Small colony variant of Escherichia coli isolated from a recurrent urinary tract infection- a case report
Keywords:Escherichia coli, Small Colony Variant, Urinary Tract Infections.
Introduction: Small colony variant of Escherichia coli may cause persistent and recurrent infections in human. These slow growing phenotypic variants are difficult to identify and mislead the diagnosis which can lead to choice of inappropriate antibiotics. In this case report we are presenting a case of recurrent urinary tract infection which was associated with small colony variants of E. coli.
Case presentation: A two year old male child was admitted to the hospital with a complaint of passing thin stream of urine. One month earlier the child had been previously diagnosed with bilateral grade five Vesicoureteral reflux. Child had developed recurrent urinary tract infection caused by small colony variants of E. coli.
Conclusion: child had undergone bilateral ureter reimplantation as part of treatment to Vesicoureteral reflux. Since vesicoureteral reflex condition is one of the risk factor to develop urinary tract infections. Repeated exposure to antibiotic might have been induced stress condition to bacteria and emerged as slow growing sub population of E. coli.
B Foxman (March 1990). Recurring urinary tract infection: incidence and risk factors. A.M J Public Health 80(3), 331â€“333 http://dx.doi.org/10.2105/AJPH.80.3.331.
Charlotte A. Colwell (Oct 1946). Small Colony Variants of Escherichia coli Small Colony Variants of Escherichia coli Small Colony Variants of Escherichia Coli. J Bacteriol 52(4), 417â€“422.
Hooton TM & Stamm WE (Sep 1997). Diagnosis and treatment of uncomplicated urinary tract infection. Infect Dis Clin North Am. 11(3), 551-81 http://dx.doi.org/10.1016/S0891-5520 (05)70373-1.
Harald Seifert, Hilmar Wisplingh off, Petra Schnabel, Christ of von Eiff (Oct 2003). Small Colony Variants of Staphylococcus aureus and Pacemaker-related Infection. Emerg Infect Dis 9(10), 1316â€“1318 http://dx.doi.org/10.3201/eid0910.0302000.
L J Mandel, E Murphy, N H Steigbigel, M H Miller (Oct 1998). Gentamicin uptake in Staphylococcus aureus possessing plasmid-encoded, aminoglycoside-modifying enzymes. Antimicrob Agents Chemother 26(4), 563â€“569. http://dx.doi.org/10.1128/AAC.26.4.563.
Mulvey MA, Lopez-Boado YS, Wilson CL, Roth R, Parks WC, Heuser J, Hultgren SJ (20 Nov 1998). Induction and evasion of host defenses by type 1-piliated uropathogenic Escherichia coli. Science. 282(5393), 1494-7. http://dx.doi.org/10.1126/science.282.5393.1494.
Proctor RA, Van Langevelde P, Kristjansson M, Maslow JN, Arbeit RD (Jan 1995). Persistent and relapsing infections associated with small-colony variants of Staphylococcus aureus. Clin Infect Dis. 20(1), 95-102. http://dx.doi.org/10.1093/clinids/20.1.95.
Proctor RA, von Eiff C, Kahl BC, Becker K, McNamara P, Herrmann M, Peters G (Apr 2006).Small colony variants:a pathogenic form of bacteria that facilitates persistent and recurrent infections. Nat Rev Microbiol. 4(4), 295-305. http://dx.doi.org/10.1038/nrmicro1384.
Roggenkamp A, Sing A, Hornef M, Brunner U, Autenrieth IB, Heesemann J (Sep 1998). Chronic prosthetic hip infection caused by a small-colony variant of Escherichia coli. J Clin Microbiol. 36(9), 2530-4.
Sabeen Habib (July 2012). Highlights for Management of a Child with a Urinary Tract Infection. Int J Pediatr. doi: 10.1155/2012/943653. http://dx.doi.org/10.1155/2012/943653.
Vaudaux P, Kelley WL, Lew DP (Oct 2006). Staphylococcus aureus small colony variants: difficult to diagnose and difficult to treat. Clin Infect Dis. 15; 43(8), 968-70.