Clinical Presentation, Anti-microbial Resistance, and Outcome of Salmonella typhimurium Causing Urinary Tract Infections: A Report of Two Cases

沙门氏菌引起的尿路感染的临床表现、抗菌药物耐药性和预后:两例报告

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Abstract

Non-typhoidal Salmonella causing urinary tract infections is uncommon.Their presence in urine is usually suggestive of genitourinary abnormalities, immunosuppression, andother comorbid conditions. The first patient is an 18-year-old female who presented to the Emergency Department with abdominal pain and burning micturition. There were no significant findings in the physical examination Urine culture grew Salmonella Typhimuriumwhich was resistant to quinolones and third-generation cephalosporins and positive for the genes encoding their resistance such as bla (OXA-1) and gyr A respectively. MRI pelvis and CT cystogram revealed findings that were suggestive of vesicovaginal reflux with transient urocolpos. The second patient is a 68-year-old female with a history of CKD and diabetes mellitus who presented for altered sensorium and reduced urine output. Urine culture indicated the presence of Salmonella Typhimuriumwhich was susceptible to all the antimicrobial agents tested. This case series highlights that isolation of Salmonella Typhimuriumin urine should not be ignored as its presence may indicate the presence of certain predisposing conditions like genitourinary abnormalities, chronic kidney disease and diabetes mellitus. Multidrug resistance is not uncommon among Salmonella Typhimurium; hence the antimicrobial sensitivity should be assessed and appropriate treatment should be administered.

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