1
|
Sahuquillo-Arce J, Suárez-Urquiza P, Hernández-Cabezas A, Tofan L, Chouman-Arcas R, García-Hita M, Sabalza-Baztán O, Sellés-Sánchez A, Lozano-Rodríguez N, Martí-Cuñat J, López-Hontangas J. Actinotignum schaalii infection: Challenges in diagnosis and treatment. Heliyon 2024; 10:e28589. [PMID: 38590897 PMCID: PMC10999919 DOI: 10.1016/j.heliyon.2024.e28589] [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: 07/17/2023] [Revised: 03/20/2024] [Accepted: 03/21/2024] [Indexed: 04/10/2024] Open
Abstract
Actinotignum schaalii affects elderly people and is associated with individuals with urological-related predispositions, but can be found in a variety of locations, such as cutaneous, intraabdominal, genitourinary and surgical infections. Disseminated infections occur less frequently and are by and large related to urinary tract colonisation. This pathogen is often neglected due to growth requirements, especially in urinary tract infections. We present 107 Actinotignum schaalii isolated from genitourinary samples (80.4%), from skin and soft tissue infections (13.1%), from bone and deep tissue infection (4.7%) and from blood cultures (1.9%). The automated system Alfred 60/AST was paramount for the isolation of 77.6% of the UTI. All the isolates tested were susceptible to penicillin, ampicillin, linezolid, vancomycin, teicoplanin, rifampicin and tetracycline. In conclusion, we present a large series of Actinotignum schaalii infections. This pathogen is hard to isolate, and is resistant to commonly used empirical antimicrobials.
Collapse
Affiliation(s)
- J.M. Sahuquillo-Arce
- Servicio de Microbiología, Hospital Doctor Moliner, Serra, Spain
- Grupo de Investigación de Infecciones Respiratorias, IIS La Fe, Valencia, Spain
| | - P. Suárez-Urquiza
- Servicio de Microbiología, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - A. Hernández-Cabezas
- Servicio de Microbiología, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - L. Tofan
- Servicio de Análisis Clínicos, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - R. Chouman-Arcas
- Servicio de Microbiología, Hospital Francesc de Borja, Gandia, Spain
| | - M. García-Hita
- Servicio de Microbiología, Hospital de la Vega Lorenzo Guirao, Cieza, Spain
| | - O. Sabalza-Baztán
- Servicio de Microbiología, Hospital General Universitari de Castelló, Castellón de la Plana, Spain
| | | | - N. Lozano-Rodríguez
- Servicio de Microbiología, Hospital General Universitari de Castelló, Castellón de la Plana, Spain
| | - J. Martí-Cuñat
- Servicio de Microbiología, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - J.L. López-Hontangas
- Servicio de Microbiología, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| |
Collapse
|
2
|
Frickmann H, Schwinge K, Podbielski A, Warnke P. Preanalytical, Analytical and Postanalytical Analyses on Corynebacterium spp. and Actinomycetaceae in Urine Samples of Patients with Suspected Urinary Tract Infection-A Hypothesis-Forming Observational Study. Diagnostics (Basel) 2024; 14:746. [PMID: 38611658 PMCID: PMC11011480 DOI: 10.3390/diagnostics14070746] [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: 02/19/2024] [Revised: 03/24/2024] [Accepted: 03/28/2024] [Indexed: 04/14/2024] Open
Abstract
A hypothesis-forming exploratory cross-sectional assessment was conducted to assess the occurrence and relevance of Gram-positive rod-shaped bacteria like Corynebacterium spp. and Actinomycetaceae in human urine samples. In total, 1170 urine samples from 1031 inpatients with suspected urinary tract infection were assessed for culture-based growth of Gram-positive rod-shaped bacteria applying API Coryne assays, matrix-assisted laser desorption-ionization time-of-flight mass spectrometry (MALDI-TOF-MS), and in-house 16S rRNA gene sequencing. Overall, 502 different bacterial colonies from 346 urine samples taken from 324 inpatients were observed. The three quantitatively most abundant genera or genus clusters were Corynebacterium (254 isolates, 62%), Actinomyces/Winkia (79 isolates, 19%), and Actinotignum/Actinobaculum (29 isolates, 7%). Compared to sequencing, the diagnostic accuracy of all assessed competitor assays from the diagnostic routine was <80% for differentiation on the genus level and <30% for differentiation on the species level. Prolongated incubation for 4 days compared to 2 days resulted in additional detection of 15% of the totally recorded Gram-positive rod-shaped bacteria. An approximately 5-fold increased detection rate in mid-stream urine compared to urine acquired applying alternative sampling strategies was observed. In conclusion, in the rare event of the suspected clinical relevance of such findings, confirmatory testing with invasively sampled urine should be considered due to the high contamination rate observed in mid-stream urine. Confirmatory testing by DNA-sequencing methods should be considered if an exact identification of genus or species is regarded as relevant for the individual choice of the therapeutic strategy.
