A Case of Catheter-Associated Urinary Tract Infection by Pseudomonas mendocina in the Setting of COVID-19

Abstract

Pseudomonas mendocina, a Gram-negative, aerobic bacillus, has rarely been implicated in human infections. This report details the first documented case of catheter-associated urinary tract infection (CAUTI) caused by P. mendocina in a COVID-19-positive patient. We present the case of a 70-year-old male with obstructive uropathy who presented with altered mental status eight days after testing positive for COVID-19. Urine cultures identified P. mendocina and Enterococcus faecalis. The antibiotic regimen was adjusted to cefepime and fosfomycin for coverage against P. mendocina and E. faecalis, respectively, resulting in the patient's improvement and discharge with an outpatient course of ciprofloxacin. However, the patient was readmitted 12 days later for recurrent symptoms and traumatic catheter removal, requiring nephrostomy tube placement. Follow-up revealed severe bladder and prostate abnormalities, confirming a complex interplay of factors contributing to his infection. P. mendocina is a rare opportunistic pathogen, often occurring in patients with pre-existing health conditions. This case is significant as the first CAUTI caused by P. mendocina and highlights potential links between COVID-19 and increased susceptibility to bacterial infections. The patient's comorbidities, particularly obstructive uropathy, and prolonged catheter use, were likely major factors in his infection. The role of COVID-19 in facilitating bacterial colonization remains speculative but warrants further investigation. This case report underscores the need for heightened clinical awareness and prompt intervention in patients with similar risk factors. The successful treatment regimen provides a valuable reference for managing such infections. Further research is needed to explore the interplay between viral and bacterial infections, particularly in the context of COVID-19.

Keywords: catheter-associated uti; covid-19; obstructive uropathy; pseudomonas mendocina; uti.

Figure 1. Abdominal CT image on admission revealing marked bilateral hydronephrosis and hydroureter (red arrows).