Please answer the one question listed below the scenario. Thank you!
CC: AB is 63 year-old obese female who presents to the general medicine clinic with a 3-day history of urinary frequency and dysuria.
PMH: AB has a long history of Type II diabetes, which has been poorly controlled on glipizide. AB was most recently treated 1 month prior to this visit with a 10 day course of sulfamethoxazole/trimethoprim DS for an E. coli UTI. Six weeks prior to the E. coli infection she was treated for another UTI with a single 3 gram dose of amoxicillin. This will be her third UTI in 6 months.
Glipizide (Glucotrol) XL 5mg QD
GEN: obese female in no apparent distress
VS: BP 140/85, HR 70, Temp 37, RR 13, Wt. 85kg
ABD: soft, non-tender, no flank pain
GU: no discharge, no vaginal itching
EXT: decreased pulses in both feet, tingling feet and toes
NEURO: alert and oriented x3
WBC 7,000 no left shift
UA: > 40 bacteria with HPF, 20-30 WBC per HPF, nitrite positive
Urine culture: pending
- What bacteria pathogens do you suspect?