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Fuochi V, Furnari S, Trovato L, Calvo M, Furneri PM. Therapies in preclinical and in early clinical development for the treatment of urinary tract infections: from pathogens to therapies. Expert Opin Investig Drugs 2024. [PMID: 38700945 DOI: 10.1080/13543784.2024.2351509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 05/01/2024] [Indexed: 05/05/2024]
Abstract
INTRODUCTION Urinary tract infections (UTIs) are a prevalent health challenge characterized by the invasion and multiplication of microorganisms in the urinary system. The continuous exploration of novel therapeutic interventions is imperative. Advances in research offer hope for revolutionizing the management of UTIs and improving the overall health outcomes for individuals affected by these infections. AREAS COVERED This review aimed to provide an overview of existing treatments for UTIs, highlighting their strengths and limitations. Moreover, we explored and analyzed the latest therapeutic modalities under clinical development. Finally, the review offered a picture into the potential implications of these therapies on the future landscape of UTIs treatment, discussing possible advancements and challenges for further research. EXPERT OPINION Comprehensions into the pathogenesis of UTIs have been gleaned from foundational basic science studies, laying the groundwork for the exploration of novel therapeutic interventions. The primary source of evidence originates predominantly from animal studies conducted on murine models. Nevertheless, the lack of clinical trials interferes the acquisition of robust evidence in humans. The challenges presented by the heterogeneity and virulence of uropathogens add an additional layer of complexity, posing an obstacle that scientists and clinicians are actively grappling with in their pursuit of effective solutions.
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Affiliation(s)
- Virginia Fuochi
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Salvatore Furnari
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Laura Trovato
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
- U.O.C. Laboratory Analysis Unit, A.O.U. "Policlinico-San Marco", Catania, Italy
| | - Maddalena Calvo
- U.O.C. Laboratory Analysis Unit, A.O.U. "Policlinico-San Marco", Catania, Italy
| | - Pio Maria Furneri
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
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Razali K, Nalbone L, Giarratana F. Aerococcus viridans and Public Health: Oral Carriage and Antimicrobial Resistance in Stray Dogs and Cats in Algeria. Microb Drug Resist 2023; 29:576-581. [PMID: 37855893 DOI: 10.1089/mdr.2022.0165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2023] Open
Abstract
The current study aimed to determine the occurrence and antimicrobial resistance of oral Aerococcus viridans in stray dogs and cats in Algeria. Oral swabs from 200 stray animals (100 dogs and 100 cats) were collected and cultured on Columbia agar medium supplemented with 5% defibrinated sheep blood. Isolates were identified using analytical profile index Rapid 20 Strep commercial kits, and antibiotic susceptibility was determined using the disk diffusion method. Of the 200 animals sampled, 34 carried A. viridans in their oral cavities, with 26 isolates (76.47%) resistant to at least 2 drugs. Multidrug resistance profiles (to more than three different antimicrobials) were observed only in cats (26.08% of isolates). More isolates were resistant to erythromycin and tetracycline (71% and 65%, respectively) than to other antimicrobials. This is the first research study in Algeria detecting antimicrobial resistance in oral A. viridans isolated from dogs and cats and highlights potential public health concerns. Clinical trials registration number: 01/2018.
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Affiliation(s)
- Kahina Razali
- Institute of Veterinary Sciences, University of Saad Dahlab Blida, Blida, Algeria
| | - Luca Nalbone
- Department of Veterinary Sciences, University of Messina, Messina, Italy
| | - Filippo Giarratana
- Department of Veterinary Sciences, University of Messina, Messina, Italy
- RICONNEXIA SRLS, Spin-off of the University of Messina, Messina, Italy
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Xi H, Fu Y, Chen C, Feng X, Han W, Gu J, Ji Y. Aerococcus viridans Phage Lysin AVPL Had Lytic Activity against Streptococcus suis in a Mouse Bacteremia Model. Int J Mol Sci 2023; 24:16670. [PMID: 38068990 PMCID: PMC10706753 DOI: 10.3390/ijms242316670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 11/19/2023] [Accepted: 11/22/2023] [Indexed: 12/18/2023] Open
Abstract
Streptococcus suis (S. suis) is a swine pathogen that can cause sepsis, meningitis, endocarditis, and other infectious diseases; it is also a zoonotic pathogen that has caused a global surge in fatal human infections. The widespread prevalence of multidrug-resistant S. suis strains and the decline in novel antibiotic candidates have necessitated the development of alternative antimicrobial agents. In this study, AVPL, the Aerococcus viridans (A. viridans) phage lysin, was found to exhibit efficient bactericidal activity and broad lytic activity against multiple serotypes of S. suis. A final concentration of 300 μg/mL AVPL reduced S. suis counts by 4-4.5 log10 within 1 h in vitro. Importantly, AVPL effectively inhibited 48 h S. suis biofilm formation and disrupted preformed biofilms. In a mouse model, 300 μg/mouse AVPL protected 100% of mice from infection following the administration of lethal doses of multidrug-resistant S. suis type 2 (SS2) strain SC19, reduced the bacterial load in different organs, and effectively alleviated inflammation and histopathological damage in infected mice. These data suggest that AVPL is a valuable candidate antimicrobial agent for treating S. suis infections.
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Affiliation(s)
- Hengyu Xi
- State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Key Laboratory for Zoonosis Research of the Ministry of Education, Institute of Zoonosis, College of Veterinary Medicine, Jilin University, Changchun 130062, China; (H.X.); (Y.F.); (C.C.); (W.H.); (J.G.)
| | - Yao Fu
- State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Key Laboratory for Zoonosis Research of the Ministry of Education, Institute of Zoonosis, College of Veterinary Medicine, Jilin University, Changchun 130062, China; (H.X.); (Y.F.); (C.C.); (W.H.); (J.G.)
| | - Chong Chen
- State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Key Laboratory for Zoonosis Research of the Ministry of Education, Institute of Zoonosis, College of Veterinary Medicine, Jilin University, Changchun 130062, China; (H.X.); (Y.F.); (C.C.); (W.H.); (J.G.)
| | - Xin Feng
- State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Key Laboratory for Zoonosis Research of the Ministry of Education, Institute of Zoonosis, College of Veterinary Medicine, Jilin University, Changchun 130062, China; (H.X.); (Y.F.); (C.C.); (W.H.); (J.G.)
| | - Wenyu Han
- State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Key Laboratory for Zoonosis Research of the Ministry of Education, Institute of Zoonosis, College of Veterinary Medicine, Jilin University, Changchun 130062, China; (H.X.); (Y.F.); (C.C.); (W.H.); (J.G.)
- Jiangsu Co-Innovation Center for the Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou University, Yangzhou 225009, China
| | - Jingmin Gu
- State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Key Laboratory for Zoonosis Research of the Ministry of Education, Institute of Zoonosis, College of Veterinary Medicine, Jilin University, Changchun 130062, China; (H.X.); (Y.F.); (C.C.); (W.H.); (J.G.)
- Jiangsu Co-Innovation Center for the Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou University, Yangzhou 225009, China
| | - Yalu Ji
- State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Key Laboratory for Zoonosis Research of the Ministry of Education, Institute of Zoonosis, College of Veterinary Medicine, Jilin University, Changchun 130062, China; (H.X.); (Y.F.); (C.C.); (W.H.); (J.G.)
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Zhang X, Lu B, Chen G, Wang L, Lin B, Peng Z, Lu S, Li D, Chen J. Culturable and inhalable airborne bacteria in a semiunderground municipal wastewater treatment plant: Distribution, transmission, and health risk assessment. JOURNAL OF HAZARDOUS MATERIALS 2023; 459:132234. [PMID: 37586239 DOI: 10.1016/j.jhazmat.2023.132234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 06/15/2023] [Accepted: 08/04/2023] [Indexed: 08/18/2023]
Abstract
Airborne pathogens constitute a growing threat to global public health. Wastewater treatment plants (WWTPs) are important sources of airborne bacteria, which pose great health risks to the employee and nearby residents. In this study, the distribution, transmission and health risk of the airborne culturable and inhalable bacteria carried by PM2.5 in a semiunderground WWTP were evaluated. The concentrations of culturable bacteria in the air were 21.2-1431.1 CFU/m3, with the main contributions of primary and biological treatments. The relative abundances of culturable and total inhalable bacterial taxa were positively correlated (p < 0.05). However, certain bacteria, including Bacillus, Acinetobacter and Enterococcus, exhibited high reproductive capacity despite their low concentration in the air, suggesting that they can survive and regrow in suitable environments. Transmission modeling revealed that the concentrations of airborne bacteria exponentially decreased with distance from 18.67 to 24.12 copies /m3 at the source to 0.06-0.14 copies /m3 at 1000 m downwind. The risks of 8-h exposure in this WWTP except the outlet exceeded the reference value recommended by WHO, which were primarily dependent on P. aeruginosa, Salmonella, and E. coli. Management practices should consider improved controls for bioaerosols in order to reduce the risk of disease transmission.
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Affiliation(s)
- Xiang Zhang
- Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention (LAP3), IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan Tyndall Centre, Department of Environmental Science and Engineering, Fudan University, Shanghai 200433, China
| | - Bingjie Lu
- Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention (LAP3), IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan Tyndall Centre, Department of Environmental Science and Engineering, Fudan University, Shanghai 200433, China
| | - Guang Chen
- Shanghai Chengtou Sewage Treatment Co., LtD., Shanghai 201203, China
| | - Lihua Wang
- Shanghai Chengtou Sewage Treatment Co., LtD., Shanghai 201203, China
| | - Bingjie Lin
- Shanghai Chengtou Sewage Treatment Co., LtD., Shanghai 201203, China
| | - Zhengliang Peng
- Shanghai Chengtou Sewage Treatment Co., LtD., Shanghai 201203, China
| | - Songliu Lu
- Shanghai Investigation, Design & Research Institute, Shanghai 200335, China
| | - Dan Li
- Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention (LAP3), IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan Tyndall Centre, Department of Environmental Science and Engineering, Fudan University, Shanghai 200433, China.
| | - Jianmin Chen
- Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention (LAP3), IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan Tyndall Centre, Department of Environmental Science and Engineering, Fudan University, Shanghai 200433, China
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Choi BI, Ene A, Du J, Johnson G, Putonti C, Schouw CH, Dargis R, Senneby E, Christensen JJ, Wolfe AJ. Taxonomic considerations on Aerococcus urinae with proposal of subdivision into Aerococcus urinae, Aerococcus tenax sp. nov., Aerococcus mictus sp. nov., and Aerococcus loyolae sp. nov. Int J Syst Evol Microbiol 2023; 73. [PMID: 37755156 DOI: 10.1099/ijsem.0.006066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/28/2023] Open
Abstract
Average nucleotide identity analysis, based on whole genome sequences of 115 strains previously identified as Aerococcus urinae, an emerging uropathogen, discriminates at least six unique genomic taxa. The whole genome analysis affords clearer species boundaries over 16S rRNA gene sequencing and traditional phenotypic approaches for the identification and phylogenetic organization of Aerococcus species. The newly described species can be differentiated by matrix-assisted laser desorption ionization time-of-flight analysis of protein signatures. We propose the emendation of the description of A. urinae (type strain ATCC 51268T = CCUG 34223T=NCFB 2893) and the names of Aerococcus tenax sp. nov. (ATCC TSD-302T = DSM 115700T = CCUG 76531T=NR-58630T), Aerococcus mictus sp. nov. (ATCC TSD-301T = DSM 115699T = CCUG 76532T=NR-58629T), and Aerococcus loyolae sp. nov. (ATCC TSD-300T = DSM 115698T = CCUG 76533T=NR-58628T) for three of the newly identified genomic taxa.
