Community-Acquired urinary tract infection by pseudomonas oryzihabitans
A 45-year-old male patient was admitted in the surgery ward with complaints of difficulty in passing urine since two months. There was no history of burning micturition and hematuria and no history of chronic illness suggestive of immunocompromised status. Test for HIV and hepatitis B surface antigen (HBsAg) was negative. Hemoglobin was 13.8g/dL and erythrocyte sedimentation rate (ESR) was19 mm/h. General and systemic examination was normal. Ultrasonography of the abdomen and pelvis was normal. Retrourethrogram showed narrowing in the anterior urethra. The case was provisionally diagnosed as stricture of urethra with UTI. Urine sample was received for culture and sensitivity, and processed by routine semiquantitative method. On blood agar and Muller Hinton agar rough wrinkled yellow pigmented colonies were grown [] and on MacConkey agar, nonlactose-fermenting colonies were grown. Gram-negative, motile, oxidase-negative, nonfermenter bacilli were isolated. The isolate was further identified as P. oryzihabitans (% id98.3) by the API ID 32 GN automated identification system (bioMérieux, Marcy I’ Étoile, France). Identification was based on the following tests: Negative nitrate reduction, esculin hydrolysis, lysine decarboxylase, arginine dehydrolase, and orthonitrophenyl-β-D-galactopyranoside activity (ONPG), positive oxidation fermentation glucose, maltose, mannitol, and xylose activity. Antibiotic sensitivity was done by disc diffusion method using Clinical and Laboratory Standards Institute (CLSI) guidelines. The isolate was sensitive to piperacillin, cephalosporins, imipenem, meropenem, cotrimoxazole, aminoglycosides, and fluoroquinolones, and resistant to nitrofurantoin. The patient was treated with oral norfloxacin 400 mg twice daily for ten days, and advised to come for follow-up after 15 days. Initial retrourethrogram showed narrowing in anterior urethra, but as the patient responded to antibiotic treatment and dysuria was relieved, repeat retrourethrogram was not done.