Collapse
Affiliation(s)
- Hagen Frickmann
- Institute for Medical Microbiology, Virology and Hygiene, University Medicine Rostock, 18057 Rostock, Germany; (K.S.); (A.P.)
- Department of Microbiology and Hygiene, Bundeswehr Hospital Hamburg, 20239 Hamburg, Germany
| | - Kerstin Schwinge
- Institute for Medical Microbiology, Virology and Hygiene, University Medicine Rostock, 18057 Rostock, Germany; (K.S.); (A.P.)
| | - Andreas Podbielski
- Institute for Medical Microbiology, Virology and Hygiene, University Medicine Rostock, 18057 Rostock, Germany; (K.S.); (A.P.)
| | - Philipp Warnke
- Institute for Medical Microbiology, Virology and Hygiene, University Medicine Rostock, 18057 Rostock, Germany; (K.S.); (A.P.)
| |
Collapse
|
3
|
Lieu A, Mah J, Peirano G, Somayaji R, Church D. Microbiological Characterization of Actinotignum schaalii Strains Causing Invasive Infections during a Multiyear Period in a Large Canadian Health Care Region. Microbiol Spectr 2022; 10:e0344222. [PMID: 36409090 PMCID: PMC9769901 DOI: 10.1128/spectrum.03442-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 11/03/2022] [Indexed: 11/23/2022] Open
Abstract
Actinotignum schaalii is an underrecognized Gram-positive bacillus that is associated with urinary tract infections and cutaneous abscesses. The role of A. schaalii in invasive infections continues to be unappreciated because the bacteria can be isolated from a diverse spectrum of clinical specimens, ranging from being a single pathogen in urine and blood cultures to being deemed a colonizer in polymicrobial anaerobic cultures of sterile fluids and tissues. We conducted a microbiological analysis of clinical isolates obtained from 2012 through 2019. A total of 86 isolates were analyzed; 37 (43%) were from blood cultures, 35 (41%) were from deep wounds and abscesses, 6 (7%) were from urine samples, and the rest were recovered from peritoneal, kidney, and scrotal fluid samples. Urinary tract infections were clinically identified as the source of most cases of bacteremia, although no simultaneous urine cultures yielded positive results. The 16S rRNA gene sequences were available for 32 isolates (37%). Phylogenetic analysis revealed that AS.1/AS.2 strains caused a larger proportion of bloodstream infections (BSIs) (100% versus 52% [P = 0.01]) and trended toward a higher rate of hospitalization (91% versus 76% [P = 0.18]) but had a lower clindamycin MIC90 (0.12 versus >256 μg/mL). Our study emphasizes the emergence of A. schaalii as a pathogen in human urine samples, BSIs, and skin and soft tissue infections. It highlights the pitfalls of current laboratory methods in recovering and identifying this organism from clinical specimens, particularly urine samples. Phylogenetic analysis showed unique genotypic sequences for A. schaalii AS.1/AS.2 strains causing urosepsis, which requires further study to identify potential virulence factors. IMPORTANCE Actinotignum schaalii is an underrecognized Gram-positive bacillus due to its special growth requirements and prior phenotypic identification methods, and it is often mistaken as a contaminant. It has been associated with various clinical syndromes, from urinary tract infections to cutaneous infections. The widespread use of molecular diagnostic methods allowed for improved detection. However, its role in invasive infections remains underappreciated. We conducted a detailed microbiological analysis to improve our understanding of this organism's genotypic and phenotypic characteristics. Our results highlight the pitfalls of clinical laboratory recovery, particularly from urine cultures. Although most BSIs were caused by urinary tract infections, no simultaneous urine cultures identified A. schaalii, largely due to the failure of phenotypic methods to reliably isolate and identify this organism. Additionally, this is the first study demonstrating A. schaalii strains with differences in clinical and microbiological characteristics, raising the possibility of potential bacterial virulence factors contributing to invasive infections.