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Affiliation(s)
- Brian I Choi
- Loyola University Chicago, Department of Microbiology & Immunology, Maywood IL, USA
| | - Adriana Ene
- Loyola University Chicago, Bioinformatics Program, Chicago IL, USA
| | - Jingjie Du
- Loyola University Chicago, Department of Microbiology & Immunology, Maywood IL, USA
| | | | - Catherine Putonti
- Loyola University Chicago, Department of Microbiology & Immunology, Maywood IL, USA
- Loyola University Chicago, Bioinformatics Program, Chicago IL, USA
- Loyola University Chicago, Department of Biology, Chicago IL, USA
| | - Christian H Schouw
- The Regional Department of Clinical Microbiology, Region Zealand, Denmark
| | - Rimtas Dargis
- The Regional Department of Clinical Microbiology, Region Zealand, Denmark
| | - Erik Senneby
- Lund University, Clinical Microbiology, Department of Translational Medicine, Lund, Sweden
| | - Jens J Christensen
- The Regional Department of Clinical Microbiology, Region Zealand, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Alan J Wolfe
- Loyola University Chicago, Department of Microbiology & Immunology, Maywood IL, USA
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Yee AC, Wong TTJ. Aero to the heart: A case of aortic valve endocarditis caused by Aerococcus Urinae in an elderly woman. IDCases 2023; 32:e01769. [PMID: 37128511 PMCID: PMC10148111 DOI: 10.1016/j.idcr.2023.e01769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 04/14/2023] [Accepted: 04/17/2023] [Indexed: 05/03/2023] Open
Abstract
Aerococcus urinae (A. urinae) is an infrequent cause of infective endocarditis (IE) and few cases have been reported especially in older women. As of this publication, there are 31 reported cases of IE caused by aerococcus urinae, and of these, 4 are of women, 3 of which are aged > 75 years. Here, we describe a case of A. urinae endocarditis in an 80-year-old woman presenting with worsening fatigue. A diagnosis of native aortic valve endocarditis was established based on characteristic findings of aortic valvular vegetation on transesophageal echocardiogram along with isolation of A. urinae on blood cultures.
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Affiliation(s)
- Aaron C. Yee
- Correspondence to: 506 6th St, Brooklyn, NY 11215, USA.
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Zhang Y, Yang H, Huang R, Wang X, Ma C, Zhang F. Effects of Lactiplantibacillus plantarum and Lactiplantibacillus brevis on fermentation, aerobic stability, and the bacterial community of paper mulberry silage. Front Microbiol 2022; 13:1063914. [PMID: 36483209 PMCID: PMC9722757 DOI: 10.3389/fmicb.2022.1063914] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 11/07/2022] [Indexed: 02/03/2024] Open
Abstract
The present study investigated the dynamic profiles of fermentation quality, aerobic stability, and the bacterial community of paper mulberry silage inoculants without (Control) or with Lactiplantibacillus plantarum (LP), Lactiplantibacillus brevis (LB), or their combination (LPLB), which was screened from naturally fermented paper mulberry. The results showed that the inoculated treatments had significantly reduced neutral detergent fiber, water-soluble carbohydrates, and ammoniacal nitrogen contents compared with the control after 60 days of ensiling (the decreased proportion of LP, LB, and LPLB treatments ranged from 7.33%-11.23%, 9.60%-21.44%, and 21.53%-29.23%, respectively, p < 0.05). The pH value of the LP and LB treatments was significantly lower than that of the control after 60 days of ensiling (4.42 and 4.56 vs. 4.71, p < 0.05). The LP treatment promoted lactic acid accumulation and LAB number compared with the control (66.59% vs. 54.12% and 8.71 log10 CFU/g vs. 8.52 log10 CFU/g, respectively, p < 0.05), and the LB and LPLB treatments inhibited the growth of yeast and mold after 14 days of fermentation. After 5 days of aerobic exposure, both the LB and LPLB treatments increased the aerobic stability time and acetic acid content (from 29 to 75 h and 16.14%-48.72%, respectively, p < 0.05), inhibited the growth of yeast and mold, and did not detect butyric acid. Additionally, the bacteria community of each treatment was dominated by Aerococcus on day 3 of ensilage (accounting for 54.36%-69.31%), while the inoculated treatments reduced the abundance of Aerococcus on day 60 (from 59.73% to 85.16%, p < 0.05), and Lactobacillus became the dominant genus (accounting for 54.57%-70.89%). Inoculation of L. plantarum effectively maintained the acidic environment at the end of the fermentation system by maintaining the abundance of Lactobacillus, maximizing the preservation of dry matter and protein, and reducing protein corruption. Inoculation of L. brevis alone or in combination with L. plantarum significantly inhibited the growth of mold and improved the aerobic stability of paper mulberry silage.
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Affiliation(s)
- Yulin Zhang
- Grass Land Science, College of Animal Science and Technology, Shihezi University, Shihezi, China
- Grass Land Science, College of Animal Science and Technology, Tarim University, Alar, China
| | - Hanjun Yang
- Grass Land Science, College of Animal Science and Technology, Shihezi University, Shihezi, China
| | - Rongzheng Huang
- Grass Land Science, College of Animal Science and Technology, Shihezi University, Shihezi, China
| | - Xuzhe Wang
- Grass Land Science, College of Animal Science and Technology, Shihezi University, Shihezi, China
| | - Chunhui Ma
- Grass Land Science, College of Animal Science and Technology, Shihezi University, Shihezi, China
| | - Fanfan Zhang
- Grass Land Science, College of Animal Science and Technology, Shihezi University, Shihezi, China
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Tiong CW, Bartolo C, Walton A, Athan E. Aerococcus urinae, a rare cause of aortic root abscess: a case report. J Med Case Rep 2022; 16:438. [PMCID: PMC9670598 DOI: 10.1186/s13256-022-03564-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 08/10/2022] [Indexed: 11/19/2022] Open
Abstract
Background Aerococcus urinae is a bacterium of emerging clinical interest that most commonly causes urinary tract infections (UTI) but can also result in invasive infections. It is a catalase-negative, alpha-haemolytic gram-positive coccus that grows in clusters or tetrads and usually causes urinary tract infections. While rare, infective endocarditis must be considered when A. urinae is isolated in blood culture. The mortality rate of A. urinae infective endocarditis is similar to overall endocarditis mortality. We report a rare case of aortic root abscess caused by A. urinae. Case presentation An 82-year-old Caucasian man presented to hospital with behavioural change and severe malnutrition and was managed for psychotic depression. On day 34 of his inpatient stay, a febrile episode prompted blood cultures, which grew Aerococcus. urinae. Investigations revealed a bicuspid aortic valve, aortic valve endocarditis and aortic root abscess. He also had prostatomegaly. He underwent aortic valve replacement, received 6 weeks of intravenous ceftriaxone and recovered. Conclusion Infective endocarditis should be considered in patients with persistent Aerococcus urinae bacteraemia. Accurate identification with mass spectrometry is recommended to avoid misidentification as staphylococcus, streptococcus or enterococcus, which is a possibility with conventional laboratory methods.
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Affiliation(s)
- Chong Wei Tiong
- grid.414257.10000 0004 0540 0062Department of General Medicine, Barwon Health, Geelong, VIC Australia
| | - Caroline Bartolo
- grid.414257.10000 0004 0540 0062Department of Infectious Diseases, Barwon Health, Geelong, VIC Australia
| | - Aaron Walton
- grid.414257.10000 0004 0540 0062Department of General Medicine, Barwon Health, Geelong, VIC Australia ,grid.414257.10000 0004 0540 0062Department of Infectious Diseases, Barwon Health, Geelong, VIC Australia
| | - Eugene Athan
- grid.414257.10000 0004 0540 0062Department of Infectious Diseases, Barwon Health, Geelong, VIC Australia ,grid.1021.20000 0001 0526 7079Deakin University, Melbourne, VIC Australia
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Rasmussen M, Sunnerhagen T. Get the Species Right: Aerococcus viridans is Likely not Responsible. Indian J Crit Care Med 2022; 26:1158. [PMID: 36876206 PMCID: PMC9983669 DOI: 10.5005/jp-journals-10071-24330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 07/12/2022] [Indexed: 11/23/2022] Open
Abstract
How to cite this article: Rasmussen M, Sunnerhagen T. Get the Species Right: Aerococcus viridans is Likely not Responsible. Indian J Crit Care Med 2022;26(10):1158.
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Affiliation(s)
- Magnus Rasmussen
- Department of Clinical Sciences, Division of Infection Medicine, Faculty of Medicine, Lund University; Skåne University Hospital, Lund, Sweden
| | - Torgny Sunnerhagen
- Department of Clinical Sciences, Division of Infection Medicine, Faculty of Medicine, Lund University, Sweden; Clinical Microbiology and Disease Control, Region Skåne, Lund, Sweden; Department of Clinical Microbiology, Rigshospitalet - Copenhagen University Hospital, Copenhagen, Denmark
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Schilder Y, Manders I, Tukkie R, Soetekouw R. A rare case of native tricuspid valve endocarditis caused by Aerococcus sanguinicola. CLINICAL INFECTION IN PRACTICE 2022. [DOI: 10.1016/j.clinpr.2022.100156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Scholtz SL, Faron ML, Buchan BW, Ledeboer NA. Comparison of Methods for Determining the Antibiotic Susceptibility of Aerococcus Species in a Clinical Setting. Am J Clin Pathol 2022; 157:781-788. [PMID: 34893797 DOI: 10.1093/ajcp/aqab195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 10/21/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Aerococcus spp are Gram-positive cocci increasingly recognized as uropathogens. The Clinical and Laboratory Standards Institute recently published specific breakpoints for Aerococcus spp (M45, third edition); however, the standardized method used for antimicrobial susceptibility testing (AST) requires media not often maintained in clinical laboratories. The purpose of this study was to evaluate and compare alternative methods of AST for Aerococcus isolates. METHODS AST was performed on 134 clinical isolates using the Etest on three different types of agar, Vitek 2, and BD Phoenix. These results were compared with broth microdilution using the Sensititre STP6F. RESULTS Aerococcus exhibited low minimum inhibitory concentrations to benzylpenicillin, meropenem, linezolid, and vancomycin. Variable resistance was seen to levofloxacin, ceftriaxone, and tetracycline. Meropenem and vancomycin met all acceptance criteria with every alternative method tested. Benzylpenicillin and linezolid did not meet essential agreement on any AST method. Tetracycline met the majority of acceptance criteria with the exception of more than 3% very major error when using the Etest on chocolate agar, the Vitek 2, and BD Phoenix. CONCLUSIONS Overall, the alternate AST method with the highest agreement with broth microdilution was the Etest on Mueller-Hinton agar with 5% sheep blood and may be an optimal alternative to broth microdilution.
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Affiliation(s)
| | | | - Blake W Buchan
- Medical College of Wisconsin, Milwaukee, WI, USA
- Wisconsin Diagnostic Laboratories, Milwaukee, WI, USA
| | - Nathan A Ledeboer
- Medical College of Wisconsin, Milwaukee, WI, USA
- Wisconsin Diagnostic Laboratories, Milwaukee, WI, USA
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Identification of an Aerococcus urinaeequi isolate by Whole Genome Sequencing and Average Nucleotide Identity analysis. J Glob Antimicrob Resist 2022; 29:353-359. [PMID: 35477007 DOI: 10.1016/j.jgar.2022.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 02/12/2022] [Accepted: 04/12/2022] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES Identification and classification of microorganisms is one of the most important but difficult and challenging issues in microbiology. Whole genome sequencing (WGS), which can give a thorough understanding for the genome of bacteria strain, has been universally used for studying bacterial classification, evolution, and drug-related resistant genes. We in this study aimed to identify a gram-positive, microaerophilic, catalase-negative cocci strain named AV208, which has shown resistance to vancomycin, by whole genome's average nucleotide identity (ANI) and high-throughput sequencing technology. METHODS The AV208 strain was identified by following commercially available identification systems, including API 20 Strep system and Vitek 2 Compact gram-positive identification system for biochemical phenotypic test. Matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF-MS) and 16S rRNA gene sequencing were used for confirmation identification. The whole genome of AV208 was sequenced by using high throughput sequencing technology and ANI between AV208, and its phylogenetic neighbors were analyzed by the Orthologous Average Nucleotide Identity Tool (OAT) software. Polymerase chain reaction (PCR) and DNA sequencing were used to investigate the potential molecular mechanism for vancomycin resistance. RESULTS The AV208 strain was isolated from an ascites sample from a patient with chronic kidney disease who showed extensive resistance to the drugs detected, such as vancomycin with MIC > 256 μg/ml. With combination of biochemical phenotypic test, MALDI-TOF-MS and 16S rRNA gene sequencing, the AV208 strain was tentatively identified as an Aercoccus viridans. By using complete genome sequence, we found a 96.24% ANI between strain AV208 and Aerococcus urinaeequi CCUG 28094T, which was higher than that with A. viridans CCUG4311T (94.9%). The consistency of 16S rRNA sequence of strain AV208 was 100% with A. urinaeequi CCUG 28094T and 99.9% with A. viridans CCUG4311T, with only one base difference between them. PCR and sequencing for van genes revealed that AV208 was positive for the vanA gene. A Tn1546 transposon-like structure with vanA gene was found in the genome, which was predicted locating in plasmid, causing vancomycin resistance phenotypes. CONCLUSIONS Average nucleotide identity analysis based on whole genome sequence is an accurate and effective method for identification of bacteria, especially for strains that are not discernible by existing methods such as Aerococcus.
