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07 Apr 2003

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Dear Urologist

I am a regular visitor to Health 24 forums and (unless I'm mistaken!) your forum is pretty new. A great addition to the experts. How long have you in fact been on the site? It's nice to have your expert advice available and I hope you don't get too bombarded with abuse, as has happened to one or two of the other Health 24 experts.

I suffer from chronic kidney infections and am under permanent treatment by my urologist - so I will be interested in any bladder/kidney topics that might arise. I have to be on permanent maintenance treatment for prevention of my infections - or I land up in hospital with my bad infection - as happened to me last year. I went off my maintenance treatment (on the advice of a different specialist, who I was consulting for a 2nd opinion) and six weeks later landed up in hospital requiring IV treatment for my infection. My urologist, who was already treating me before I was in hospital, recommended that I go back onto my maintenance treatment, which I promptly did.

One question I would like to ask is:

I have monthly routine blood and urine tests for monitering my kidney condition and to make sure that the medication I am taking is suitable, and on a number of my lab accounts one of the tests that seems to often appear is ESBL DETECTION - URINE. What does this mean? I have always been under the impression that labs only do urine sensitivity tests if your results are cultured and show up infection. But my lab seems to do these tests often and my GP/urologist give results which they say sometimes show a "contaminent", but not an infection. Both are not convinced that I have an infection if there are no cells in the results. I seem to get a mixture of results which show genuine infections and contamination results. Would the lab do these tests anyway, i.e. it can't distinguish between a "contaminent" and infection, which a doctor could.

Sorry for the long story. Your comments would be appreciated.



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Expert
urologist

01 Jan 0001

Dear anxious

You are correct in that I am a new addition to the forum. It takes half an hour a day to answer all these questions. A full history regarding my track record will appear shortly.

ESBL stands for "Extended Spectrum Beta Lactamase " which really refers to a bug that has new properties in that it is resistant to different types of antibiotics (The extended spectrum). This means it is more difficult to treat.

If an infection is present, we would like to see cells in the urine which indicates that there is some kind of inflammation going on. If they are not present, one wonders about the accuracy of the result. The lab can identify organisms that are normally on the skin, which they would call contaminants. Some labs do a full sensitivity and others don't.
My advice is stay on the preventative antibiotics. You obviously have a complex problem that your urologist is managing.
JG
The information provided does not constitute a diagnosis of your condition. You should consult a medical practitioner or other appropriate health care professional for a physical examination, diagnosis and formal advice. Health24 and the expert accept no responsibility or liability for any damage or personal harm you may suffer resulting from making use of this content.
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