Collapse
Affiliation(s)
- Anthony Lieu
- Section of Infectious Diseases, Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Jordan Mah
- Section of Infectious Diseases, Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Gisele Peirano
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Ranjani Somayaji
- Section of Infectious Diseases, Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Deirdre Church
- Section of Infectious Diseases, Department of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
| |
Collapse
|
4
|
Mah J, Lieu A, Somayaji R, Church D. Characterizing Actinotignum schaalii infections in a large Canadian healthcare region. Future Microbiol 2022; 17:1353-1362. [PMID: 36169260 DOI: 10.2217/fmb-2022-0049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aims: We characterize the epidemiology of Actinotignum schaalii within a large Canadian region after implementation of improved identification methods. Patients & methods: Positive cultures for A. schaalii from a centralized microbiology laboratory in Canada were analyzed. Clinical data were retrieved through administrative databases and chart reviews. Primary outcome was incidence of A. schaalii infections; secondary outcomes included mortality, hospital admission and length of stay. Results & conclusions: 86 unique isolates were studied, 37 bloodstream infections (BSI) and 49 non-BSIs. Patients with BSIs were older with more comorbidities, with urinary tract infections implicated as the most frequent source; skin abscesses caused the most non-BSIs. Hospitalization and 90-day mortality was higher in the BSI group. A. schaalii is an important community-acquired pathogen with the potential to cause invasive infections.
Collapse
Affiliation(s)
- Jordan Mah
- Division of Infectious Diseases, Department of Medicine, University of Calgary, Calgary, AB T2N 2T9, Canada.,Division of General Internal Medicine, Department of Medicine, University of Calgary, Calgary, AB T2N 2T9, Canada
| | - Anthony Lieu
- Division of Infectious Diseases, Department of Medicine, University of Calgary, Calgary, AB T2N 2T9, Canada
| | - Ranjani Somayaji
- Division of Infectious Diseases, Department of Medicine, University of Calgary, Calgary, AB T2N 2T9, Canada.,Department of Microbiology, Immunology & Infectious Disease, University of Calgary, Calgary, AB T2N 2T9, Canada.,Department of Community Health Sciences, University of Calgary, Calgary, AB T2N 2T9, Canada
| | - Deirdre Church
- Division of Infectious Diseases, Department of Medicine, University of Calgary, Calgary, AB T2N 2T9, Canada.,Department of Microbiology, Immunology & Infectious Disease, University of Calgary, Calgary, AB T2N 2T9, Canada.,Department of Pathology & Laboratory Medicine, University of Calgary, AB T2N 2T9, Canada
| |
Collapse
|
5
|
A 2-Year Retrospective Case Series on Isolates of the Emerging Pathogen Actinotignum schaalii from a Canadian Tertiary Care Hospital. Microorganisms 2022; 10:microorganisms10081608. [PMID: 36014029 PMCID: PMC9412865 DOI: 10.3390/microorganisms10081608] [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: 07/03/2022] [Revised: 07/29/2022] [Accepted: 08/03/2022] [Indexed: 11/21/2022] Open
Abstract
(1) Background: Actinotignum schaalii is an emerging, opportunistic pathogen often linked with UTIs but can extend beyond the urogenital system. Data on the clinical significance of A. schaalii are still emerging. (2) Methods: A retrospective review of A. schaalii isolates in a Canadian tertiary care hospital was conducted. The clinical data of patients that grew A. schaalii from January 2020 to 2022 were documented. Demographics, site, management, and microbiological parameters surrounding culture and sensitivities were recorded. (3) Results: A total of 43 cases of A. schaalii were identified. Actinotignum schaalii was primarily involved in UTIs (n = 17), abscesses (n = 9), bacteremia (n = 6), septic arthritis (n = 5), and ulcers (n = 5). A. schaalii had a slight predilection for polymicrobial infections (51.1%, n = 22 out of 43), with Aerococcus urinae (n = 5) being the most common coisolate. Susceptibility testing was only performed in two cases that showed sensitivity to beta-lactam antibiotics and resistance to metronidazole and ciprofloxacin. Amoxicillin–clavulanate (n = 5) is the most frequently prescribed antibiotic. (4) Conclusions: The non-urogenic clinical significance of A. schaalii remains undervalued. The management of A. schaalii infection is multimodal, consisting predominantly of antimicrobials and surgical procedures specific to the etiology. Clinicians should request sensitivities for A. schaalii so that appropriate antimicrobial coverage can be provided.
