### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
I have been diagnosed yet again with another UTI with Klebsiella being the bug that is always found in my urine. The dr says it is not caught from my partner but every time I have sex with him I am back to the Drs again complaining of the same symptoms. Sometimes the urine samples show nothing but most of the time it does. Why is it that I no sooner get rid of the infection then have sex and the infection starts all over again. I m beginning to wonder if my partner is the cause of all of this. Never ever had this issue before with any other partner. I m in my 40 s and have been with my partner for 2 years and am completely monogamous (never have numerous partners). I m so over this please help me

### output:

Hello, Klebsiella is mostly and primarily found in not immunocompetent individuals, usually in hospital settings and cause the so-called hospital-acquired infections (HAI). They could cause opportunistic urinary tract infections, pneumonia and other respiratory infections, bacteremia, infection of surgical wounds, etcetera. In diabetics, people with chronic obstructive pulmonary disease, etcetera. Due to their particular structure, Klebsiella species are naturally resistant to penicillin-type antibiotics, some Aminoglycosides (Gentamicin, Kanamycin, Streptomycin, etcetera.). Often their treatment is possible only through the use of Carbapenems and Fluoroquinolones (Ciprofloxacin, Levofloxacin, etcetera.). Klebsiella is considered part of the normal flora in various parts of intestine and colon. Recent studies have reported that recurrent Klebsiella urinary tract infections are caused by persistent Klebsiella found in the urinary tract even after appropriate antibiotic treatment and all persons with recurrent infections were elderly and diabetics. Recurrent strains of Klebsiella also had increased adhesion and invasiveness compared to colonization strains (those causing infection for the first time) and this might explain their tendency to cause repeated infections. Now, it is known that frequent sexual intercourse is the strongest risk factor for recurrent urinary tract infections in healthy women, and it is why your disease comes back each time you have sex with your partner. The fact that the disease comes back after you have sex with your partner puts in high risk of future urinary tract infections. In your case the following measures could be of benefit: 1. Continuous antibiotic prophylaxis for six months, by using low doses of the antibiotic that is more effective in your case. You have to consult with your doctor about which antibiotic you will use and for how long.2. Post-coital therapy, by applying a single dose of the most effective antibiotic each time after having sex. You again have to consult with your doctor about the dose and type of antibiotic. 3. Apply the so-called post-coital voiding that is: urinating immediately after sex.4. You should maintain high genital hygiene as it could help as well. It is also important that you have a thorough evaluation by radiological examinations in order to rule out abnormalities of the urinary tract (anatomical or functional) that could boost infection recurrence. Lastly, Klebsiella is not transmitted sexually, thus clearly your partner has nothing to do with your recurrent infections. But, during each intercourse, it is easier for the bacteria to get contact with your urinary tract (remember that Klebsiella is a normal part of intestinal tract and colon). Hope I have answered your query. Let me know if I can assist you further.  