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Feghaly J, Rivas Rios J, Ravi M, Sattiraju S, Missov E. Aerococcus urinae Infective Endocarditis. Cureus 2022; 14:e23947. [PMID: 35547451 PMCID: PMC9085717 DOI: 10.7759/cureus.23947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 04/07/2022] [Indexed: 11/18/2022] Open
Abstract
Aerococcus urinae is a gram-positive organism frequently found in the urinary tract. It is often mistaken for Streptococcus and Enterococcus based on its appearance. It commonly causes urinary tract infections but has rarely been associated with fatal infective endocarditis and sepsis. We present a case of Aerococcus urinae infective endocarditis and discuss echocardiographic imaging findings and management approach.
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Affiliation(s)
- Julien Feghaly
- Cardiology, University of Florida College of Medicine - Jacksonville, Jacksonville, USA
| | - Jose Rivas Rios
- Cardiology, University of Florida College of Medicine - Jacksonville, Jacksonville, USA
| | - Malleswari Ravi
- Infectious Disease, University of Florida College of Medicine - Jacksonville, Jacksonville, USA
| | - Srinivasan Sattiraju
- Cardiology, University of Florida College of Medicine - Jacksonville, Jacksonville, USA
| | - Emil Missov
- Cardiology, University of Florida College of Medicine - Jacksonville, Jacksonville, USA
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14
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Otero-Colón J, Farraj KL, Desai Z. An Uncommon Cause of Urinary Tract Infections: A Case Report. Cureus 2022; 14:e23325. [PMID: 35464535 PMCID: PMC9015076 DOI: 10.7759/cureus.23325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2022] [Indexed: 11/12/2022] Open
Abstract
Urinary tract infections (UTI) in the elderly are common. UTI ranges in severity from mild disease to severe sepsis. Many organisms can cause UTIs yet many UTIs are caused by the same few organisms. An organism that has been increasingly gaining notoriety for infections is Aerococcus urinae. Aerococcus infections are constantly misdiagnosed due to their difficulty to identify. Here we present a case of an elderly male who was found to have a urinary tract infection with Aerococcus urinaethat progressed into bacteremia, severe sepsis and ultimately death.
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15
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Rosales-Castillo A, Jiménez-Guerra G, Ruiz-Gómez L, Expósito-Ruíz M, Navarro-Marí JM, Gutiérrez-Fernández J. Emerging Presence of Culturable Microorganisms in Clinical Samples of the Genitourinary System: Systematic Review and Experience in Specialized Care of a Regional Hospital. J Clin Med 2022; 11:jcm11051348. [PMID: 35268439 PMCID: PMC8911399 DOI: 10.3390/jcm11051348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 02/24/2022] [Accepted: 02/26/2022] [Indexed: 11/16/2022] Open
Abstract
The detection of emerging pathogens responsible for genitourinary infections has increased with technological advances. We conducted a systematic review of publications on the involvement of these microorganisms in genitourinary samples, and we also investigated their presence and antibiotic susceptibility in samples from patients at our regional hospital (Granada, Spain). The MEDLINE database was searched up to 31 December 2020, and a cross-sectional descriptive study was performed of results obtained in urine samples and genital exudates from January 2016 through December 2019. The review highlighted the frequent involvement of Neisseria meningitidis in genital infections, while the data on other microorganisms were consistent with findings in our patient series. The emerging microorganisms most often responsible for urinary tract infections were Streptococcus bovis (58.5%) and Gardnerella vaginalis (23.6%) in females, and S. bovis (32.3%), Aerococcus urinae (18.6%), and Corynebacterium spp. (16.9%) in males; those most frequently reported in genital infections were S. viridans (36.4%) in females and C. glucuronolyticum (32.2%) and G. vaginalis (35.6%) in males. In general, emerging pathogens are resistant to conventional antibiotics such as penicillin. However, there has also been an increase in beta-lactam resistance by the S. bovis group and Corynebacterium spp. The systematic review showed that emerging microorganisms are responsible for only a small percentage of genitourinary infections but are of major clinical interest, with a predominance of the S. bovis group, G. vaginalis, Lactobacillus spp., Aerococcus spp., and Corynebacterium spp. in urine samples and of G. vaginalis and C. glucuronolyticum in genital samples. Given the increasing resistance to antibiotics empirically prescribed in patients with genitourinary infections, it is recommended to create an antibiogram in all cases.
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Affiliation(s)
- Antonio Rosales-Castillo
- Servicio de Medicina Interna, Virgen de las Nieves University Hospital & Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Avenida de las Fuerzas Armadas 2, 18014 Granada, Spain;
- Program in Clinical Medicine and Public Health, University of Granada & Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), 18016 Granada, Spain
| | - Gemma Jiménez-Guerra
- Laboratory of Microbiology, Virgen de las Nieves University Hospital & Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Avenida de las Fuerzas Armadas 2, 18014 Granada, Spain; (G.J.-G.); (J.M.N.-M.)
| | - Lara Ruiz-Gómez
- Department of Microbiology, School of Medicine, University of Granada & Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Avenida de la Investigación 11, 18016 Granada, Spain;
| | - Manuela Expósito-Ruíz
- Unit of Biostatistics, Department of Statistics, School of Medicine, University of Granada, 18016 Granada, Spain;
| | - José María Navarro-Marí
- Laboratory of Microbiology, Virgen de las Nieves University Hospital & Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Avenida de las Fuerzas Armadas 2, 18014 Granada, Spain; (G.J.-G.); (J.M.N.-M.)
| | - José Gutiérrez-Fernández
- Program in Clinical Medicine and Public Health, University of Granada & Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), 18016 Granada, Spain
- Laboratory of Microbiology, Virgen de las Nieves University Hospital & Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Avenida de las Fuerzas Armadas 2, 18014 Granada, Spain; (G.J.-G.); (J.M.N.-M.)
- Department of Microbiology, School of Medicine, University of Granada & Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Avenida de la Investigación 11, 18016 Granada, Spain;
- Correspondence:
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16
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Varshini K, Ganesan V, Charles J. Aerococcus viridans Bacteremia: A Rare Case Report from India. Indian J Crit Care Med 2022; 26:127-128. [PMID: 35110856 PMCID: PMC8783239 DOI: 10.5005/jp-journals-10071-24072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aerococci are fastidious, gram-positive Streptococcus-like organisms widely distributed in the hospital environment. Aerococcus viridans is primarily an opportunistic pathogen. Very few cases of A. viridans bacteremia have been reported so far probably because of its misidentification as streptococci. Here we report an interesting case of A. viridans bacteremia. How to cite this article: Varshini K, Ganesan V, Charles J. Aerococcus viridans Bacteremia: A Rare Case Report from India. Indian J Crit Care Med 2022;26(1):127–128.
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Affiliation(s)
- Krithika Varshini
- Department of Microbiology, Velammal Medical College Hospital and Research Institute, Madurai, Tamil Nadu, India
- Krithika Varshini, Department of Microbiology, Velammal Medical College Hospital and Research Institute, Madurai, Tamil Nadu, India, Phone: +91 7708643134, e-mail:
| | - Vithiya Ganesan
- Department of Microbiology, Velammal Medical College Hospital and Research Institute, Madurai, Tamil Nadu, India
| | - Jhansi Charles
- Department of Microbiology, Velammal Medical College Hospital and Research Institute, Madurai, Tamil Nadu, India
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17
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Crippen TL, Singh B, Anderson RC, Sheffield CL. Adult Alphitobius diaperinus Microbial Community during Broiler Production and in Spent Litter after Stockpiling. Microorganisms 2022; 10:microorganisms10010175. [PMID: 35056628 PMCID: PMC8778262 DOI: 10.3390/microorganisms10010175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 01/03/2022] [Accepted: 01/05/2022] [Indexed: 12/10/2022] Open
Abstract
The facilities used to raise broiler chickens are often infested with litter beetles (lesser mealworm, Alphitobius diaperinus). These beetles have been studied for their carriage of pathogenic microbes; however, a more comprehensive microbiome study on these arthropods is lacking. This study investigated their microbial community in a longitudinal study throughout 2.5 years of poultry production and after the spent litter, containing the mealworms, was piled in pastureland for use as fertilizer. The mean most abundant phyla harbored by the beetles in house were the Proteobacteria (39.8%), then Firmicutes (30.8%), Actinobacteria (21.1%), Tenericutes (5.1%), and Bacteroidetes (1.6%). The community showed a modest decrease in Firmicutes and increase in Proteobacteria over successive flock rotations. The beetles were relocated within the spent litter to pastureland, where they were found at least 19 weeks later. Over time in the pastureland, their microbial profile underwent a large decrease in the percent of Firmicutes (20.5%). The lesser mealworm showed an ability to survive long-term in the open environment within the spent litter, where their microbiome should be further assessed to both reduce the risk of transferring harmful bacteria, as well as to enhance their contribution when the litter is used as a fertilizer.
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Affiliation(s)
- Tawni L. Crippen
- Southern Plains Agricultural Research Center, Agricultural Research Service, United States Department of Agriculture, College Station, TX 77845, USA; (R.C.A.); (C.L.S.)
- Correspondence:
| | - Baneshwar Singh
- Department of Forensic Science, Virginia Commonwealth University, Richmond, VA 23298, USA;
| | - Robin C. Anderson
- Southern Plains Agricultural Research Center, Agricultural Research Service, United States Department of Agriculture, College Station, TX 77845, USA; (R.C.A.); (C.L.S.)
| | - Cynthia L. Sheffield
- Southern Plains Agricultural Research Center, Agricultural Research Service, United States Department of Agriculture, College Station, TX 77845, USA; (R.C.A.); (C.L.S.)
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18
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Aragão BB, Trajano SC, de Oliveira RP, Sobral da Silva DM, de Carvalho RG, Juliano MA, Pinheiro Junior JW, Mota RA. Multiresistant zoonotic pathogens isolated from goat milk in Northeastern Brazil. Comp Immunol Microbiol Infect Dis 2021; 79:101701. [PMID: 34455153 DOI: 10.1016/j.cimid.2021.101701] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 08/23/2021] [Indexed: 12/29/2022]
Abstract
Dairy goats play a significant role in socio-economic, cultural, and nutritional development in many countries. This study aimed to identify multiresistant zoonotic pathogens causing mastitis in goats, in addition to characterizing them for the presence of resistance genes and phenotypic resistance. A total of 714 milk samples from 357 lactating goats in 12 farms in the Northeast region of Brazil were analyzed. The isolates were submitted to Matrix Associated Laser Desorption-Ionization - Time of Flight to identify bacterial species, Polymerase Chain Reaction (PCR) to search for resistance genes, and an antibiogram to evaluate the phenotypic profile of antimicrobial resistance. A total of 214 pathogens were identified and bacterial prevalence was 83.29 % (178/214) Staphylococcus spp.; 6.50 % (14/214) Micrococcus luteus; 3.73 % (8/214) Corynebacterium spp.; 2.80 % (6/214) Bacillus spp.; 1.38 % (3/214) Escherichia coli; 0.92 % (2/214) Enterobacter cloacae; 0.46 % (1/214) Aerococcus viridans; 0.46 % (1/214) Morganella morganii; and 0.46 % (1/214) Turicella otitidis. As for gene frequency, 64.60 % (115/178) of the isolates carried the blaZ gene; 37.07 % (66/178) norA; 22.47 % (40/178) tet(L); 16.85 % (30/178) tet(M); 14.04 % (25/178) norB; 8.42 % (15/178) vanA; 7.30 % (13/178) msrA; 6.41 % (5/178) tet-38; 4.49 % (8/178) norC; 2.25 % (4/178) mecA; and 0.56 % (1/178) vanB. Emerging multiresistant zoonotic pathogens are present in the goat milk production chain, especially the coagulase-negative Staphylococcus species that pose a risk to human and animal health.
