What I learned today about Group B Strep in Urine

Today I learned that Group B Strep in the urine can be quite transient. All by itself, without any medical intervention.

Or, you could look at it like this - maybe if they find Group B Strep in your urine, you don't really have a UTI. Maybe you are simply like one of the 40% of adults out there who are colonized with Group B Strep vaginally and somehow some of that made it into your urine when you gave the sample.

Unless you are pregnant, maybe you don't need to be on antibiotics at all. If you ARE pregnant, that is a whole different ball game and you should be reading a different blog. The field of medicine feels pretty strongly about treating GBS in pregnant women in order to save babies. Who would argue with that? Not me.

So, how did I learn that Group B Strep in my urine can be transient?

Three months of urine samples. All this started because of the vaginal burning I was feeling when they released me from the hospital in late December. First urine sample at the end of December: GBS isolated at >100,000 cfu/ml. I took two days of Keflex followed by five days of amoxicillin. GBS in urine cultured one week later = 0

The burning? Still there.

Second urine sample, almost a month later: GBS isolated at 10,000 - 50,000 cfu/ml. I was ready to go back on antibiotics but had a weird reaction to the amoxicillin this time. Had to go through two allergists, a skin test and an oral challenge to find out that I am actually not allergic to penicillin. This took weeks. (More on that in another post.)

Third urine sample, about 14 days later: GBS isolated at >100,000 cfu/ml. Now I was really, really worried. I kept thinking any day I would wake up with a kidney infection. I was so anxious to get on a powerful antibiotic. The other antibiotic options were considered to be very harsh on the system. I was waiting for results of the allergy testing.

At this point (right before my period was to start) burning was intense.

Fourth urine sample, the day BEFORE I finally got back on amoxicillin: GBS isolated at 1,000 - 10,000 cfu/ml.

Um, what?

Yes, that's right. Within a few weeks with absolutely no medical interventions or drugs beyond regular probiotics, the GBS in my urine went from >100,000 cfu/ml to 1,000 - 10,000 cfu/ml.

Now I've been on amoxicillin again for six days. Guess what? I still have all the same pain and burning symptoms I did a week ago.

What I've learned today? Group B Strep is not my problem. It is not what has been causing the vaginal burning and pain over the last three months. Yes, I am colonised with it. Yes, sometimes it gets in my urine (or at least my urine sample). Yes, the drugs can kill it.

But it can come and go. By itself.

The Group B Strep is a red herring. My doctors grabbed for it in January because it was the most obvious answer, but now we know that treating it isn't the solution at all.

So what happens now? Your guess is as good as mine. My pH is still way out of whack and I am still in almost constant burning pain, especially when I sit. In the next three weeks I have appointments set up with a gastroenterologist, urologist and infectious disease doctor. I'm also set to get results back from the hormone blood tests that my OB ordered last week. There are probably other things that could be going on too - like vaginal atrophy, perimenopause, maybe even desquamative vaginitis.

I am working hard on changing my diet (no more red meat or dairy, fewer eggs) to work on reducing inflammation in my body. I am on an anti-inflammation diet to get rid of the bad category 2 prostaglandins (another blog post for another time).

My gut? I think this is a hormonal problem. I think I have an estrogen imbalance, maybe caused by my thyroid replacement hormone therapy. Maybe the pain and burning are a side effect of the medicine.

This is what I know as of today.

I'll let you know what I learn tomorrow.