** Thanks for contacting with your health concern. 1. Although E.coli is the commonest organism in all the age groups, but kleibsella, pseudomonas, are more common in patients with risk factors for complicated urinary tract infections. [as might be the case for you], so one has to exclude conditions which may impede urine flow like congenital urinary tract abnormalities, enlarge prostate, and inflammation. PS. According to the rule of thumb: Frequency of sexual intercourse is the strongest predictor of recurrent urinary tract infections in patients presenting with recurrent dysuria. 2. according to the Journal of American Family Physician: Patients at risk of complicated urinary tract infections are best managed with -broad-spectrum antibiotics initially, - urine culture to guide subsequent therapy, and - renal imaging studies if structural abnormalities are suspected. 3. Other predisposing factors which can be considered are any immunosuppression, diabetes, chronic kidney disease [CKD], being in a nursing home or hospital and since every time there is presence of blood in urine [hematuria], consult a Urologist for differential diagnosis of the same [bladder cancer or interstitial cystitis] 4. Patients with recurrent UTIs should be counseled about risk factors such as spermicide use, frequent sexual intercourse, and new sex partners, as well as about preventive measures, like i. Cranberrry juice has shown benefits in women with recurrent UTI [daily intake of 150 - 750 ml] ii. Several studies have demonstrated the effectiveness of using topical estrogen (0.5 mg of estriol vaginal cream nightly for two weeks, then twice weekly for eight months), but adverse effects are common.