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Affiliation(s)
- Breno Bezerra Aragão
- Federal Rural University of Pernambuco - UFRPE, Department of Veterinary Medicine - R. Manuel de Medeiros, s/n - Dois Irmãos, CEP. 52171-900, Recife, PE, Brazil.
| | - Sabrina Cândido Trajano
- Federal Rural University of Pernambuco - UFRPE, Department of Veterinary Medicine - R. Manuel de Medeiros, s/n - Dois Irmãos, CEP. 52171-900, Recife, PE, Brazil
| | - Raylson Pereira de Oliveira
- Federal Rural University of Pernambuco - UFRPE, Department of Veterinary Medicine - R. Manuel de Medeiros, s/n - Dois Irmãos, CEP. 52171-900, Recife, PE, Brazil
| | - Débora Mirelly Sobral da Silva
- Federal Rural University of Pernambuco - UFRPE, Department of Veterinary Medicine - R. Manuel de Medeiros, s/n - Dois Irmãos, CEP. 52171-900, Recife, PE, Brazil
| | - Rafaella Grenfell de Carvalho
- Federal University of São Paulo - UNIFESP, Institute of Pharmacology and Molecular Biology, Rua Três de Maio, 100 - Vila Clementino, CEP. 04044-020, São Paulo, SP, Brazil
| | - Maria Aparecida Juliano
- Federal University of São Paulo - UNIFESP, Institute of Pharmacology and Molecular Biology, Rua Três de Maio, 100 - Vila Clementino, CEP. 04044-020, São Paulo, SP, Brazil
| | - José Wilton Pinheiro Junior
- Federal Rural University of Pernambuco - UFRPE, Department of Veterinary Medicine - R. Manuel de Medeiros, s/n - Dois Irmãos, CEP. 52171-900, Recife, PE, Brazil
| | - Rinaldo Aparecido Mota
- Federal Rural University of Pernambuco - UFRPE, Department of Veterinary Medicine - R. Manuel de Medeiros, s/n - Dois Irmãos, CEP. 52171-900, Recife, PE, Brazil
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19
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Ahmed Y, Bardia N, Judge C, Ahmad S, Malozzi C, Calderon E. Aerococcus urinae: A Rare Cause of Endocarditis Presenting With Acute Stroke. J Med Cases 2021; 12:65-70. [PMID: 34434432 PMCID: PMC8383606 DOI: 10.14740/jmc3612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 11/25/2020] [Indexed: 11/11/2022] Open
Abstract
Aerococcus urinae is a rare organism infrequently isolated from cultures. Mostly known to cause urinary tract infection, it can cause bacteremia leading to severe urosepsis and infective endocarditis. Embolization is frequently reported with Aerococcus urinae endocarditis (AUE); hence, the presentation is highly variable. Sequelae such as various central nervous system manifestations, sepsis, valvular regurgitation with heart failure and even coronary artery involvement have been reported. We report a case of a 58-year-old man with AUE of the aortic valve, severe aortic regurgitation and embolic stroke as a result of embolization from AUE and ultimately required aortic valve replacement. Our case highlights this rare cause of endocarditis and offers insight into the variability of patient presentation and risk factors to consider.
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Affiliation(s)
- Yasir Ahmed
- Department of Internal Medicine, University of South Alabama, Mobile, AL, USA
| | - Nikky Bardia
- Department of Internal Medicine, University of South Alabama, Mobile, AL, USA
| | - Caleb Judge
- Department of Internal Medicine, University of South Alabama, Mobile, AL, USA
| | - Sajjad Ahmad
- Department of Cardiology, University of South Alabama, Mobile, AL, USA
| | | | - Eduardo Calderon
- Department of Infectious Diseases, University of South Alabama, Mobile, AL, USA
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20
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Gilbert NM, Choi B, Du J, Collins C, Lewis AL, Putonti C, Wolfe AJ. A mouse model displays host and bacterial strain differences in Aerococcus urinae urinary tract infection. Biol Open 2021; 10:271827. [PMID: 34387311 PMCID: PMC8380466 DOI: 10.1242/bio.058931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 07/15/2021] [Indexed: 11/30/2022] Open
Abstract
In recent years, the clinical significance of Aerococcus urinae has been increasingly recognized. A. urinae has been implicated in cases of urinary tract infection (UTI; acute cystitis and pyelonephritis) in both male and female patients, ranging from children to older adults. Aerococcus urinae can also be invasive, causing urosepsis, endocarditis, and musculoskeletal infections. Mechanisms of pathogenesis in A. urinae infections are poorly understood, largely due to the lack of an animal model system. In response to this gap, we developed a model of A. urinae urinary tract infection in mice. We compared A. urinae UTI in female C3H/HeN and C57BL/6 mice and compared four clinical isolates of A. urinae isolated from patients with UTI, urgency urinary incontinence, and overactive bladder. Our data demonstrate that host genetic background modulates A. urinae UTI. Female C57BL/6 female mice rapidly cleared the infection. Female C3H/HeN mice, which have inherent vesicoureteral reflux that flushes urine from the bladder up into the kidneys, were susceptible to prolonged bacteriuria. This result is consistent with the fact that A. urinae infections most frequently occur in patients with underlying urinary tract abnormalities or disorders that make them susceptible to bacterial infection. Unlike uropathogens such as E. coli, which cause infection and inflammation both of the bladder and kidneys in C3H/HeN mice, A. urinae displayed tropism for the kidney, persisting in kidney tissue even after clearance of bacteria from the bladder. Aerococcus urinae strains from different genetic clades displayed varying propensities to cause persistent kidney infection. Aerococcus urinae infected kidneys displayed histological inflammation, neutrophil recruitment and increased pro-inflammatory cytokines. These results set the stage for future research that interrogates host-pathogen interactions between A. urinae and the urinary tract. Summary:Aerococcus urinae clinical isolates are genetically diverse and display differential capacity to cause UTI in a mouse model. Infection was rapidly cleared from the bladder, but persisted and caused inflammation in the kidney.
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Affiliation(s)
- Nicole M Gilbert
- Department of Pediatrics, Division of Infectious Diseases, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Brian Choi
- Department of Microbiology and Immunology, Stritch School of Medicine, Loyola University Chicago, Maywood, IL 60153, USA
| | - Jingjie Du
- Department of Microbiology and Immunology, Stritch School of Medicine, Loyola University Chicago, Maywood, IL 60153, USA
| | - Christina Collins
- Department of Pediatrics, Division of Infectious Diseases, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Amanda L Lewis
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Diego School of Medicine, La Jolla, CA 92093, USA
| | - Catherine Putonti
- Bioinformatics Program, Loyola University Chicago, Chicago, IL 60660, USA.,Department of Biology, Loyola University Chicago, Chicago, IL 60660, USA
| | - Alan J Wolfe
- Department of Microbiology and Immunology, Stritch School of Medicine, Loyola University Chicago, Maywood, IL 60153, USA
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21
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Yonetani S, Hirao C, Ohnishi H. Background of patients with Aerococcus spp. detected in blood cultures, and drug sensitivity of Aerococcus spp. Diagn Microbiol Infect Dis 2021; 101:115506. [PMID: 34391074 DOI: 10.1016/j.diagmicrobio.2021.115506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 07/03/2021] [Accepted: 07/18/2021] [Indexed: 10/20/2022]
Abstract
This study aimed to review the clinical characteristics of patients with Aerococcus spp. detected by blood culture, and drug susceptibility of Aerococcus spp. All cases of Aerococcus spp. determined using blood culture between June 2013 and May 2020 in a single institution were included; patient information (age, sex, comorbidities, outcome, diagnosis, antimicrobial agents) was analyzed. The cohort comprised 25 patients (18 [72%] men and 7 [28%] women; median age, 84.5 [range, 75-87] years). Thirteen (52%) patients had urinary tract infections(UTI) caused by Aerococcus spp. All patients had a favorable prognosis, except 1 who died owing to infective endocarditis. Drug susceptibility testing showed that most isolates were susceptible to β-lactams except 1. However, 24 (96%) cases were resistant to trimethoprim-sulfamethoxazole and 10 (40%) to quinolones. Aerococcus spp. are important causative agents of bacteremia and UTI. The increasing reports of Aerococcus spp. infections could lead to better treatment schemes and facilitate diagnosis.
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Affiliation(s)
- Shota Yonetani
- Department of Medical Technology faculty of Health Sciences, Kyorin University, Tokyo, Japan; Department of Clinical Laboratory, Kyorin University School of Medicine, Tokyo, Japan.
| | - Chihiro Hirao
- Department of Clinical Laboratory, Kyorin University School of Medicine, Tokyo, Japan
| | - Hiroaki Ohnishi
- Department of Clinical Laboratory, Kyorin University School of Medicine, Tokyo, Japan; Department of Laboratory Medicine, Kyorin University School of Medicine, Tokyo, Japan
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22
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Khan M, Gill H, Khan M, Saravanan V, Jha P. Urine My Heart: A Case of Aerococcal Endocarditis. Cureus 2021; 13:e14593. [PMID: 34036011 PMCID: PMC8136881 DOI: 10.7759/cureus.14593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
An elderly woman with previously known valvular disease presented to the emergency department due to altered mental status. In addition to obtaining an infectious work-up, a bedside echocardiogram was performed and revealed right heart strain prompting a formal echocardiogram evaluation and treatment for a possible pulmonary embolism. Initial laboratory work returned with blood and urine cultures positive for Aerococcus urinae. A transthoracic echocardiogram further revealed new aortic regurgitation. Given this, a transesophageal echocardiogram was completed, confirming new aortic insufficiency as well as findings of infective endocarditis. She did not undergo surgical intervention; however, she was discharged with a plan to continue intravenous antibiotics for six weeks. Although typically seen in genitourinary infections, A. urinae is a rare cause of infective endocarditis and is increasingly identified due to improved speciation techniques. We describe a unique presentation of invasive A. urinae infection to increase awareness and further research on a less commonly encountered bacteria that may present as a urinary tract infection and has the potential to cause invasive disease.
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Affiliation(s)
- Marium Khan
- Internal Medicine, Medical College of Wisconsin, Milwaukee, USA
| | - Harpreet Gill
- Internal Medicine, Medical College of Wisconsin, Milwaukee, USA
| | - Mudassir Khan
- Revenue Cycle, Providence St. Joseph Health, Tegria Consulting, Renton, USA
| | | | - Pinky Jha
- Internal Medicine, Medical College of Wisconsin, Milwaukee, USA
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23
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Santos-Veloso MAO, Barros MDNDDS, Carvalho MH, Barbosa DADCK, Rodrigues JV. Aerococcus spp infective endocarditis following a prostate biopsy: a case report. Rev Inst Med Trop Sao Paulo 2021; 63:e18. [PMID: 33787738 PMCID: PMC7997663 DOI: 10.1590/s1678-9946202163018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 02/23/2021] [Indexed: 11/21/2022] Open
Abstract
We report a rare case of an infective endocarditis by Aerococcus
spp in a bioprosthetic aortic valve following a prostate biopsy, in an
asymptomatic adult with no additional risk factor for prostate cancer, excepting
for age. The diagnosis was based on the presence of vegetations on the
bioprosthesis seen on the echocardiogram, positive blood cultures and fever, and
a favorable clinical outcome following the treatment with ceftriaxone and
gentamicin.
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Affiliation(s)
- Marcelo Antônio Oliveira Santos-Veloso
- Hospital dos Servidores do Estado, Serviço de Clínica Médica, Recife, Pernambuco, Brazil.,Universidade Federal de Pernambuco, Departamento de Biociências, Programa de Pós-Graduação em Inovação Terapêutica, Recife, Pernambuco, Brazil
| | | | - Marcos Holmes Carvalho
- Hospital dos Servidores do Estado, Serviço de Clínica Médica, Recife, Pernambuco, Brazil
| | | | - Jorge Vieira Rodrigues
- Hospital dos Servidores do Estado, Serviço de Cirurgia Torácica, Recife, Pernambuco, Brazil
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24
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Obradovic MR, Segura M, Segalés J, Gottschalk M. Review of the speculative role of co-infections in Streptococcus suis-associated diseases in pigs. Vet Res 2021; 52:49. [PMID: 33743838 PMCID: PMC7980725 DOI: 10.1186/s13567-021-00918-w] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 02/25/2021] [Indexed: 12/21/2022] Open
Abstract
Streptococcus suis is one of the most important bacterial swine pathogens affecting post-weaned piglets, causing mainly meningitis, arthritis and sudden death. It not only results in severe economic losses but also raises concerns over animal welfare and antimicrobial resistance and remains an important zoonotic agent in some countries. The definition and diagnosis of S. suis-associated diseases can be complex. Should S. suis be considered a primary or secondary pathogen? The situation is further complicated when referring to respiratory disease, since the pathogen has historically been considered as a secondary pathogen within the porcine respiratory disease complex (PRDC). Is S. suis a respiratory or strictly systemic pathogen? S. suis is a normal inhabitant of the upper respiratory tract, and the presence of potentially virulent strains alone does not guarantee the appearance of clinical signs. Within this unclear context, it has been largely proposed that co-infection with some viral and bacterial pathogens can significantly influence the severity of S. suis-associated diseases and may be the key to understanding how the infection behaves in the field. In this review, we critically addressed studies reporting an epidemiological link (mixed infections or presence of more than one pathogen at the same time), as well as in vitro and in vivo studies of co-infection of S. suis with other pathogens and discussed their limitations and possibilities for improvement and proposed recommendations for future studies.
