DEAR DR. ROACH: I am a 62-year-old woman and am at my wits’ end. For the past two years, I have suffered from recurrent UTIs, usually Group B strep infections. I am not diabetic, and my weight, blood pressure and cholesterol are all good. I do take thyroid medication and also use a vaginal estriol cream.
It seems like every three months I need another round of antibiotics, and despite making many lifestyle changes — such as wearing cotton underwear and no tight jeans, taking only showers and adding D-Mannose, apple cider vinegar and vitamins C and B-12 to my diet daily — I still get these Group B strep infections. I had a urodynamic test done, which was negative. Where do I go from here, and could this Group B strep possibly be related to food sensitivities? Also, I had a partial hysterectomy at 34 due to a prolapsed uterus, with repair to my bladder and rectum, and was wondering if after all these years something had torn or moved and might be causing the strep to move from these areas into the urinary tract. Do any medical centers specialize in treating these types of infections? — D.A.
ANSWER: Recurrent urinary infections should prompt a careful look for anatomical abnormalities in the urinary tract. The most common cause of recurrent UTI that I see in a woman your age is atrophic vaginitis, but you already are on appropriate medication (estriol) to both treat and prevent that. A urodynamic study also should have picked up many of the anatomic causes that might predispose to recurrent infection. I can’t imagine that your surgery 28 years ago would be likely to predispose you.
Group B streptococci in nonpregnant adults is indeed strongly associated with diabetes, and a definitive test for diabetes, such as a glucose tolerance test or A1c, should be done, even if you have never been diagnosed.