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Worried about urine culture

DR Hunter,

I am a merchant sailor operating in the Persian gulf. I had oral sex
from a bar girl with a condom however prior to putting on the condom she
put in her mouth briefly maybe 30 seconds not sure if it went past her
lips, I am paranoid about std;s so when the ship pulled into Dubai I
went to an STD clinic, called Zacks a DR Zacharias he tested me for
everything, which was negative even the urine showed no problems, he
gave me a shot and Doxycyclone since my ship was leaving in two days. He
e-mailed the result of my urine culture positive for Ureaplasma
urealyticum colony count - > 10^ 4 Cfu/ Spec and positive for
Streptococcus agalactie colony count < 10^3 cfu/ml he recommended cipro
for five days.
Are these infections something of concern? I did some research on
Ureaplasma urealyticum some say is a serious STD and others state is a
benign bacteria that exists in most people and harmless, should I be
concerned? It seems to be resistant to many antibiotics according to the
sensitivity test the doctor sent me.
Is Streptococcus a concern? I have a phobia about STD and don't want to
overreact like I have in the past, I have no discharge does not burn
when I pee only discomfort and irratation thru out the day at the end of
my penis, I completed the cipro  Should I re-test to see if infection is
eradicated? Or do you recommend putting this behind me? Worried about
going home to my wife and infecting her.  

Thank you for your time
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1 Answers
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239123 tn?1267651214
Welcome back to the forum.

The Zack clinic and Dr. Zacharias personally are experts in STD.  (I have corresponded with him about STD/HIV issues in Dubai and UAR.)

However, there are differing attitudes and approaches by some STD experts.  Every probably has U. urealyticum in their genital tracts from time to time; it's a normal component of vaginal and urethral bacteria.  Some strains of it (probably a small minority) can sometimes cause NGU.  Some experts would say "treat it all, just to be safe"; others just disregard it unless there are symptoms.  That's the approach taken by me and Dr. Hook, and most STD specialists in North America.  (We never test patients for UU in my STD clinic.)  In Europe and Asia, more people take the former tactic.  Zack clinic seems to be in that group.

As for streptococcus species, most in the genital tract clearly are normal.  They are not known to ever contribute to any health problem.  That includes S. agalactiae -- and the numbers of that bacteria were extremely low as well.

You may not want to "overreact" as you have in the past -- but that's exactly the problem here.  Once again, you have once again found yourself in a dilemma of your own doing.  The exposure you described carried no risk for STD; the brief, fleeting kind of potential exposure to your partner's saliva carried no chance of infection.  You should not have sought medical care based on that event, unless you had symptoms -- which you did not.  Because you did so, and you found a clinic that does more testing that most experts find necessary, some normal results were found that really don't mean anything.  And yet nobody can prove that the U urealyticum might not cause a problem someday.

So in my clinic we would not have tested you for those bacteria, assuming your exam was normal (no discharge observed, no elevated WBC on a urethral swab), and would not have treated you with cipro or anything else.  At this point, however, you're going to have to decide whether to continue or discontinue treatmetn (if you haven't already finished it).  In any case, I strongly recommend you not have any more testing and that you continue unprotected sex with your wife without fear of infecting her with anything.

In the future, if your sexual lifestyle continues -- unprotected sex with your wife at home, plus occasional protected sex commercially -- I would advise that you be tested once a year for the main important, treatable STDs (gonorrhea, chlamydia, syphilis, HIV); and otherwise never be tested at all unless and until you develop obvious STD symptoms (penile sores or other lesions, discharge of pus or mucus).  And for goodness' sake do your best to stop worrying about NGU.  When not caused by chlamydia, NGU is generally harmless for affected men and probably for their female sex partners as well.  It isn't something to go around worried about, even with your lifestyle.

Best wishes--  HHH, MD
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239123 tn?1267651214
University of Washington
Seattle, WA