"Treliske Microbiology and recurrent UTIs"

I am a patient who regularly uses the services of the microbiology department, both from my GP practice and inpatient in Treliske hospital. I could truly write a dissertation on the inadequacies of the testing and the results emanating out of this department. Let me list some but not all of the incidents:

     1) Urine tests that indicate the presence of a bacterium that is resistant to oral antibiotics, this usually comes back with the result with

URINE CULTURE

Culture 10^7 - 10^8 cfu/l

Pseudomonas aeruginosa

Ciprofloxacin (Resistant)

       The first obvious question that comes to mind is, why are they reporting which antibiotic it is resistant to, the GP needs to make an informed decision regarding treatment, this literally tells them nothing to help with that, the GP knows it is resistant to oral antibiotics and needs to know what it is sensitive too, so appropriate treatment can be made.

      2) False negatives, I took a specimen in which after dip stick testing was high on both the leukocytes and blood readings, I know the infection is there because I am symptomatic. Their test shows it does not need to be cultured, so again the GP does not know what to treat it with, because it has not been cultured, and given (1), it would be a fruitless exercise anyway, because no treatment would be suggested.

       3) Suggestions that catheters patients should not be treated with antibiotics unless symptomatic, one thing I can ensure them is I would not go through this process if it were not symptomatic, this statement is redundant. I have had 100s of infections and know when it is symptomatic, the department needs to apply the appropriate gravitas and take a more holistic approach and own the patient's condition and work with the GP.

       4) The department appears not to be looking at the patient history when performing tests. I would like to point out that patients with recurrent problems like this are very likely to suffer sepsis if the problem is treated in such a cavalier manner. My whole history has been trying to stop infections progressing to this state, even where I am at home trying to stave it off with

Ciprofloxacin and paracetamol with a 40C fever (this has worked up to now despite the bacteria being "resistant", my assumption being that the bacterium is being kept in check expelling the Cipro toxins.), however this does not stop it flaring up again because, the bacterium has not been eradicated. On that point, if the resistant bacteria are not eradicated, it renders the whole arsenal of oral antibiotics ineffective. The usual modus operandi of the infection is progression to sepsis. Because of my condition, it will never result in a mild UTI that clears up.

      5) Lastly, I would like to point out that the expenditure of the NHS because of ineffective treatment must be very high, particularly if it progresses to hospitalization. Besides this there is the effect on the patients due to organ failure and unnecessary deaths when urgent treatment is required but prior and current tests result in meaningless statements like in (1) above and slow treatment as a result in doctors trying a trial and error approach to treatment.