Infection and Drug Resistance (Jul 2023)
A Case of Urinary Tract Infection Caused by Multidrug Resistant Streptococcus mitis/oralis
Abstract
Baohu Zhang,1,* Jie Zhou,1,* Guancong Xie,2,* Li Zhang,1 Yang Zhang,1 Kangli Xu,1 Tianyuan Feng,1 Shucai Yang1 1Department of Clinical Laboratory, Pingshan General Hospital, Southern Medical University (Pingshan District People’s Hospital of Shenzhen), Shenzhen, Guangdong, People’s Republic of China; 2Department of Cardiovascular Medicine, Pingshan General Hospital, Southern Medical University (Pingshan District People’s Hospital of Shenzhen), Shenzhen, Guangdong, People’s Republic of China*These authors contributed equally to this workCorrespondence: Shucai Yang; Tianyuan Feng, Email [email protected]; [email protected]: S. mitis/oralis has been previously reported in isolated cases of bacterial endocarditis and liver abscesses. Its presence in urine is generally considered a contaminant. A 66-year-old male patient was admitted to the hospital due to recurrent chest tightness and four-year history of exertional dyspnea. On the second day of admission, the patient presented with urgent and frequent urination, as well as dysuria. Both initial and subsequent urine cultures showed S. mitis/oralis infection, with polymorphonuclear leukocyte phagocytosis observed in the second sample. MALDI-TOF results confirmed the isolated strain as S. mitis/oralis. Drug susceptibility testing revealed multidrug resistance to penicillin, ceftriaxone, cefepime, levofloxacin, ofloxacin, and tetracycline, but sensitivity to quinupristin/dalfopristin, vancomycin, and linezolid. The clinician then prescribed vancomycin for anti-infective treatment, which proved effective. Keywords: S. mitis/oralis, UTI, MDR, phagocytosisKeywords: Streptococcus mitis/oralis, UKI, multidrug resistant, phagocytosis