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Affiliation(s)
- Milan R Obradovic
- Groupe de Recherche Sur Les Maladies Infectieuses en Production Animale (GREMIP), Centre de Recherche en Infectiologie Porcine et Aviaire (CRIPA), Faculty of Veterinary Medicine, University of Montreal, 3200 Sicotte, Saint-Hyacinthe, QC, J2S 2M2, Canada
| | - Mariela Segura
- Groupe de Recherche Sur Les Maladies Infectieuses en Production Animale (GREMIP), Centre de Recherche en Infectiologie Porcine et Aviaire (CRIPA), Faculty of Veterinary Medicine, University of Montreal, 3200 Sicotte, Saint-Hyacinthe, QC, J2S 2M2, Canada
| | - Joaquim Segalés
- UAB, CReSA (IRTA-UAB), Campus de la UAB, 08193, Bellaterra (Cerdanyola del Vallès), Spain.,Departament de Sanitat I Anatomia Animals, Facultat de Veterinària, UAB, 08193, Bellaterra (Cerdanyola del Vallès), Spain.,OIE Collaborating Centre for the Research and Control of Emerging and Re-Emerging Swine Diseases in Europe (IRTA-CReSA), 08193, Bellaterra, Barcelona, Spain
| | - Marcelo Gottschalk
- Groupe de Recherche Sur Les Maladies Infectieuses en Production Animale (GREMIP), Centre de Recherche en Infectiologie Porcine et Aviaire (CRIPA), Faculty of Veterinary Medicine, University of Montreal, 3200 Sicotte, Saint-Hyacinthe, QC, J2S 2M2, Canada.
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25
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Smieško G, Banović P, Gusman V, Milosavljević B, Medić D, Bulajić T, Pejaković-Budinski M, Golocorbin-Kon S. What Is fishy in asymptomatic patients?: Co-occurrence of Aerococcus urinae infection in pediatric patient with phimosis. ACTA FACULTATIS MEDICAE NAISSENSIS 2021. [DOI: 10.5937/afmnai38-32051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Here we present the first case of Aerococcus urinae isolated from urine sample of a 5-year-old boy from Vojvodina province (Serbia). The patient had predisposing factors related to the susceptibility of genitourinary system to infection. Thus, he reported no complaints related to active urinary infections. Eradication of infection was achieved after 10-day treatment with meropenem. From this case, the question emerges: Is there a possibility that A. urinae infections are neglected in pediatric patients with susceptibility of genitourinary system to infection? Only after wide introduction of matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) in competent laboratories, we will be able to give a precise answer.
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Sahu KK, Lal A, Mishra AK, Abraham GM. Aerococcus-Related Infections and their Significance: A 9-Year Retrospective Study. J Microsc Ultrastruct 2020; 9:18-25. [PMID: 33850708 PMCID: PMC8030539 DOI: 10.4103/jmau.jmau_61_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 06/12/2020] [Accepted: 06/22/2020] [Indexed: 11/17/2022] Open
Abstract
Introduction: Aerococcus spp. is a Gram-positive, catalase- and oxidase-negative, microaerophilic, nonmotile bacteria species rarely associated with human infections such as arthritis, bacteremia, endocarditis, and meningitis. The bacteria are also often confused with streptococci species or treated as a contaminant. Patients and Methodology: We conducted a retrospective, observational cohort study on all patients with Aerococcus spp. isolates in blood samples from July 2010 to June 2019. All categorical data were presented as counts and proportions, whereas continuous data were presented as median and interquartile ranges. Results: A total of 20 Aerococcus spp. isolates were identified over the study period of 9 years. Of these, Aerococcus urinae was isolated in 10 (50%), Aerococcus viridans in 6 (30%), and Aerococcus spp. (not speciated) in 4 (20%). The median age was 74.3 years (12 males and 8 females). The two most frequent presentations were fever (15 of 20) and altered mentation (6 of 15). Most of the patients (11 of 15) had at least one predisposing comorbidity related to the urinary tract system (8 with recurrent urinary tract infection, 7 with urinary incontinence, 3 with an indwelling catheter, 2 with renal stones, and 1 each with benign prostatic hyperplasia and a recent cystoscopy). The median white blood cell count was 18,426 cells/mL, median hemoglobin 10.96 g/dL, median platelet count 191,000 cells/μL, median blood urea nitrogen 28.6 mg/dL, and median creatinine 1.54 mg/dL. The urinary tract was the most likely source of bacteremia (10 of 20) based on either imaging findings (5 cases), positive urine culture for Aerococcus spp. (4 cases), or instrumentation history (1 case). In the rest, the cause of bacteremia could not be found. Endocarditis was suspected in 9 out of 20 patients. Transthoracic echocardiography/transesophageal echocardiography (TEE) confirmed 3 cases (2 aortic valves, 1 mitral valve and pacemaker). Interestingly, one case had septic emboli causing a right frontal stroke with a normal TEE and normal Doppler study for deep venous thrombosis. Blood cultures were positive in 35% (7 of 20) with polymicrobial growth, 3 with coagulase-negative staphylococci, 2 with Enterococcus faecalis, and the other 2 each with Diphtheroids spp. and Proteus mirabilis. Of the 20 cases, 9 and 10 required intensive care unit level care and vasopressor support, respectively. Most of the patients were treated for 5–14 days except the 3 cases with infective endocarditis (IE). The median hospital stay duration was 6.55 days with 2 fatalities (2 out of 20 patients). Conclusion: Old age and underlying urologic conditions are the best-known risk factors for Aerococcus spp. infection. Recent advances in diagnostic technology have led to an increase in detection of Aerococcus spp.-related infections. The rare occurrence of Aerococcus spp. in human infections and resultant lack of randomized control trials have resulted in a significant degree of clinical uncertainty in the management of Aerococcus spp. IE.
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Affiliation(s)
- Kamal Kant Sahu
- Department of Internal Medicine, Saint Vincent Hospital, Worcester, Massachusetts, USA
| | - Amos Lal
- Department of Internal Medicine, Saint Vincent Hospital, Worcester, Massachusetts, USA
| | - Ajay Kumar Mishra
- Department of Internal Medicine, Saint Vincent Hospital, Worcester, Massachusetts, USA
| | - George M Abraham
- Department of Internal Medicine, Saint Vincent Hospital, Worcester, Massachusetts, USA
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Endocarditis infecciosa por Aerococcus urinae. Enferm Infecc Microbiol Clin 2020; 38:452-453. [DOI: 10.1016/j.eimc.2020.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 01/14/2020] [Accepted: 01/16/2020] [Indexed: 11/20/2022]
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Varughese R, Mathew A, Chadha R, Kostka J, Regelmann D. Prosthetic valve endocarditis caused by Aerococcus Urinae. IDCases 2020; 21:e00912. [PMID: 32884902 PMCID: PMC7452621 DOI: 10.1016/j.idcr.2020.e00912] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 07/12/2020] [Accepted: 07/12/2020] [Indexed: 11/18/2022] Open
Abstract
Infective endocarditis (IE) caused by Aerococcus urinae is rare. The true incidence rate of this pathogen is likely underestimated as this is easily misidentified as Staphylococci or Streptococci. It is also associated with increased risk of complications such as systemic emboli. Aerococcus usually affects elderly males with underlying urological conditions. Here we present a case of IE with this rare Aerococcus urinae in a young man with a bioprosthetic aortic valve, despite negative urine cultures.
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Affiliation(s)
- Reba Varughese
- Department of Internal Medicine, Quinnipiac University Frank H. Netter MD School of Medicine/St. Vincent’s Medical Center, Bridgeport, CT, USA
- Corresponding author.
| | - Achsah Mathew
- Pushpagiri Institute of Medical Sciences and Research Centre, Medicine, Tiruvalla, Kerala, India
| | - Rishi Chadha
- Department of Internal Medicine, Quinnipiac University Frank H. Netter MD School of Medicine/St. Vincent’s Medical Center, Bridgeport, CT, USA
| | - Julia Kostka
- Department of Internal Medicine, Quinnipiac University Frank H. Netter MD School of Medicine/St. Vincent’s Medical Center, Bridgeport, CT, USA
| | - David Regelmann
- Department of Internal Medicine, Quinnipiac University Frank H. Netter MD School of Medicine/St. Vincent’s Medical Center, Bridgeport, CT, USA
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Ishihara T, Watanabe N, Inoue S, Aoki H, Tsuji T, Yamamoto B, Yanagi H, Oki M, Kryukov K, Nakagawa S, Inokuchi S, Ozawa H, Imanishi T. Usefulness of next-generation DNA sequencing for the diagnosis of urinary tract infection. Drug Discov Ther 2020; 14:42-49. [PMID: 32101813 DOI: 10.5582/ddt.2020.01000] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Acute urinary tract infection (UTI) is a highly common clinical condition. Although bacterial culture is the gold standard diagnostic test, false negative results may be possible, leading to the pathogen being unidentified. In recent years, bacterial DNA sequencing analysis has garnered much attention, but clinical studies are rare in Japan. In this study, we assessed the usefulness of next-generation DNA sequencing (NGS) analysis for acute UTI patients. We thus performed an observational, retrospective case series study. Urine and blood samples were collected from ten acute UTI patients, of whom four had also been diagnosed with urosepsis. Seven variable regions of bacterial 16S rRNA genes were amplified by PCR and then sequenced by IonPGM. The identified bacterial species were compared with those identified using the culture tests and the clinical parameters were analyzed. As a result, the NGS method effectively identified predominant culture-positive bacteria in urine samples. The urine NGS also detected several culture-negative species, which have been reported to be potentially pathogenic. Out of four urosepsis cases, three were pathogen-positive in blood NGS results, while two were pathogen-negative in blood culture. In one sepsis case, although blood culture was negative for Escherichia coli, this species was detected by blood NGS. For non-sepsis cases, however, blood NGS, as well as blood culture, was less effective in detecting bacterial signals. In conclusion, NGS is potentially useful for identifying pathogenic bacteria in urine from acute UTI patients but is less applicable in patients who do not meet clinical criteria for sepsis.
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Affiliation(s)
- Toru Ishihara
- Department of General Internal Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Nobuo Watanabe
- Department of Emergency and Critical Care Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Shigeaki Inoue
- Department of Emergency and Critical Care Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Hiromichi Aoki
- Department of Emergency and Critical Care Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Tomoatsu Tsuji
- Department of Emergency and Critical Care Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Bunsei Yamamoto
- Department of Emergency and Critical Care Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Hidetaka Yanagi
- Department of General Internal Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Masayuki Oki
- Department of General Internal Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Kirill Kryukov
- Department of Molecular Life Science, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - So Nakagawa
- Department of Molecular Life Science, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Sadaki Inokuchi
- Department of Emergency and Critical Care Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Hideki Ozawa
- Department of General Internal Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Tadashi Imanishi
- Department of Molecular Life Science, Tokai University School of Medicine, Isehara, Kanagawa, Japan
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Sous N, Piwoz JA, Baer AZ, Bhavsar SM. Subacute Aerococcus urinae Infective Endocarditis With Mycotic Aneurysms in a Pediatric Patient: Case Report and Literature Review. J Pediatric Infect Dis Soc 2019; 8:492-494. [PMID: 30892601 DOI: 10.1093/jpids/piz016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 02/09/2019] [Indexed: 12/11/2022]
Abstract
Aerococcus urinae has been found to cause urinary tract infection in elderly patients and has been reported as a rare cause of infective endocarditis associated with significant morbidity and death in adults. However, information regarding its occurrence in children is lacking. We report here the case of a pediatric patient with subacute A urinae infective endocarditis with mycotic aneurysms.
