Urinary tract infection due to Aeromonas spp., a lesser known causative bacterium.

Copyright © 2010 Mandal et al. This is an open-access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Aeromonas spp. are often associated with diarrhoeal illnesses, soft tissue infections, bloodstream infections leading to sepsis, and intra-abdominal infections, among others [1]. Although Aeromonas was isolated many years ago, evidence implicating this genus as a cause of gastro-intestinal disease in humans has been amassed only since the early 1980s. They are a lesser known cause of urinary tract infection (UTI) and are not known uropathogens. So far there have been few case reports regarding UTI caused by Aeromonas spp. [2-6]. They have also been associated with haemolytic uremic syndrome [3]. Here, we present a series of cases of UTI due to organisms of this genus. Seven cases of Aeromonas spp. infection were reported to the Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) hospital, Puducherry, between 2007 and 2009. All the cases were from different wards and outpatient departments with no observable common link between any cases. All of our patients had attended different clinics at different times and in different departments. No gender or age group trend was noted; five cases were below 50 years of age, while one case was above 60 years and one was below five years of age. Three patients were treated on an outpatient basis, while four required hospital admission (see Table). Urine samples from suspected cases of UTI received in the laboratory were subjected to culture onto cysteine lactose electrolyte deficient medium (CLED) by the semi-quantitative technique and microscopic examination. Four of the samples had demonstrable significant pus cells while three samples did not have any pus cells; the latter three cases presented with significant bacteriuria and the organism was isolated in pure culture. The CLED plates were examined after an incubation period of 18 to 24 hours and processed [7] per recommendations. Significant bacterial isolates were identified according to standard methods [7] and antimicrobial susceptibility testing was performed by the Kirby Bauer method according to the Clinical Laboratory Standards Institute guidelines [8]. All of our Aeromonas isolates were obtained in pure culture [9]. The biochemical tests applied were aesculin hydrolysis, Voges-Proskauer reaction, lysine decarboxylase, ornithine decarboxylase, arginine hydrolysis, indole production, and production of acid and gas from fermentation of glucose, arabinose, mannitol, and sucrose. Four of …