Management of recurrent urinary infection by ESBL-producing Escherichia coli with vaginal pH regulation: a case report
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Keywords
Urinary tract infections, Vaginal microbiota, case report
Abstract
Urinary tract infections (UTIs) caused by Extended-Spectrum Beta-Lactamase (ESBL)-producing Escherichia coli are common and often require broad-spectrum antibiotics. These bacteria deactivate antibiotics like penicillins and cephalosporins. Patients with these UTIs often have chronic vaginal infections due to changes in vaginal microbiota and altered pH. The elevated pH allows E. coli to ascend from the intestine, causing recurrent UTIs. We present a case of a patient with recurrent UTIs caused by ESBL-producing E. coli, treated with Meropenem without improvement. By measuring her vaginal pH (7.0), we regulated the pH and improved the microbiota with a low-sugar diet and probiotics. At 3 and 6 months, there were no UTIs with negative cultures. Given the rise in ESBL UTIs, improving microbiota may reduce the use of broad antibiotics and enhance the management of these infections.
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