Collapse
|
6
|
Clinical characteristics of Actinotignum schaalii bacteremia in a Japanese tertiary hospital. Anaerobe 2022; 77:102513. [DOI: 10.1016/j.anaerobe.2022.102513] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 12/28/2021] [Accepted: 01/02/2022] [Indexed: 11/18/2022]
|
7
|
Kotásková I, Syrovátka V, Obručová H, Vídeňská P, Zwinsová B, Holá V, Blaštíková E, Růžička F, Freiberger T. Actinotignum schaalii: Relation to Concomitants and Connection to Patients' Conditions in Polymicrobial Biofilms of Urinary Tract Catheters and Urines. Microorganisms 2021; 9:microorganisms9030669. [PMID: 33807120 PMCID: PMC8004716 DOI: 10.3390/microorganisms9030669] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 03/05/2021] [Accepted: 03/11/2021] [Indexed: 12/30/2022] Open
Abstract
Actinotignum schaalii is an emerging, opportunistic pathogen and its connection to non-infectious diseases and conditions, such as prostate or bladder cancer, or chronic inflammation has been proposed. Here, we analyzed 297 urine, ureteral and urinary catheter samples from 128 patients by Polymerase Chain Reaction followed by Denaturing Gradient Gel Electrophoresis and Sequencing (PCR-DGGE-S), and culture, and 29 of these samples also by 16S rRNA Illumina sequencing, to establish A. schaalii’s prevalence in urinary tract-related samples, its relation to other bacteria, and its potential association with patients’ conditions and samples’ characteristics. A. schaalii-positive samples were significantly more diverse than A. schaalii negative and between-group diversity was higher than intra-group. Propionimicrobium lymphophilum, Fusobacterium nucleatum, Veillonella sp., Morganella sp., and Aerococcus sp. were significantly more often present in A. schaalii-positive samples; thus, we suggest these species are A. schaalii’s concomitants, while Enterobacter and Staphylococcaceae were more often identified in A. schaalii-negative samples; therefore, we propose A. schaalii and these species are mutually exclusive. Additionally, a significantly higher A. schaalii prevalence in patients with ureter stricture associated hydronephrosis (p = 0.020) was noted. We suggest that A. schaalii could be an early polybacterial biofilm colonizer, together with concomitant species, known for pro-inflammatory features.
Collapse
Affiliation(s)
- Iva Kotásková
- Molecular Genetics Laboratory, Centre for Cardiovascular Surgery and Transplantation, 61600 Brno, Czech Republic; (I.K.); (H.O.); (E.B.)
- Department of Clinical Immunology and Allergology, Medical Faculty, Masaryk University, 61600 Brno, Czech Republic
- Research Centre for Toxic Compounds in the Environment, Masaryk University, 61600 Brno, Czech Republic; (P.V.); (B.Z.)
| | - Vít Syrovátka
- Department of Botany and Zoology, Faculty of Science, Masaryk University, 61600 Brno, Czech Republic;
| | - Hana Obručová
- Molecular Genetics Laboratory, Centre for Cardiovascular Surgery and Transplantation, 61600 Brno, Czech Republic; (I.K.); (H.O.); (E.B.)
| | - Petra Vídeňská
- Research Centre for Toxic Compounds in the Environment, Masaryk University, 61600 Brno, Czech Republic; (P.V.); (B.Z.)
| | - Barbora Zwinsová
- Research Centre for Toxic Compounds in the Environment, Masaryk University, 61600 Brno, Czech Republic; (P.V.); (B.Z.)
| | - Veronika Holá
- Institute of Microbiology, Faculty of Medicine, St. Anne’s University Hospital, Masaryk University, 61600 Brno, Czech Republic; (V.H.); (F.R.)
| | - Eva Blaštíková
- Molecular Genetics Laboratory, Centre for Cardiovascular Surgery and Transplantation, 61600 Brno, Czech Republic; (I.K.); (H.O.); (E.B.)
| | - Filip Růžička
- Institute of Microbiology, Faculty of Medicine, St. Anne’s University Hospital, Masaryk University, 61600 Brno, Czech Republic; (V.H.); (F.R.)
| | - Tomáš Freiberger
- Molecular Genetics Laboratory, Centre for Cardiovascular Surgery and Transplantation, 61600 Brno, Czech Republic; (I.K.); (H.O.); (E.B.)
