A persistent, symptomatic urinary tract infection with multiple "negative" urine cultures
Jeffrey Dabkowski1, Peter Dodds, Kathleen Hughes
1Department of Surgery, Norwalk Hospital, Norwalk, USA.
Connecticut Medicine
|February 23, 2013
Summary
Diagnosing bacterial urinary tract infections (UTIs) typically requires 24-48 hours of incubation. A rare slow-growing organism, Oligella ureolytica, necessitates longer incubation periods for accurate UTI diagnosis.
Area of Science:
- Microbiology
- Clinical Diagnostics
- Infectious Diseases
Background:
- Urinary tract infections (UTIs) are commonly diagnosed based on clinical signs and urinalysis findings like pyuria.
- Bacterial UTI confirmation relies on significant uropathogen growth on agar medium incubated at 35-37°C.
- Standard incubation times for bacterial cultures range from 24 to 48 hours.
Observation:
- A case of a UTI was associated with the gram-negative organism Oligella ureolytica.
- Oligella ureolytica is characterized as a slow-growing bacterium.
- This organism was identified only after prolonged incubation of the agar medium.
Findings:
- Extended incubation beyond the standard 48 hours is crucial for detecting slow-growing uropathogens.
- Oligella ureolytica requires incubation periods exceeding 48 hours for definitive identification.
- The study highlights a specific instance where delayed incubation led to the documentation of a UTI.
Implications:
- Current diagnostic protocols for bacterial UTIs may need revision to accommodate slow-growing organisms.
- Extended incubation times could improve the detection rates of uncommon uropathogens, leading to more accurate diagnoses.
- This case underscores the importance of considering prolonged incubation in microbiology labs for challenging UTI cases.
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