Background:
Oligella urethralis is an organism which is normally isolated as a commensal from the genitourinary tract. Clinical infection due to this organism is rarely reported in the literature. We hereby report a case series of six patients with oligella urethralis infection. We studied the clinical features, antibiotic susceptibility and clinical outcome in these patients.
Methods:
We constructed a case series,the first till date to our knowledge, of patients diagnosed with oligella urethralis infection. Inclusion criteria were determined by reviewing PubMed index journals on case reports. On the basis of that review, patients were included if they had blood, urine, wound or any body fluid culture positive for oligella urethralis. The Electronic medical record and laboratory records were reviewed from January 2010 to October 2015 and 6 patients were identified who met inclusion criteria.
Results:
All six patients identified were adults with a mean age of 73.5(range 49 to 93). Of the six patients, 3 were males (50%) and 3 were females (50%). Culture was positive for oligella urethralis from urine in 4 out of 6 patients, wound in one patient and blood in one patient. All six patients had underlying type 2 diabetes mellitus, and previous use of antibiotics for recurrent urine or lung infections. Urinary incontinence was observed in 2 of 6 patients. Decubitus ulcer was present in the patient with oligella bacteremia. Antimicrobial susceptibility of all clinical isolates were found to be sensitive to a wide variety of antibiotics including penicillin, but resistant to fluoroquinolones. All patients were treated with at least one drug to which the organism was sensitive and all recovered without any morbidity.
Conclusions:
Of the reported cases of oligella in literature, most occurred as an opportunistic infection in patients with a source of immunosuppression such as malignancy, HIV or newborns. In the cases we studied, however, there was no major source of immunosuppression, and there was no clinical or laboratory evidence to suggest any abnormality of urinary tract. The possible explanation for bacteremia in our patient is contamination of decubitus ulcer with urine. We also observed that in all six cases, the organism is sensitive to a wide variety of antibiotics including penicillin, but resistant to fluoroquinolone. According to literature, oligella urethralis may be an opportunistic pathogen and quinolone resistance may arise in patients for whom quinolones are used extensively. Our review suggest that further studies are necessary to understand this bacterium’s clinical significance and antibiotic susceptibility.