Title : Profile of rare community acquired uropathogens in a public health institute
Abstract:
Introduction: Urinary tract infections (UTI) may be caused by bacteria and also yeasts. The common uropathogens are Escherichia coli and Klebsiella pneumoniae, but sometimes rare bacteria like Streptococcus bovis, Burkholderia pseudomallei, Enterococcus spp. and yeasts like Candida spp. can also cause UTI. Materials and methods: Over a 2-year period we isolated many bacteria from midstream urine samples received in our lab from Urban Outpatient department. Isolates were identified by staining and other phenotypic and biochemical tests. Results: Overall culture positivity was 16-19% in urine samples over the 2-year study period. Most positive cases were seen in January-June. The commonest uropathogens were E. coli, Proteus spp. and Klebsiella spp. but rare bacteria were also isolated, like Enterococcus spp., Acinetobacter lwoffii, Streptococcus bovis, yeasts like Candida spp. and Pichia anomala were also isolated. Enterococcus spp. and Streptococcus bovis were found more commonly in females than males. For Enterococcus spp. the age group was variable, ranging from 3 years and 3 months to 60 years, and the most effective antibiotics were Vancomycin , Nitrofurantoin. Linezolid and Tetracycline. Yeasts were isolated only in females and belonged to species like Candida tropicalis, Pichia anomala and C. glabrata. Fluconazole was effective in 80% yeast isolates. Burkholderia pseudomallei was also isolated, and only in 1 36-year old female patient. It was susceptible to Cefotaxime, Norfloxacin, Azithromycin and Nitrofurantoin. Conclusion: This highlights the importance of yeasts and non-fermenters and other rare bacteria as emerging causes of Urinary tract infections in all age groups and seasons. Empirical chemotherapy also needs to be tailored accordingly in these patients.