- Department of Clinical Immunology and Allergology, Medical Faculty, Masaryk University, 61600 Brno, Czech Republic
- Correspondence:
| |
Collapse
|
8
|
Kitano H, Hieda K, Kitagawa H, Nakaoka Y, Koba Y, Ota K, Shigemoto N, Hayashi T, Kashiyama S, Teishima J, Shime N, Ohge H, Hinata N. Case Report: Emphysematous Pyelonephritis With a Congenital Giant Ureterocele. Front Pediatr 2021; 9:775468. [PMID: 34900875 PMCID: PMC8662358 DOI: 10.3389/fped.2021.775468] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 10/28/2021] [Indexed: 11/16/2022] Open
Abstract
A 14-year-old girl noticed malodorous urine and experienced left flank pain. The patient was presented to our hospital with gradually increasing pain. She had no underlying disease but had a history of pain on micturition for several days. Hematologic examination indicated low white blood cell and platelet counts and a high serum lactate level. Computed tomography showed that a part of the parenchyma of the left kidney had poor contrast and was deteriorated, with fluid and gas retention from the perirenal region to the retroperitoneal cavity. A left hydroureter and large ureterocele were observed in the bladder. She was diagnosed with emphysematous pyelonephritis (EPN) with a giant congenital ureterocele. Vasopressors and blood transfusion failed to maintain normal circulatory dynamics, and an open left nephrectomy and transurethral ureterocele fenestration were performed. The excised outer portion of the left kidney was dissolved by the infection and replaced with blood clots and necrotic tissue. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry identified the inflammatory, gas-producing bacteria Actinotignum schaalii, Peptoniphilus asaccharolyticus, and Actinomyces odontolyticus. Meropenem was administered for 4 days postoperatively and then de-escalated to sulbactam/ampicillin for another 10 days. The patient was discharged on day 17 of hospitalization, and the postoperative course remained favorable. EPN is extremely rare in pediatric patients, and it is believed that nephrectomy is sometimes necessary if the patient does not have normal circulatory dynamics despite the use of catecholamines.
Collapse
Affiliation(s)
- Hiroyuki Kitano
- Department of Urology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Keisuke Hieda
- Department of Urology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hiroki Kitagawa
- Department of Infectious Diseases, Hiroshima University Hospital, Hiroshima, Japan
| | - Yusuke Nakaoka
- Department of Clinical Practice and Support, Hiroshima University Hospital, Hiroshima, Japan
| | - Yumiko Koba
- Department of Clinical Practice and Support, Hiroshima University Hospital, Hiroshima, Japan
| | - Kohei Ota
- Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Norifumi Shigemoto
- Department of Infectious Diseases, Hiroshima University Hospital, Hiroshima, Japan
| | - Tetsutaro Hayashi
- Department of Urology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Seiya Kashiyama
- Department of Infectious Diseases, Hiroshima University Hospital, Hiroshima, Japan
| | - Jun Teishima
- Department of Urology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Nobuaki Shime
- Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hiroki Ohge
- Department of Infectious Diseases, Hiroshima University Hospital, Hiroshima, Japan
| | - Nobuyuki Hinata
- Department of Urology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| |
Collapse
|
9
|
Gajdács M, Urbán E. The Pathogenic Role of Actinomyces spp. and Related Organisms in Genitourinary Infections: Discoveries in the New, Modern Diagnostic Era. Antibiotics (Basel) 2020; 9:E524. [PMID: 32824418 PMCID: PMC7459602 DOI: 10.3390/antibiotics9080524] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 08/14/2020] [Accepted: 08/15/2020] [Indexed: 12/16/2022] Open
Abstract
Actinomycosis is a chronic, suppurative, granulomatous infectious disease, caused by different species of Actinomyces bacteria. To date, 26 validly published Actinomyces species have been described as part of a normal human microbiota or from human clinical specimens. Due to the rapid spread of new, modern diagnostic procedures, 13 of 26 of these species have been described in this century and the Actinomycetaceae family has undergone several taxonomic revisions, including the introduction of many novel species termed Actinomyces-like organisms (ALOs). There is scarce data available on the role of these novel bacterial species in various infectious processes in human medicine. The aim of this review is to provide a comprehensive overview of Actinomyces and closely related organisms involved in human diseases-with a special focus on newly described species-in particular their role in genitourinary tract infections in females and males.
