Microscopic landscape with Raoultella Planticola bacterium at a crossroads

UTI Breakthrough: How a Rare Infection is Changing Post-Op Care

Kai Mendoza in Health & Wellness July 2025 • 4 min read.

"Discover the emerging threat of Raoultella Planticola UTIs after surgery and how doctors are adapting their treatment strategies to protect vulnerable patients."

Urinary tract infections (UTIs) are a common health issue, but what happens when a rare and unexpected bacteria is the cause? Raoultella Planticola, a gram-negative bacterium typically found in water and soil, is emerging as a concerning source of UTIs, especially following surgical procedures. This article explores this unusual infection, its risk factors, and how healthcare professionals are adapting their approaches to protect patients.

Traditionally, Raoultella Planticola was classified under the Klebsiella genus but has since been reclassified based on genetic sequencing. While it's not usually a threat to human health, there have been increasing reports of severe infections linked to this bacterium since the first recorded case of sepsis in 1984. Most of these cases involve bacteremia, a bloodstream infection, making the recent discovery of UTIs caused by Raoultella Planticola particularly noteworthy.

This article will delve into a specific case of a patient who developed a Raoultella Planticola UTI after undergoing a hysterectomy, examining the potential risk factors and treatment strategies employed. Additionally, it will review existing literature to provide a comprehensive understanding of this rare infection and its implications for post-operative care.

The Case: A Post-Operative UTI Surprise

Microscopic landscape with Raoultella Planticola bacterium at a crossroads

A 50-year-old woman with a history of lupus, dysphagia, degenerative disc disease, and peripheral neuropathy underwent a total vaginal hysterectomy with several related procedures to address a stage 4 utero-vaginal prolapse. Her pre-existing condition of lupus required her to take methotrexate, an immunosuppressant, before surgery.

Post-operatively, the patient faced some initial difficulties, including being unable to urinate, which required her to be discharged with a Foley catheter. While she eventually passed a void trial a few days later, she presented two weeks later with lower quadrant pain and some unusual discharge. A urinalysis revealed the presence of blood, nitrites, and a high level of leukocyte esterase, indicating an infection.

Diagnosis: The urine culture confirmed the presence of Raoultella Planticola, sensitive to most antibiotics but resistant to Tetracycline.
Treatment: She was prescribed Nitrofurantoin to combat the infection.
Outcome: Following the antibiotic treatment, her symptoms resolved, and a repeat urine culture showed no further bacterial growth.

This case highlights the potential for unusual pathogens to cause post-operative infections, particularly in individuals with compromised immune systems. It also emphasizes the importance of thorough testing and appropriate antibiotic selection to ensure effective treatment.

Adapting to Emerging Pathogens

The rise of Raoultella species as significant pathogens requires increased vigilance and awareness among healthcare providers. Cystitis, or bladder infection, is the most common type of infection associated with R. Planticola. A five-year review indicated that 50% of Raoultella Planticola infections were UTIs. Beyond UTIs, this bacterium has been linked to a range of other infections, including septicemia, pneumonia, and surgical site infections. Immunosuppression, invasive procedures, and contaminated equipment appear to be significant risk factors.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1016/j.eucr.2018.11.004, Alternate LINK

Title: Urinary Tract Infection With Rare Pathogen Raoultella Planticola: A Post-Operative Case And Review

Subject: Urology

Journal: Urology Case Reports

Publisher: Elsevier BV

Authors: Charlotte Fager, Ladin Yurteri-Kaplan

Published: 2019-01-01

Everything You Need To Know

What is Raoultella Planticola, and why is it a concern in post-operative care?

Raoultella Planticola is a gram-negative bacterium, typically found in water and soil, that is emerging as a concerning cause of urinary tract infections (UTIs), particularly after surgical procedures. Unlike common bacteria, Raoultella Planticola is rare but can cause significant health issues, including bacteremia (bloodstream infection). Its emergence as a post-operative concern is due to its potential to infect patients, especially those with compromised immune systems or after invasive procedures, making it a significant factor in post-operative care.

What are the main risk factors associated with Raoultella Planticola UTIs?

The primary risk factors for Raoultella Planticola UTIs include immunosuppression, invasive procedures, and the potential use of contaminated equipment. Immunosuppression weakens the body's defenses, making it easier for the bacteria to establish an infection. Invasive procedures, like the hysterectomy mentioned in the case study, provide an entry point for the bacteria. The use of contaminated equipment can directly introduce the bacteria into the patient's system, leading to infection. Patients with underlying health conditions like lupus, as seen in the provided example, are at higher risk due to the immunosuppressive medications they may take.

How does Raoultella Planticola differ from other bacteria causing UTIs?

Unlike more common bacteria associated with UTIs, such as E. coli, Raoultella Planticola is a rare pathogen, which presents unique challenges in diagnosis and treatment. Initially classified within the Klebsiella genus, it was reclassified due to genetic sequencing. This bacterium's resistance profile can differ, as seen in the case where it was resistant to Tetracycline but sensitive to Nitrofurantoin. Its rarity means healthcare providers must be vigilant and aware of its potential presence, especially in post-operative settings. This includes the need for thorough testing and appropriate antibiotic selection to ensure effective treatment.

What treatment strategies are typically used to combat Raoultella Planticola UTIs?

Treatment for Raoultella Planticola UTIs typically involves antibiotics to which the bacteria is sensitive. The case study highlights the use of Nitrofurantoin as an effective treatment, while the bacteria showed resistance to Tetracycline. Due to the varying antibiotic sensitivities, accurate identification and culture sensitivity testing are crucial to guide treatment. The goal is to eradicate the infection and prevent complications such as sepsis. Healthcare providers must consider the patient's overall health, existing medications, and any potential drug interactions when prescribing antibiotics.

Can you explain the importance of the case of the 50-year-old woman with Raoultella Planticola UTI after a hysterectomy, and its implications?

The case of the 50-year-old woman who developed a Raoultella Planticola UTI after a hysterectomy is important because it underscores the potential for rare pathogens to cause post-operative infections, particularly in individuals with compromised immune systems. Her pre-existing conditions such as lupus, dysphagia, degenerative disc disease, and peripheral neuropathy, alongside taking methotrexate, a medication that suppresses the immune system, increased her vulnerability. The diagnosis, treatment with Nitrofurantoin, and successful outcome highlight the importance of recognizing the emergence of Raoultella Planticola as a pathogen and adapting treatment strategies accordingly. It emphasizes the need for thorough testing, appropriate antibiotic selection, and increased vigilance among healthcare providers to safeguard patients, especially those undergoing surgical procedures.