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Affiliation(s)
- Natalie Sous
- Rutgers New Jersey Medical School, Medicine and Pediatrics, Newark, New Jersey
| | - Julia A Piwoz
- Joseph M. Sanzari Children's Hospital at Hackensack Meridian Health, Hackensack, New Jersey
| | - Aryeh Z Baer
- Joseph M. Sanzari Children's Hospital at Hackensack Meridian Health, Hackensack, New Jersey
| | - Sejal Makvana Bhavsar
- Joseph M. Sanzari Children's Hospital at Hackensack Meridian Health, Hackensack, New Jersey
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31
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Chhibber AV, Muttaiyah S, Hill AA, Roberts SA. Aerococcus urinae Aortitis: A Case Report. Open Forum Infect Dis 2019; 6:ofz453. [PMID: 31850388 PMCID: PMC6910077 DOI: 10.1093/ofid/ofz453] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 10/21/2019] [Indexed: 11/12/2022] Open
Abstract
Background Aerococcus urinae is a Gram-positive coccus that is increasingly recognized as a urinary pathogen since the introduction of mass spectrometry for identification of bacteria. We report a case of abdominal aortitis (with aneurysm) caused by A urinae in a male with recurrent urinary tract infections and recently treated A urinae bacteremia. A 63-year-old gentleman with a history of A urinae urosepsis 7 weeks prior, presented to the Emergency Department with thoracolumbar back pain radiating bilaterally into the groin. Radiological and surgical findings were consistent with infective infrarenal aortitis with aneurysm. Methods The patient successfully underwent open surgical debridement and reconstruction of the infrarenal aorta with autologous vein graft. Results Aerococcus urinae was isolated from excised tissue. The patient completed a 4-week course of intravenous antimicrobial therapy. Conclusions Aurinae is a urinary pathogen with the ability to cause severe invasive disease including endovascular infections.
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Affiliation(s)
- Aakash Varun Chhibber
- Department of Microbiology, LabPLUS, Auckland District Health Board, Auckland, New Zealand
| | - Sharmini Muttaiyah
- Department of Microbiology, LabPLUS, Auckland District Health Board, Auckland, New Zealand
| | - Andrew A Hill
- Department of Vascular Surgery, Auckland City Hospital, Auckland District Health Board, Auckland, New Zealand
| | - Sally A Roberts
- Department of Microbiology, LabPLUS, Auckland District Health Board, Auckland, New Zealand
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Mitral Valve Endocarditis with Perforation from a Urinary Source: An Unusual Case and Literature Review. Case Rep Cardiol 2019; 2019:5496851. [PMID: 31281678 PMCID: PMC6590612 DOI: 10.1155/2019/5496851] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Accepted: 05/23/2019] [Indexed: 02/06/2023] Open
Abstract
Aerococcus urinae (AU) is a rare pathogen, identified as gram-positive, catalase-negative coccus that grows in pairs and clusters which has been reported to mainly cause urinary tract infections (UTI), especially in elderly males. Treatment for this microorganism is usually with beta-lactams although cultures with antibiotic susceptibility testing are imperative. We present a case of AU endocarditis initially treated with IV antibiotics; nevertheless, the patient required emergent mitral valve replacement due to severe mitral insufficiency and perforation. We also present an analysis with high-yield points summarizing epidemiology, risk factors, microbiology, clinical features, diagnostic workup, and management of AU in general and AU endocarditis. Finally, we post a literature review of relevant cases and the impact of different variables associated with it.
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33
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Forsvall A, Wagenius M, Rasmussen M. Perigenital necrotizing soft tissue infection caused by Aerococcus urinae. IDCases 2019; 18:e00590. [PMID: 31367520 PMCID: PMC6656800 DOI: 10.1016/j.idcr.2019.e00590] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 07/04/2019] [Accepted: 07/04/2019] [Indexed: 12/27/2022] Open
Abstract
Aerococcus urinae can cause severe invasive infections emanating from the urinary tract especially in older males with comorbidities. Here we describe a case of an 80 year-old man with multiple comorbidities presenting with a peri-penile abscess and signs of severe infection. Upon incision A. urinae was isolated in pure culture and the infection was cured by a combination of drainage and antimicrobials. This case demonstrates the potential of A. urinae to cause severe soft tissue infections in predisposed individuals.
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Affiliation(s)
- Andreas Forsvall
- Lund University, Medical Faculty, Department for Clinical Sciences Lund, Division of Infection Medicine, Lund, Sweden
| | - Magnus Wagenius
- Lund University, Medical Faculty, Department for Clinical Sciences Lund, Division of Infection Medicine, Lund, Sweden
| | - Magnus Rasmussen
- Lund University, Medical Faculty, Department for Clinical Sciences Lund, Division of Infection Medicine, Lund, Sweden
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The Characteristics and Genome Analysis of vB_AviM_AVP, the First Phage Infecting Aerococcus viridans. Viruses 2019; 11:v11020104. [PMID: 30691182 PMCID: PMC6409932 DOI: 10.3390/v11020104] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 01/20/2019] [Accepted: 01/23/2019] [Indexed: 01/21/2023] Open
Abstract
Aerococcus viridans is an opportunistic pathogen that is clinically associated with various human and animal diseases. In this study, the first identified A. viridans phage, vB_AviM_AVP (abbreviated as AVP), was isolated and studied. AVP belongs to the family Myoviridae. AVP harbors a double-stranded DNA genome with a length of 133,806 bp and a G + C content of 34.51%. The genome sequence of AVP showed low similarity (<1% identity) to those of other phages, bacteria, or other organisms in the database. Among 165 predicted open reading frames (ORFs), there were only 69 gene products exhibiting similarity (≤65% identity) to proteins of known functions in the database. In addition, the other 36 gene products did not match any viral or prokaryotic sequences in any publicly available database. On the basis of the putative functions of the ORFs, the genome of AVP was divided into three modules: nucleotide metabolism and replication, structural components, and lysis. A phylogenetic analysis of the terminase large subunits and capsid proteins indicated that AVP represents a novel branch of phages. The observed characteristics of AVP indicate that it represents a new class of phages.
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35
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Hemenway AN, Christensen A, Schriever C. Treatment considerations for potential uropathogens detected by precision microbiological testing. Am J Health Syst Pharm 2018; 75:1775-1782. [PMID: 30404894 DOI: 10.2146/ajhp180208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The clinical and microbiological data for urinary tract infections (UTIs) for 6 organisms detected by matrix-assisted laser desorption ionization time-of-flight (MALDI-TOF) at community health systems were examined. SUMMARY The use of precision microbiological diagnostic testing such as MALDI-TOF and real-time quantitative polymerase chain reaction has increased the ability to detect a wider spectrum of organisms. This has raised questions of the clinical relevance of infrequently encountered organisms, especially when cultured from urine. This article reviews clinical and microbiological data for UTIs for 6 organisms detected by MALDI-TOF at community health systems (Actinotignum schaalii, Chryseobacterium indologenes, Aerococcus urinae, Aerococcus sanguinicola, Corynebacterium riegelii, and Corynebacterium urealyticum). Since little information currently exists, most of the data associating the aforementioned organisms with UTIs were derived from case reports. Although these organisms are more readily identified using precision microbiological diagnostic testing methods, infection should not be assumed based on culture results alone since asymptomatic bacteriuria has been reported. Similar to more common urinary pathogens, clinical correlation is essential. To facilitate treatment, we provide a table of empirical options likely to achieve clinical success based on in vivo and in vitro data. If available, pathogen-specific susceptibility data should be used to direct therapy. CONCLUSION Clinical and microbiological data and potential treatment options were presented for 6 traditionally underrecognized organisms that are increasingly being found from urinary specimens. The treatment recommendations should be interpreted cautiously as they were devised through the use of very limited data.
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Affiliation(s)
- Alice N Hemenway
- Department of Pharmacy Practice, University of Illinois at Chicago College of Pharmacy, Rockford, IL
| | - Alyssa Christensen
- Department of Pharmacy Practice, University of Illinois at Chicago College of Pharmacy, Rockford, IL
| | - Christopher Schriever
- Department of Pharmacy Practice, University of Illinois at Chicago College of Pharmacy, Rockford, IL
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36
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Yabes JM, Perdikis S, Graham DB, Markelz A. A rare case of Aerococcus urinae infective endocarditis in an atypically young male: case report and review of the literature. BMC Infect Dis 2018; 18:522. [PMID: 30333008 PMCID: PMC6191913 DOI: 10.1186/s12879-018-3414-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 09/25/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Aerococcus urinae is a gram-positive, alpha-hemolytic coccus bacterium primarily implicated in less than 1 % of all symptomatic urinary tract infections. Risk factors for disease include male gender, advanced age, and comorbid genitourinary tract pathology. Infections beyond the genitourinary tract are rare, though spondylodiscitis, perineal abscesses, lymphadenitis, bacteremia, meningitis, and endocarditis have been reported. Less than fifty cases of A. urinae infective endocarditis (IE) have been described in the literature. The rare occurrence of A. urinae in human infections and resultant lack of randomized controlled trials have resulted in a significant degree of clinical uncertainty in the management of A. urinae IE. CASE PRESENTATION We present an unusual case of a forty-three year-old male with A. urinae infective endocarditis (IE) who was successfully treated with mitral valve replacement and six weeks of penicillin/gentamicin therapy. In addition, we include a comprehensive review of all reported cases of IE due to A. urinae with specific attention to therapeutic regimens and treatment durations. CONCLUSION Recent advances in diagnostic technology have led to an increase in the frequency A. urinae is diagnosed. Reviewing cases of Aerococcus urinae infections, their clinical courses and subsequent management can assist future healthcare providers and their patients.
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Affiliation(s)
- Joseph M Yabes
- Brooke Army Medical Center, Department of Infectious Disease, 3551 Roger Brooke Drive, JBSA Fort Sam Houston, San Antonio, TX, 78234, USA.
| | - Serafim Perdikis
- Brooke Army Medical Center, Department of Internal Medicine, 3551 Roger Brooke Drive, JBSA Fort Sam Houston, San Antonio, TX, 78234, USA
| | - David B Graham
- Brooke Army Medical Center, Department of Cardiothoracic Surgery, 3551 Roger Brooke Drive, JBSA Fort Sam Houston, San Antonio, TX, 78234, USA
| | - Ana Markelz
- Brooke Army Medical Center, Department of Infectious Disease, 3551 Roger Brooke Drive, JBSA Fort Sam Houston, San Antonio, TX, 78234, USA
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Sgro M, Kobylianskii A, Yudin MH, Tran D, Diamandakos J, Sgro J, Campbell DM. Population-based study of early-onset neonatal sepsis in Canada. Paediatr Child Health 2018; 24:e66-e73. [PMID: 30996609 DOI: 10.1093/pch/pxy018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objective To determine the incidence, types of organisms and resistance patterns involved in early-onset neonatal sepsis in Canada. Study design Early-onset neonatal sepsis cases were identified through the Canadian Paediatric Surveillance Program. Neonates were excluded if they were asymptomatic or if intracranial procedures preceded a positive cerebrospinal fluid culture. Results One hundred and twenty-seven cases were identified (0.17 cases per 1000 live births). Group B Streptococcus accounted for 41.7%, Escherichia coli for 35.4%. Antibiotic resistance was present in 33.9% of all cases. 55.6% of E coli cases were resistant, most commonly to ampicillin. Infecting organism species were associated with gestational age, being very low birth weight, time at sepsis presentation, maternal antibiotic prophylaxis and rupture of membranes lasting over 18 hours. Group B Streptococcus was most common in term and E coli in preterm neonates. Twenty-two per cent of E coli cases presented after 48 hours, compared to 6% of Group B Streptococcus cases. Conclusion We identify a lower rate of early-onset neonatal sepsis than historically suggested, with differing dominant organisms based on gestational ages and other factors, as well as high rates of resistance especially among E coli cases.
