Journal Information
Vol. 37. Issue. 6.November - December 2017
Pages 563-670
Vol. 37. Issue. 6.November - December 2017
Pages 563-670
Letter to the Editor
DOI: 10.1016/j.nefroe.2017.10.009
Open Access
Study and treatment of the couple in post-coital urinary tract infection in women
Estudio y tratamiento de la pareja en ITU poscoital de la mujer
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Mario A. Pavonea,
Corresponding author
, Abelardo Aguilera Peraltab
a Servicio de Nefrología, Hospital Can Misses, Ibiza, Spain
b Servicio de Nefrología, Hospital Universitario La Princesa, Madrid, Spain
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Tables (2)
Table 1. Bacteria in female urine cultures.
Table 2. Swab culture from male glans.
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Dear Editor,

Recurrent uncomplicated urinary tract infections (UTIs) are frequent among healthy young women.1 In some women, there is a clear relationship with sexual activity; the frequency of is sexual intercourse described as an important contributing factor, and it has even been reported that women having sexual intercourse on a daily basis are at 9 times’ greater risk.2–4 While changes in sexual partner during the previous year is a known risk factor, it is unusual to studied the couple.

We present the case of a 39-year-old woman with a stable partner who presented with post-coital voiding syndrome. She had no prior relevant medical history, nor repeated UTIs, and did not take oral contraceptives or use spermicide. It was discovered to have positive culture for Escherichia coli culture. She therefore received treatment with ciprofloxacin and became asymptomatic. Two months later, she again presented with post-coital voiding syndrome; this time, it was caused by Citrobacter koseri. She received treatment with fosfomycin and nutritional-hygienic measures that included post-coital voiding. After 10 months without symptoms, she again presented with post-coital voiding syndrome, again with the Citrobacter koseri culture. She therefore began another course of antibiotics with fosfomycin and compliance with hygienic measures was stressed.

Three months later, when the voiding syndrome occurred again, a new culture was requested and her asymptomatic partner was studied, using a glans swab. The man's culture showed 2 germs, Escherichia coli and Citrobacter, with identical sensitivity to the patient's cultures (Tables 1 and 2). Both started treatment with single-dose fosfomycin and no further new infections developed.

Table 1.

Bacteria in female urine cultures.

Date  18/11/2013  27/01/2014  13/11/2014  22/02/2015 
Microorganism  Escherichia coli  Citrobacter koseri  Citrobacter koseri  Citrobacter koseri 
Resistance marker
Gentamicin  Sensitive ≤1  Sensitive ≤1  Sensitive ≤1  Sensitive ≤3 1 
Cefalotin  Sensitive 16  Sensitive 4  Sensitive 8  Sensitive 4 
Cefuroxime  Sensitive 4  Sensitive 4  Sensitive 4  Sensitive 4 
Nitrofurantoin  Sensitive ≤16  Sensitive ≤16  Sensitive 32  Sensitive 32 
Amoxicillin/clav.  Sensitive 8  Sensitive ≤2  Sensitive 4  Sensitive 4 
Ampicillin  Resistant ≥32  Resistant ≥32  Resistant ≥32  Resistant ≥32 
Nalidixic acid  Sensitive ≤2  Sensitive ≤2  Sensitive ≤2  Sensitive ≤2 
Ciprofloxacin  Sensitive ≤0.25  Sensitive ≤0.25  Sensitive ≤0.25  Sensitive ≤0.25 
Trimeth/sulfam  Sensitive ≤20  Sensitive ≤20  Sensitive ≤20  Sensitive ≤20 
Fosfomycin  Sensitive ≤16  Sensitive ≤16  Sensitive ≤16  Sensitive ≤16 
Table 2.

Swab culture from male glans.

Date  02/03/2015  02/03/2015 
Microorganism  Escherichia coli  Citrobacter koseri 
Resistance marker
Gentamicin  Sensitive ≤1  Sensitive ≤1 
Cefalotin  Sensitive 16  Sensitive 4 
Cefuroxime  Sensitive 4  Sensitive 4 
Nitrofurantoin  Sensitive ≤16  Sensitive ≤16 
Amoxicillin/clav.  Sensitive 8  Sensitive ≤2 
Ampicillin  Resistant ≥32  Resistant ≥32 
Nalidixic acid  Sensitive ≤2  Sensitive ≤2 
Ciprofloxacin  Sensitive ≤0.25  Sensitive ≤0.25 
Trimeth/sulfam  Sensitive ≤20  Sensitive ≤20 
Fosfomycin  Sensitive ≤16  Sensitive ≤16 

The study and treatment of couples with post-coital UTI in women may be helpful in managing recurrent UTIs.

References
[1]
P. Little, M.V. Moore, S. Turner.
Effectiveness of five different approaches in management of urinary tract infection: randomised controlled trial.
BMJ, 340 (2010), pp. c19
[2]
C. Llor, A. Moragas.
Tratamiento y prevención de las infecciones urinarias de repetición.
FMC, 18 (2011), pp. 146-155
[3]
T.M. Hooton, D. Scholes, J.P. Hughes, C. Winter, P.L. Roberts, A.E. Stapleton, et al.
A prospective study of risk factors for symptomatic urinary tract infection in young women.
N Engl J Med, 335 (1996), pp. 468-474
[4]
D. Scholes, T.M. Hooton, P.L. Roberts, A.E. Stapleton, K. Gupta, W.E. Stamm.
Risk factors for recurrent urinary tract infection in young women.
J Infect Dis, 182 (2000), pp. 1177-1182

Please cite this article as: Pavone MA, Aguilera Peralta A. Estudio y tratamiento de la pareja en ITU poscoital de la mujer. Nefrologia. 2017;37:662–663.

Copyright © 2017. Sociedad Española de Nefrología
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