İDRAR YOLU ENFEKSİYONU ETKENİ OLARAK STREPTOCOCCUS PNEUMONIAE

Öz

Streptococcus pneumoniae, esas olarak orta kulak iltihabına, toplum kökenli pnömoniye hatta bazen bakteriyemiye neden olan Gram pozitif bir koktur. Genellikle üriner sistem enfeksiyonu etkeni olarak kabul edilmez. Dizüri şikayetiyle başvuran 58 yaşındaki erkek hastanın tekrarlanan idrar kültürlerinden Streptococcus pneumoniae izole edilmiştir. Hastada başka enfeksiyon belirtisi bulunmamıştır. İdrar analizlerinde hematüri tespit edilmiştir. Hasta parenteral seftriakson 500 mg 2×1 ile tedavi edilmiştir. Uzun süredir şikayetlerinin olması nedeniyle ileri tetkikler yapıldığında mesane kanseri tanısı konmuştur. İdrarda Streptococcus pneumoniae’nın izole edilmesi idrar yolu enfeksiyonunun nadir bir etkeni olarak kabul edilmeli, üriner sistem anomalisine sebep olacak nedenler araştırılmalıdır.

Anahtar Kelimeler

• idrar yolu enfeksiyonu
• pnömokoksüüri
• Streptococcus pneumoniae

Streptococcus pneumoniae as a Causative Agent of Urinary Tract Infection

Öz

Streptococcus pneumoniae is a Gram positive coccus that mainly causes otitis media, community-acquired pneumonia and sometimes even bacteremia. It is generally not considered to be the causative agent of urinary tract infection. Streptococcus pneumoniae was isolated from the repeated urine cultures of a 58-year-old male patient who applied with the complaint of dysuria. No other signs of infection were found in the patient. Hematuria was detected in urine analysis. The patient was treated with parenteral ceftriaxone 500 mg 2×1. When further investigations were conducted because of his complaints for a long time, he was diagnosed with bladder cancer. Isolation of Streptococcus pneumoniae in the urine should be considered as a rare cause of urinary tract infection, and the causes of urinary system anomalies should be investigated.

Anahtar Kelimeler

• urinary tract infection
• pneumococcosuria
• Streptococcus pneumoniae

Kaynakça

1. 1. Azak E. Gündeş GS Asemptomatik Bakteriüri. Türkiye Klin J Urol-Spec Top. 2010;3(3):273-3.
2. 2. Burckhardt I, Panitz J, van der Linden M, Zimmermann S. Streptococcus pneumoniae as an agent of urinary tract infections – a laboratory experience from 2010 to 2014 and further characterization of strains. Diagn Microbiol Infect Dis. 2016;86(1):97-101.
3. 3. Burckhardt I, Zimmermann S. Streptococcus pneumoniae in urinary tracts of children with chronic kidney disease. Emerg Infect Dis. 2011;17(1):120.
4. 4. Chiang C, Hwang K, Peng C, Kuo C. Antimicrobial resistance and serotype distribution of Streptococcus pneumoniae infections in Kaohsiung from 1996 through 1999. J Microbiol Immunol Infect. 2001;34(4):269-74.
5. 5. Choi R, Ma Y, Park KS, Lee NY, Cho HY, Kim YJ. Streptococcus pneumoniae as a Uropathogen in Children With Urinary Tract Abnormalities. Pediatr Infect Dis J [Internet]. 2013;32(12):1386-8.
6. 6. Dufke S, Kunze-Kronawitter H, Schubert S. Pyelonephritis and urosepsis caused by Streptococcus pneumoniae. J Clin Microbiol. 2004;42(9):4383-5.
7. 7. EUCAST. 2019. Available from: https://www.eucast.org/fileadmin/src/media/PDFs/EUCAST_files/Expert_Rules/2019/Pneumococcus_ExpertRules_V3.2_20190613.pdf. Erişim tarihi: 05.05.2023
8. 8. Green R, Selinger D. Urinary tract infection and soft tissue abscess caused by Streptococcus pneumoniae. South Med J. 1980;73(11):1550-1.

9. 9. Juda M, Korona-Glownik I, Prystupa A. Streptococcus pneumoniae as an agent of urinary tract infection. J Pre-Clin Clin Res. 2018;12(3):87-8.
10. 10. Lubarsky D. Streptococcus Pneumoniae Urinary Tract Infection in 3-Year-Old Girl. Transl Univ Toledo J Med Sci. 2019;6:32-4.
11. 11. Miller M, Kaplan B, Sorger S, Knowles K. Pneumococcosuria in children. J Clin Microbiol. 1989;27(1):99-101.
12. 12. Nguyen VQ, Penn RL. Pneumococcosuria in adults. J Clin Microbiol. 1988;26(6):1085-7.
13. 13. Shahin G, Lerner S. Rare presentation of Streptococcus pneumoniae pneumonia with bacteremia and multiple subcutaneous abscesses. Eur J Clin Microbiol Infect Dis. 2002;21(8):611-2.