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Affiliation(s)
- Michael Sgro
- Keenan Research Centre of the Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario.,Department of Paediatrics, St. Michael's Hospital, Toronto, Ontario.,Department of Paediatrics, University of Toronto, Toronto, Ontario
| | - Anna Kobylianskii
- Department of Obstetrics and Gynaecology, University of Toronto, Toronto, Ontario
| | - Mark H Yudin
- Keenan Research Centre of the Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario.,Department of Obstetrics and Gynaecology, University of Toronto, Toronto, Ontario.,Department of Obstetrics and Gynaecology, St. Michael's Hospital, Toronto, Ontario
| | - Dat Tran
- Department of Paediatrics, University of Toronto, Toronto, Ontario.,Division of Infectious Diseases, The Hospital for Sick Children, University of Toronto, Toronto, Ontario
| | - Julia Diamandakos
- Department of Physiology and Pharmacology, University of Western Ontario, London, Ontario
| | - Jonathan Sgro
- Department of Science, University of Western Ontario, London, Ontario
| | - Douglas M Campbell
- Keenan Research Centre of the Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario.,Department of Paediatrics, St. Michael's Hospital, Toronto, Ontario.,Department of Paediatrics, University of Toronto, Toronto, Ontario
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Musculoskeletal infections caused by Aerococcus urinae: a case-based review. Clin Rheumatol 2018; 37:2587-2594. [PMID: 29574655 DOI: 10.1007/s10067-018-4072-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2018] [Revised: 03/13/2018] [Accepted: 03/15/2018] [Indexed: 10/17/2022]
Abstract
Aerococcus are Gram-positive bacteria that have been historically misidentified using standard techniques. We report a case of a 63-year-old man with septic oligoarthritis caused by Aerococcus urinae (isolated in two ankle synovial fluid cultures and in two blood cultures). Due to the lack of evidence found in a search performed to identify similar cases, a systematic review was conducted with the objective to identify and analyze all documented cases of musculoskeletal infections caused by Aerococcus urinae. A total of 8 cases were selected: 6 spondylodiscitis, 1 periarticular hip abscess, and 1 prosthetic hip infection. Similarly, as in other Aerococcus urinae invasive infections, these were presented predominantly in older males with history of urinary tract disease, being identified mostly by sequencing of the 16S rRNA or by matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS), with an increasing incidence in the last years and generally with good sensitivity to beta-lactams (aminoglycosides were associated in some cases due to its synergistic effect). Additionally, 4 cases of musculoskeletal infections caused by Aerococcus viridans and 4 cases of Aerococcus urinae with ammoniacal and pervasive malodorous urine were identified; the last was a symptom also present in our case. In this review, we identify a recent increase of musculoskeletal infections caused by Aerococcus urinae, which as well as in series of other invasive infections could be well correlated with an increasing use of more sensible diagnosis methods in clinical laboratories. Therefore, we suggest that these probably will be more frequently diagnosed in the future.
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Fang B, Li JW, Zhang M, Ren FZ, Pang GF. Chronic chlorpyrifos exposure elicits diet-specific effects on metabolism and the gut microbiome in rats. Food Chem Toxicol 2018; 111:144-152. [DOI: 10.1016/j.fct.2017.11.001] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 10/31/2017] [Accepted: 11/01/2017] [Indexed: 01/07/2023]
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40
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Oskooi M, Sunnerhagen T, Senneby E, Rasmussen M. A prospective observational treatment study of aerococcal urinary tract infection. J Infect 2017; 76:354-360. [PMID: 29253561 DOI: 10.1016/j.jinf.2017.12.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 12/11/2017] [Accepted: 12/12/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Aerococcus urinae and Aerococcus sanguinicola cause urinary tract infections (UTIs) and antibiotic treatment recommendations are solely based on in vitro findings and limited clinical experience. Our objective was to investigate the effectiveness of different treatment strategies in aerococcal UTI through a prospective observational study. METHODS Urine samples with aerococci were identified and patients were enrolled. The aerococci were subjected to Etests. Information on clinical symptoms, and the treatment given, was collected. Patients were interviewed after the conclusion of treatment to assess clinical cure and a control urine culture assessed the microbiological cure. RESULTS Of 31,629 urine samples, 144 grew aerococci and fulfilled the inclusion criteria. 91 patients gave consent and the 72 patients with UTI were assessed for treatment outcome. 53 patients had A. urinae UTI, while 19 had A. sanguinicola UTI. Nitrofurantoin was most commonly prescribed, achieving clinical and microbiological success in 71/76% of cases of A. urinae UTI, and 42/50% of cases of A. sanguinicola UTI. Pivmecillinam achieved success in patients with A. urinae cystitis and ciprofloxacin in patients with pyelonephritis. CONCLUSIONS Our results support that nitrofurantoin is a valid option for the treatment of cystitis caused by A. urinae.
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Affiliation(s)
- Mohammad Oskooi
- Division of Infection Medicine, Department of Clinical Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Torgny Sunnerhagen
- Division of Infection Medicine, Department of Clinical Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Erik Senneby
- Division of Infection Medicine, Department of Clinical Sciences, Faculty of Medicine, Lund University, Lund, Sweden; Clinical Microbiology, Laboratory, Region Skåne, Lund, Sweden
| | - Magnus Rasmussen
- Division of Infection Medicine, Department of Clinical Sciences, Faculty of Medicine, Lund University, Lund, Sweden; Division of Infection Medicine, Skåne University Hospital, Lund, Sweden.
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Carkaci D, Højholt K, Nielsen XC, Dargis R, Rasmussen S, Skovgaard O, Fuursted K, Andersen PS, Stegger M, Christensen JJ. Genomic characterization, phylogenetic analysis, and identification of virulence factors in Aerococcus sanguinicola and Aerococcus urinae strains isolated from infection episodes. Microb Pathog 2017; 112:327-340. [PMID: 28943151 DOI: 10.1016/j.micpath.2017.09.042] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Revised: 09/14/2017] [Accepted: 09/18/2017] [Indexed: 11/18/2022]
Abstract
Aerococcus sanguinicola and Aerococcus urinae are emerging pathogens in clinical settings mostly being causative agents of urinary tract infections (UTIs), urogenic sepsis and more seldomly complicated infective endocarditis (IE). Limited knowledge exists concerning the pathogenicity of these two species. Eight clinical A. sanguinicola (isolated from 2009 to 2015) and 40 clinical A. urinae (isolated from 1984 to 2015) strains from episodes of UTIs, bacteremia, and IE were whole-genome sequenced (WGS) to analyze genomic diversity and characterization of virulence genes involved in the bacterial pathogenicity. A. sanguinicola genome sizes were 2.06-2.12 Mb with 47.4-47.6% GC-contents, and 1783-1905 genes were predicted whereof 1170 were core-genes. In case of A. urinae strains, the genome sizes were 1.93-2.44 Mb with 41.6-42.6% GC-contents, and 1708-2256 genes of which 907 were core-genes. Marked differences were observed within A. urinae strains with respect to the average genome sizes, number and sequence identity of core-genes, proteome conservations, phylogenetic analysis, and putative capsular polysaccharide (CPS) loci sequences. Strains of A. sanguinicola showed high degree of homology. Phylogenetic analyses showed the 40 A. urinae strains formed two clusters according to two time periods: 1984-2004 strains and 2010-2015 strains. Genes that were homologs to virulence genes associated with bacterial adhesion and antiphagocytosis were identified by aligning A. sanguinicola and A. urinae pan- and core-genes against Virulence Factors of Bacterial Pathogens (VFDB). Bacterial adherence associated gene homologs were present in genomes of A. sanguinicola (htpB, fbpA, lmb, and ilpA) and A. urinae (htpB, lap, lmb, fbp54, and ilpA). Fifteen and 11-16 CPS gene homologs were identified in genomes of A. sanguinicola and A. urinae strains, respectively. Analysis of these genes identified one type of putative CPS locus within all A. sanguinicola strains. In A. urinae genomes, five different CPS loci types were identified with variations in CPS locus sizes, genetic content, and structural organization. In conclusion, this is the first study dealing with WGS and comparative genomics of clinical A. sanguinicola and A. urinae strains from episodes of UTIs, bacteremia, and IE. Gene homologs associated with antiphagocytosis and bacterial adherence were identified and genetic variability was observed within A. urinae genomes. These findings contribute with important knowledge and basis for future molecular and experimental pathogenicity study of UTIs, bacteremia, and IE causing A. sanguinicola and A. urinae strains.
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Affiliation(s)
- Derya Carkaci
- Department of Clinical Microbiology, Slagelse Hospital, Slagelse, Denmark; Department of Science and Environment, Roskilde University, Roskilde, Denmark; Department of Microbiology & Infection Control, Statens Serum Institut, Copenhagen, Denmark.
| | - Katrine Højholt
- Department of Clinical Microbiology, Slagelse Hospital, Slagelse, Denmark; Department of Bio and Health Informatics, Technical University of Denmark, Kongens Lyngby, Denmark.
| | | | - Rimtas Dargis
- Department of Clinical Microbiology, Slagelse Hospital, Slagelse, Denmark.
| | - Simon Rasmussen
- Department of Bio and Health Informatics, Technical University of Denmark, Kongens Lyngby, Denmark.
| | - Ole Skovgaard
- Department of Science and Environment, Roskilde University, Roskilde, Denmark.
| | - Kurt Fuursted
- Department of Microbiology & Infection Control, Statens Serum Institut, Copenhagen, Denmark.
| | - Paal Skytt Andersen
- Department of Microbiology & Infection Control, Statens Serum Institut, Copenhagen, Denmark; Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
| | - Marc Stegger
- Department of Microbiology & Infection Control, Statens Serum Institut, Copenhagen, Denmark.
| | - Jens Jørgen Christensen
- Department of Clinical Microbiology, Slagelse Hospital, Slagelse, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
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42
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Clinical Characteristics and Laboratory Identification of Aerococcus Infections: An Australian Tertiary Centre Perspective. Int J Microbiol 2017; 2017:5684614. [PMID: 29056969 PMCID: PMC5615948 DOI: 10.1155/2017/5684614] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 08/09/2017] [Indexed: 11/24/2022] Open
Abstract
Aerococci uncommonly cause urinary tract (UTI) and bloodstream infections (BSI). The clinical characteristics and laboratory identification rates of Aerococcus in the Australian context are unknown. A retrospective observational cohort study of patients with positive Aerococcus cultures between 2010 and 2015 was performed. Patients were analysed according to predefined “asymptomatic bacteriuria,” “UTI,” and “BSI” groups. Forty-seven [40 (85%) for urine and 7 (15%) for blood] isolates were identified [38% male, median age of 79 (IQR 62–85) years], with corresponding identification rates of 24.2/100,000/year for urine (0.02%) and 7.3/100,000/year for blood cultures (0.007%). Since the use of matrix-assisted laser desorption ionisation time-of-flight mass spectrometry (MALDI-TOF MS) identification rate in urine has increased from 14.7/100,000/year to 32/100,000/year (p = 0.02). For urine isolates, 14 (35%) met the definition for UTI whilst 26 (65%) were “asymptomatic bacteriuria.” Underlying urological abnormalities, catheterisation, and polymicrobial growth were common. Seventy percent of bacteriuria was treated regardless of colonisation or active infection status. Symptomatic patients were more likely to receive treatment (OR 7.2, 95% CI 1.4–35.3). In patients with BSI, 1 (14.2%) had endocarditis and 1 (14.2%) died. The majority of isolates were susceptible to penicillin (11/12 tested, 92%).
