and is known to be "finnicky" and hard to be rid of. And while it is usually known to be susceptible to pip-tazo (and recommended by Microgen, lol) he says it's not one of the classic antibiotics that work well against it.

He wants me try a short course of penicillin to see how it goes. I asked him about the penicillins' poor prostatic penetration and he says that he's treated patients with enterococcal prostatitis with amoxicillin, so it could very well still be fine, even if not optimal.

I'm inclined to take his word for it since he's an authority on antibiotics and bacteria here in my country and probably takes into account local trends and stuff, (in fact he's frequently interviewed on the news and such) but I have to admit that the huge discrepancy between his expertise and Microgen's recommendations does not inspire me with much faith. I'm a little "ehh" about trying a short course of penicillin, but I guess it can't hurt.

Seems like while long courses are necessary for eradication but there should be some results at least I guess.

Would love to hear thoughts from you guys.


Tue Jul 30, 2019 7:33 am
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Joined: Tue Aug 18, 2015 10:49 pm
Posts: 33
Post Re: Microgen results and doctor's interpretation. Thoughts?
It's been my experience that doctors' protocol is often a basic, couple-week treatment of some antibiotic with low prostate penetration. I had a Microgen test done as well, but they don't test for STI's, or at least aren't listed there right?


Wed Jul 31, 2019 2:54 pm
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Joined: Sat Dec 22, 2018 7:54 am
Posts: 19
Post Re: Microgen results and doctor's interpretation. Thoughts?
They do test for sti, it’s part of the level 1 pcr screening


Wed Jul 31, 2019 3:13 pm
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Joined: Mon Dec 31, 2018 10:24 am
Posts: 18
Post Re: Microgen results and doctor's interpretation. Thoughts?
mrjump136 wrote:
It's been my experience that doctors' protocol is often a basic, couple-week treatment of some antibiotic with low prostate penetration. I had a Microgen test done as well, but they don't test for STI's, or at least aren't listed there right?


They offer a "prostate STI" kit for the same cost which I got.


Thu Aug 01, 2019 4:44 am
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Joined: Wed Mar 06, 2019 7:46 am
Posts: 15
Post Re: Microgen results and doctor's interpretation. Thoughts?
Thanks for posting your Microgen results. It's extremely interesting to look at what it shows. I wonder why you have a cocktail of bacteria and not just one significant bacteria? Is that normal? I have no idea.

I had the Microgen test done too, however it was a negative result which wasn't much of a surprise as I was still taking antibiotics (Bactrim) at the time.

It seems to me, as is often discussed here, that the bacteria have found a little home in the prostate so whatever antibiotic you take it cannot penetrate and kill. For me, I've had a sonogram done which showed a calcification and I reckon that's why I can't shift the infection anymore because the antibiotics never reach inside of it.

In this situation, maybe no antibiotics are going to work anymore. Some people believe in the daily massages helping to break down the calcifications and to help promote the antibiotics into the prostate. Alternatively injections flooding the prostate with antibiotics could also work. Have you considered either of these?

I'm not sure I have a lot of faith in your urologist. Given that you've got the Microgen results it must be frustrating that both you and your urologist are still guessing what antibiotic might be best. Short courses of antibiotics are never a good idea, and remember it does do harm, the more antibiotics the bacteria are exposed to the more resistant they become. If you do decide to get injections or massages done somewhere, then you want to maintain the sensitivity of the antibiotics.

Regards
Simon


Fri Aug 09, 2019 11:39 am
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Joined: Mon Dec 31, 2018 10:24 am
Posts: 18
Post Re: Microgen results and doctor's interpretation. Thoughts?
Bit of an update:

I've been taking 6 weeks of penicillin at a fairly high dose under my ID doctor now.

For about 4 weeks my post-massage urine WBC went to 0 and we were all overjoyed. And then it returned when I'm still taking the antibiotic, just like it did before.... ._.

Doctors are still telling me that I have a persistent low-grade infection that's refusing to die out completely for whatever reason.

I'm still getting fatigued and feel sick in general. It's been a year now :(

It breaks my heart to think about how my well-being has been affected by this stupid disease


Wed Sep 11, 2019 2:40 pm
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