Kocuria: A Potential Problem in Patients with Complicated Urinary Tract Infections

Kocuria species are Gram-positive, catalase positive and coagulase-negative cocci that were not previously associated with human infections; but have recently emerged as human pathogens. These organisms have been implicated in different infections including urinary tract infections (UTIs), mostly in patients with underlying diseases. The aim of this study was to investigate the possible involvement of Kocuria species in UTIs in patients attending different clinics at Enugu State University of Science and Technology Teaching Hospital, Enugu, southeastern Nigeria. In this cross-sectional study, urine specimens from 867 patients were analyzed by standard microbiological and biochemical techniques. Polymerase chain reaction (PCR) was used to confirm Kocuria species and mecA gene. Antibiotic resistance profile (ARP) of Kocuria was determined using Kirby-Bauer disc diffusion method. Of the participants, 26.2% had UTI. The highest prevalence was observed among out-patients (52.4%), followed by male patients having bladder outlet obstruction (22.5%), diabetics (15.4%), Human Immunodeficiency Virus (HIV) Patients (9.7%). Kocuria was identified as the etiologic agent in 4 cases (1.8% prevalence); one was a male patient with supra-pubic cystotomy due to urethral strictures, while 3 were out-patients suspected of UTIs. Antibiotic resistance profile showed the Kocuria spp. to have a high degree of antibiotic resistance to various antibiotics including methicillin. This study suggests that Kocuria spp. are a potential problem for patients with complicated and uncomplicated UTI, more so as antibiotic resistance already exists among these organisms. It also highlights the need to investigate every case of suspected coagulase-negative Staphylococcus with more sensitive diagnostic techniques, such as PCR