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43
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Tathireddy H, Settypalli S, Farrell JJ. A rare case of aerococcus urinae infective endocarditis. J Community Hosp Intern Med Perspect 2017. [PMID: 28638578 PMCID: PMC5473194 DOI: 10.1080/20009666.2017.1314072] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Introduction:Aerococcus urinae is a rare cause of infective endocarditis. Aerococcus is a gram positive cocci that is easily misidentified as Staphylococci or Streptococci. The true incidence rate of this pathogen is likely underestimated. Recent advances in laboratory diagnostic methods with matrix-associated laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF-MS) have lead to increased recognition of this pathogen in the clinical microbiology lab, and awareness as a cause of infective endocarditis in the infectious disease community. Case reports: Aerococcus usually affects males with underlying urinary tract conditions. Herein, we report a case of prosthetic aortic valve endocarditis caused by Aerococcus urinae. Discussion: Our patient was considered high risk for cardiac surgery and was treated successfully with intravenous antibiotics alone for six weeks. Conclusion: Infective endocarditis should be considered in all cases of Aerococcus bacteremia and appropriate diagnostic evaluations pursued. Abbreviations: AV: Aortic valve; IE: Infective endocarditis
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Affiliation(s)
- Harsha Tathireddy
- Department of Internal Medicine, OSF Saint Francis Medical Center, Peoria, IL, USA
| | - Sahitya Settypalli
- Department of Internal Medicine, University of Illinois College of Medicine at Peoria, Peoria, IL, USA
| | - John J Farrell
- Department of Internal Medicine, Division of Infectious Disease, OSF Saint Francis Medical Center, University of Illinois College of Medicine at Peoria, Peoria, IL, USA
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Ahn K, Hwang GY, Uh Y, Yoon KJ, Hyun S. Vancomycin Resistance due to vanA Gene Expression in an Aerococcus viridans Isolate: First Case in Korea. Ann Lab Med 2017; 37:288-289. [PMID: 28224779 PMCID: PMC5339105 DOI: 10.3343/alm.2017.37.3.288] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 10/11/2016] [Accepted: 12/29/2016] [Indexed: 11/19/2022] Open
Affiliation(s)
- Kwangjin Ahn
- Department of Laboratory Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Gyu Yel Hwang
- Department of Laboratory Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Young Uh
- Department of Laboratory Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
| | - Kap Jun Yoon
- Department of Laboratory Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Shinyoung Hyun
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
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45
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Aerococcus urinae: An Emerging Cause of Urinary Tract Infection in Older Adults with Multimorbidity and Urologic Cancer. Urol Case Rep 2017; 13:24-25. [PMID: 28435789 PMCID: PMC5393163 DOI: 10.1016/j.eucr.2017.03.022] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 03/09/2017] [Accepted: 03/16/2017] [Indexed: 11/21/2022] Open
Abstract
Aerococcus urinae is a rare organism isolated from urine cultures. We present a case of an 80 year-old male with bladder cancer and multimorbidity who developed A. urinae infection. A. urinae may cause simple and complicated UTIs, bacteremia, and endocarditis in older adults with multimorbidity, chronic urinary retention, or indwelling catheters. A. urinae treatment should employ penicillin, amoxicillin, and nitrofurantoin. Due to increasing antibiotic resistance, urine culture should include antibiotic susceptibility testing. Prompt and culture-specific treatment is critical to avoid clinical progression of the infection.
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46
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Sun M, Gao J, Ali T, Yu D, Zhang S, Khan SU, Fanning S, Han B. Characteristics of Aerococcus viridans isolated from bovine subclinical mastitis and its effect on milk SCC, yield, and composition. Trop Anim Health Prod 2017; 49:843-849. [PMID: 28321788 DOI: 10.1007/s11250-017-1271-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Accepted: 03/14/2017] [Indexed: 10/19/2022]
Abstract
Aerococcus viridians (A. viridans), an environmental Gram-positive bacterium, has been documented to be associated with bovine mastitis. However, its exact role in bovine mastitis and the changes it brings about in milk characteristics are not yet known. The objectives of the current study were to describe the antibiotic resistance of A. viridans from bovine mastitis as well as the correlation between existence of this pathogen in udders and the somatic cell counts (SCC), daily milk yield, and composition of individual cow. One-year sampling for subclinical mastitis composite milk was conducted based on monthly DHI data from September 2013 to August 2014, in a commercial herd located in Beijing, China. All samples were cultured and pathogens were identified using microbiology method. A. viridians isolates were further identified by API identification system and 16S ribosomal RNA (rRNA) sequencing method. Kirby-Bauer disk diffusion method was used to test the antibiotic resistance of A. viridians against kinds of antimicrobial substance. SCC, milk yield, and milk composition data were from monthly Dairy Herd Improvement (DHI) results. Results showed that a total of 279 (16.67%) A. viridans isolates were identified from among 1674 bacterial isolates cultured from milk samples with high SCC. The incidence of mastitis caused by A. viridans was the highest (48-53%) during the summer season. Majority of the isolates were susceptible to most of antimicrobial compounds tested, especially to β-lactams, but were found to be resistant (50-90%) to aminoglycosides, sulfonamides, and tetracycline. The average SCC of the A. viridans infected cows was significantly higher (1000.0 × 103 cells/mL) (P < 0.01) as compared to healthy cows (72.4 × 103 cells/mL) and daily milk yield decreased (P > 0.05) by 1.86 kg/day. Reductions were also observed in fat content (P > 0.05), lactose (P < 0.01), and total solids (P > 0.05), whereas protein content increased significantly (P < 0.01) in milk samples of cows infected with A. viridans. The results of this study suggest that A. viridans could be considered as an emerging aetiological agent of bovine subclinical mastitis wherein it exerts an effect on SCC, milk yield, and composition.
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Affiliation(s)
- Meng Sun
- Department of Clinical Veterinary Medicine, College of Veterinary Medicine, China Agricultural University, Yuan Ming Yuan West Road No. 2, Haidian District, 100193, Beijing, People's Republic of China
| | - Jian Gao
- Department of Clinical Veterinary Medicine, College of Veterinary Medicine, China Agricultural University, Yuan Ming Yuan West Road No. 2, Haidian District, 100193, Beijing, People's Republic of China
| | - Tariq Ali
- Department of Clinical Veterinary Medicine, College of Veterinary Medicine, China Agricultural University, Yuan Ming Yuan West Road No. 2, Haidian District, 100193, Beijing, People's Republic of China
| | - Dan Yu
- Department of Clinical Veterinary Medicine, College of Veterinary Medicine, China Agricultural University, Yuan Ming Yuan West Road No. 2, Haidian District, 100193, Beijing, People's Republic of China
| | - Shiyao Zhang
- Department of Clinical Veterinary Medicine, College of Veterinary Medicine, China Agricultural University, Yuan Ming Yuan West Road No. 2, Haidian District, 100193, Beijing, People's Republic of China
| | - Saeed U Khan
- Department of Animal Sciences, Quaid-i-Azam University, Islamabad, 45320, Pakistan
| | - Séamus Fanning
- UCD-Centre for Food Safety, School of Public Health, Physiotherapy & Sports Science, University College Dublin, Belfield, Dublin 4, Ireland
| | - Bo Han
- Department of Clinical Veterinary Medicine, College of Veterinary Medicine, China Agricultural University, Yuan Ming Yuan West Road No. 2, Haidian District, 100193, Beijing, People's Republic of China.
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Ha L, Niknam N, Mankame S, Koshy R. A rare case of perineal abscess caused by aerococcus urinae. IDCases 2017; 7:44-46. [PMID: 28105405 PMCID: PMC5226662 DOI: 10.1016/j.idcr.2016.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Revised: 11/01/2016] [Accepted: 11/01/2016] [Indexed: 11/13/2022] Open
Abstract
Aerococcus urinae, a previously misidentified pathogen, has become increasingly recognized to cause severe and even fatal infections. Aerococcus-related perineal abscess infections have not previously been reported in the literature. Most reported cases of infections caused by Aerococcus are urinary tract infections, bacteremia, and even rare cases of endocarditis. We report an unusual case of a perineal abscess caused by Aerococcus urinae.
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48
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Hirzel C, Hirzberger L, Furrer H, Endimiani A. Bactericidal activity of penicillin, ceftriaxone, gentamicin and daptomycin alone and in combination against Aerococcus urinae. Int J Antimicrob Agents 2016; 48:271-6. [PMID: 27451085 DOI: 10.1016/j.ijantimicag.2016.05.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Revised: 05/11/2016] [Accepted: 05/14/2016] [Indexed: 11/15/2022]
Abstract
Aerococcus urinae can cause severe infections (bacteraemia and endocarditis) that are associated with high mortality. However, data on the bactericidal and synergistic activity for clinically implemented antibiotics are scarce. Time-kill analyses were performed on two clinical isolates (AU1 and AU2) and the reference strain ATCC 700306 for penicillin (PG), ceftriaxone (CRO), gentamicin (GEN), daptomycin (DAP) and their combinations. AU1 and AU2 were CRO-resistant (MICs, 2 µg/mL) and ATCC 700306 was high-level GEN-resistant (MIC, 512 µg/mL), whereas all strains were PG- and DAP-susceptible (MICs, ≤0.125 and ≤1 µg/mL, respectively). CFU counts were determined at various time points from 0 to 48 h. All experiments were performed at 0.5×, 1×, 2× and 4× MIC. PG and CRO were not bactericidal for all strains, whereas DAP exhibited bactericidal activity at all concentrations for AU2 and ATCC 700306. The combination of PG or CRO with GEN was bactericidal for AU1 and AU2 at antibiotic concentrations ≥1× MIC. Bactericidal synergism was detected for PG or CRO combined with GEN in the two clinical isolates. PG plus CRO showed non-bactericidal synergism for ATCC 700306. DAP with GEN was synergistic at 1× MIC for AU1, whereas the killing activity of DAP was too pronounced to detect potential synergism in AU2. The combination of PG or CRO with GEN is synergistic and bactericidal. Moreover, these in vitro data suggest that DAP may represent a potential bactericidal treatment alternative against A. urinae. This finding could be important for the treatment of patients with a β-lactam allergy or renal insufficiency.
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Affiliation(s)
- Cédric Hirzel
- Department of Infectious Diseases, Bern University Hospital (Inselspital), University of Bern, Poliklinik Trakt 2, CH-3010 Bern, Switzerland
| | - Lea Hirzberger
- Department of Infectious Diseases, Bern University Hospital (Inselspital), University of Bern, Poliklinik Trakt 2, CH-3010 Bern, Switzerland; Institute for Infectious Diseases, University of Bern, Friedbühlstrasse 51, CH-3010 Bern, Switzerland
| | - Hansjakob Furrer
- Department of Infectious Diseases, Bern University Hospital (Inselspital), University of Bern, Poliklinik Trakt 2, CH-3010 Bern, Switzerland
| | - Andrea Endimiani
- Institute for Infectious Diseases, University of Bern, Friedbühlstrasse 51, CH-3010 Bern, Switzerland.
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49
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Complete Genome Sequences of Aerococcus christensenii CCUG 28831T, Aerococcus sanguinicola CCUG 43001T, Aerococcus urinae CCUG 36881T, Aerococcus urinaeequi CCUG 28094T, Aerococcus urinaehominis CCUG 42038 BT, and Aerococcus viridans CCUG 4311T. GENOME ANNOUNCEMENTS 2016; 4:4/2/e00302-16. [PMID: 27103727 PMCID: PMC4841142 DOI: 10.1128/genomea.00302-16] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Strains belonging to the genus Aerococcus are causative agents of human and animal infections, including urogenital infections, bacteremia/septicemia, and infective endocarditis. This study reports the first fully closed and complete genome sequences of six type strains belonging to the genus Aerococcus using a combination of Illumina HiSeq and PacBio sequencing technologies.
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50
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Carlstein C, Marie Søes L, Jørgen Christensen J. Aerococcus christensenii as Part of Severe Polymicrobial Chorioamnionitis in a Pregnant Woman. Open Microbiol J 2016; 10:27-31. [PMID: 27014376 PMCID: PMC4787314 DOI: 10.2174/1874285801610010027] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Revised: 01/03/2015] [Accepted: 02/23/2015] [Indexed: 11/22/2022] Open
Abstract
Chorioamnionitis is a potentially life threatening infection of the fetal
membranes, commonly caused by ascending bacteria from the vagina and cervix. In
our case, a healthy nullipara with a term pregnancy presented clinical signs of
infection after induced labour with an intracervical balloon. Thick green and
foul smelling amniotic fluid was observed and culture showed massive growth of
Aerococcus christensenii, a facultative anaerob species found in the
human vagina, previously only rarely alleged to cause invasive infection.
Additional testing with 16S rRNA gene analysis also identified the presence of
Gemella asaccharolytica, Snethia sanguinegens, Parvimonas
micra and Streptobacillus moniliformis. The patient was
treated with cefuroxime and metronidazole and recovered quickly. The newborn
showed no signs of infection. This case points at the possible role of these
pathogens in female genital tract infections. The case also underlines the
importance of the combination of culture and culture independent diagnostic
approaches to reveal possible polymicrobial natures of selected infections, in
this case chorioamnionitis.
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Affiliation(s)
- Catrine Carlstein
- Department of Gynaecology and Obstetrics, Næstved Hospital, Ringstedgade 61, 4700 Næstved, Denmark
| | - Lillian Marie Søes
- Department of Clinical Microbiology, Slagelse Hospital, Ingemannsvej 18, 4200 Slagelse, Denmark
| | - Jens Jørgen Christensen
- Department of Clinical Microbiology, Slagelse Hospital, Ingemannsvej 18, 4200 Slagelse, Denmark
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