strep b uti

Streptococcus Group B - Infectious Disease and Antimicrobial Agents

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1 Professor, Department of Microbiology, IMS and SUM Hospital, Bhubaneswar, Odisha, India.

2 Demonstrator, Department of Microbiology, Calcutta School of Tropical Medicine, Kolkota, West Bengal, India.

3 Associate Professor, Department of Microbiology, IMS and SUM Hospital, Bhubaneswar, Odisha, India.

4 Graduate Student, Department of Microbiology, IMS and SUM Hospital, Bhubaneswar, Odisha, India.

5 Assistant Professor, Department of Microbiology, IMS and SUM Hospital, Bhubaneswar, Odisha, India.

Dear Editor,

Group B Streptococcus (GBS), the invaders cervicovaginal, is a common cause of neonatal sepsis, pneumonia, meningitis, bacteremia, skin and soft tissue infections, chorioamnionitis, endometritis, osteomyelitis, etc., but its relationship with urinary tract infection (UTI) is a rare []. A 58 year old diabetic man presented to an outpatient department in our hospital with mild fever and frequent urination. After a thorough clinical examination, laboratory tests suggested that symbolized higher leukocyte count with neutrophilia (TLC-15000 / mm3, N-82%) and high blood sugar (FBS-170 mg / dL and PPBS 236 mg / dL). Other tests included for malaria and enteric fever were negative and kidney function tests and liver function tests within normal limits. He seronegative for HIV and non-reactive for venereal disease research laboratory (VDRL) test. By mid-stream urine sample, wet mount preparation shows a lot of pus cells with various cocci, mostly set in the chain. In the aerobic cultures after overnight incubation at 37 ° C, a large amount of the fine, opaque colonies grown on Cystine Lactose Electrolyte Deficiency (CLED) agar plate. This is a Gram-positive cocci in chains and show a negative reaction to catalase and esculin bile. These organisms are beta hemolytic, bacitracin hold [] and Christie-Atkins-Munch-Petersen (CAMP) is positive [] on sheep blood agar. Thus, while the isolates were identified as Streptococcus agalactiae was justified by the VITEK 2 system (bioMerieux) using the Gram-positive (GP) identification card with a 98% probability. Antimicrobial susceptibility testing was conducted using the Kirby-Bauer disc diffusion modified according to CLSI guidelines [] and patients became asymptomatic with appropriate antibiotic treatment. Repeat urine culture after seven days did not show growth of this organism.

Bacitracin resistant beta hemolytic colonies on sheep blood agar.

The isolates showed positive CAMP test.

UTI is the most common infectious diseases both in humans, common in females and mostly caused by Gram-negative bacilli []. In men, often associated with Streptococcus agalactiae. Despite the high prevalence of GBS in the urethra, especially in individuals with Sexually Transmitted Diseases (STDs), is a rare cause of UTI [,]. GBS is mostly associated with postpartum infection that results from vertical transmission of bacteria due to maternal cervicovaginal colonization. Group B streptococcal infection in healthy adults is rare, except in young and middle aged women, and is mostly associated with diabetes mellitus and chronic renal failure []. Diabetes, in our case, it may be a predisposing factor. Increased frequency of UTI in these patients may be due to glycosuria, neutrophil dysfunction or increased adherence of bacteria to the cells uroepithelial []. As GBS colonizes the vagina and urethra is very prevalent STD patients, so one should keep it in mind as it can be a source of infection to the urinary tract, especially in individuals with diabetes are sexually active. Rapid diagnosis will ease the development of further complications.

We thank Siksha 'O' Anusandhan University for their constant support and encouragement to complete this work.

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