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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Colonies Of Pseudomonas In Urine Culture Of A Child?

My 2 year old daughter was diagnosed with e.coli UTI ( 100000 colonies-plastic bag)on 6/17 and she was treated with antibiotics for 10 days-Rocephin for 6 days and Omnicef for 4 days. She had a repeat urine cultue on 6/18-catheterized , 12 h after starting the antibiotic and it was negative. She became afebrile 60 h after starting the antibiotic. She has been afebrile ever since. She is doing well, back to baseline. She had a repeat urine culture (plastic bag)7 days after the last antibiotic and it grew 10.000-20.000 colonies of Pseudomonas, sensitive to all the antibiotics tested. The pediatrician said that it is most likely a contaminant and we are planning to repeat the test. What do you think?
Mon, 15 Sep 2014
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Pediatrician,  's  Response
Hi, thank you for posting your question.

All laboratory reports should be correlated clinically and treatment should be directed to the patient and not just the reports. These are two of the basic principles of medical practice.
In this case as you mentioned, your daughter seems to have responded to the treatment and has shown clinical signs of improvement. In such a scenario if the reports show something that is not correlated clinically, it is better to repeat and confirm the result rather than blindly treating.
Pseudomonas is a common pathogen found in hospital acquired infections. Hence, in this case it is likely that it could be a contaminant of the collected bag or container, or the collecting method could have been faulty. Also, the colony count mentioned is not high enough to cause concern at this point of time.
Thus the next logical step would be to confirm the test and decide accordingly.

If you have any more doubts regarding the case, do reply.
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What Causes Colonies Of Pseudomonas In Urine Culture Of A Child?

Hi, thank you for posting your question. All laboratory reports should be correlated clinically and treatment should be directed to the patient and not just the reports. These are two of the basic principles of medical practice. In this case as you mentioned, your daughter seems to have responded to the treatment and has shown clinical signs of improvement. In such a scenario if the reports show something that is not correlated clinically, it is better to repeat and confirm the result rather than blindly treating. Pseudomonas is a common pathogen found in hospital acquired infections. Hence, in this case it is likely that it could be a contaminant of the collected bag or container, or the collecting method could have been faulty. Also, the colony count mentioned is not high enough to cause concern at this point of time. Thus the next logical step would be to confirm the test and decide accordingly. If you have any more doubts regarding the case, do reply.