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A Case of Urinary Tract Infection Caused by Multidrug Resistant Streptococcus mitis/oralis

Baohu Zhang1, Jie Zhou1, Guancong Xie2

  • 1Department of Clinical Laboratory, Pingshan General Hospital, Southern Medical University (Pingshan District People's Hospital of Shenzhen), Shenzhen, Guangdong, People's Republic of China.

Infection and Drug Resistance
|July 10, 2023
PubMed

Insights

Streptococcus mitis/oralis, typically a contaminant, can cause urinary tract infections (UTIs). This case highlights a multidrug-resistant UTI successfully treated with vancomycin.

Area of Science:

  • Medical Microbiology
  • Infectious Diseases
  • Clinical Urology

Background:

  • Streptococcus mitis/oralis is infrequently associated with severe infections like endocarditis and liver abscesses.
  • The presence of S. mitis/oralis in urine is often dismissed as contamination.
  • Urinary tract infections (UTIs) are common, but specific etiological agents can present diagnostic challenges.

Observation:

  • A 66-year-old male with a history of exertional dyspnea developed symptoms of a UTI, including urgency, frequency, and dysuria.
  • Urine cultures consistently identified S. mitis/oralis, with evidence of polymorphonuclear leukocyte phagocytosis.
  • Mass spectrometry (MALDI-TOF) confirmed the identification of the isolated S. mitis/oralis strain.

Findings:

  • The isolated S. mitis/oralis strain exhibited multidrug resistance (MDR) to common antibiotics including penicillin, cephalosporins, fluoroquinolones, and tetracycline.
  • The strain remained sensitive to vancomycin, quinupristin/dalfopristin, and linezolid.
  • Treatment with vancomycin resulted in effective resolution of the S. mitis/oralis UTI.

Implications:

  • This case underscores the potential for S. mitis/oralis to act as a pathogen in UTIs, challenging the assumption of contamination.
  • The identification of MDR in this strain highlights the need for comprehensive antimicrobial susceptibility testing in UTIs.
  • Successful vancomycin treatment suggests its utility in managing complex S. mitis/oralis UTIs, particularly those with MDR profiles.
Keywords:
Streptococcus mitis/oralisUKImultidrug resistantphagocytosis

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