Collapse
Affiliation(s)
- Márió Gajdács
- Department of Pharmacodynamics and Biopharmacy, Faculty of Pharmacy, University of Szeged, 6720 Szeged, Hungary;
- Institute of Medical Microbiology, Faculty of Medicine, Semmelweis University, 1089 Budapest, Hungary
| | - Edit Urbán
- Institute of Translational Medicine, Faculty of Medicine, University of Pécs, 7624 Pécs, Hungary
| |
Collapse
|
10
|
Horton LE, Mehta SR, Aganovic L, Fierer J. Actinotignum schaalii Infection: A Clandestine Cause of Sterile Pyuria? Open Forum Infect Dis 2018; 5:ofy015. [PMID: 29450211 PMCID: PMC5808804 DOI: 10.1093/ofid/ofy015] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 01/24/2018] [Indexed: 11/25/2022] Open
Abstract
Actinotignum schaalii is an underappreciated cause of urinary tract infections (UTIs) in older adults. The diagnosis may be missed due to difficulty isolating and identifying the organism. Complications can result because the organism is intrinsically resistant to 2 commonly used drugs to treat UTI, as illustrated by this case.
Collapse
Affiliation(s)
- Lucy E Horton
- Department of Medicine, VA San Diego Healthcare System and University of California, San Diego, School of Medicine, San Diego, California
| | - Sanjay R Mehta
- Department of Medicine, VA San Diego Healthcare System and University of California, San Diego, School of Medicine, San Diego, California
| | - Lejla Aganovic
- Department of Radiology, VA San Diego Healthcare System, San Diego, California
| | - Joshua Fierer
- Department of Medicine, VA San Diego Healthcare System and University of California, San Diego, School of Medicine, San Diego, California
| |
Collapse
|
11
|
Yassin AF, Langenberg S, Huntemann M, Clum A, Pillay M, Palaniappan K, Varghese N, Mikhailova N, Mukherjee S, Reddy TBK, Daum C, Shapiro N, Ivanova N, Woyke T, Kyrpides NC. Draft genome sequence of Actinotignum schaalii DSM 15541T: Genetic insights into the lifestyle, cell fitness and virulence. PLoS One 2017; 12:e0188914. [PMID: 29216246 PMCID: PMC5720513 DOI: 10.1371/journal.pone.0188914] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 11/15/2017] [Indexed: 11/19/2022] Open
Abstract
The permanent draft genome sequence of Actinotignum schaalii DSM 15541T is presented. The annotated genome includes 2,130,987 bp, with 1777 protein-coding and 58 rRNA-coding genes. Genome sequence analysis revealed absence of genes encoding for: components of the PTS systems, enzymes of the TCA cycle, glyoxylate shunt and gluconeogensis. Genomic data revealed that A. schaalii is able to oxidize carbohydrates via glycolysis, the nonoxidative pentose phosphate and the Entner-Doudoroff pathways. Besides, the genome harbors genes encoding for enzymes involved in the conversion of pyruvate to lactate, acetate and ethanol, which are found to be the end products of carbohydrate fermentation. The genome contained the gene encoding Type I fatty acid synthase required for de novo FAS biosynthesis. The plsY and plsX genes encoding the acyltransferases necessary for phosphatidic acid biosynthesis were absent from the genome. The genome harbors genes encoding enzymes responsible for isoprene biosynthesis via the mevalonate (MVA) pathway. Genes encoding enzymes that confer resistance to reactive oxygen species (ROS) were identified. In addition, A. schaalii harbors genes that protect the genome against viral infections. These include restriction-modification (RM) systems, type II toxin-antitoxin (TA), CRISPR-Cas and abortive infection system. A. schaalii genome also encodes several virulence factors that contribute to adhesion and internalization of this pathogen such as the tad genes encoding proteins required for pili assembly, the nanI gene encoding exo-alpha-sialidase, genes encoding heat shock proteins and genes encoding type VII secretion system. These features are consistent with anaerobic and pathogenic lifestyles. Finally, resistance to ciprofloxacin occurs by mutation in chromosomal genes that encode the subunits of DNA-gyrase (GyrA) and topisomerase IV (ParC) enzymes, while resistant to metronidazole was due to the frxA gene, which encodes NADPH-flavin oxidoreductase.
Collapse
Affiliation(s)
- Atteyet F. Yassin
- Institut für medizinische Mikrobiologie und Immunologie der Universität Bonn, Bonn, Germany
- * E-mail:
| | - Stefan Langenberg
- Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde/Chirurgie, Bonn, Germany
| | - Marcel Huntemann
- Department of Energy Joint Genome Institute, Genome Biology Program, Walnut Creek, CA, United States of America
| | - Alicia Clum
- Department of Energy Joint Genome Institute, Genome Biology Program, Walnut Creek, CA, United States of America
| | - Manoj Pillay
- Department of Energy Joint Genome Institute, Genome Biology Program, Walnut Creek, CA, United States of America
| | - Krishnaveni Palaniappan
- Department of Energy Joint Genome Institute, Genome Biology Program, Walnut Creek, CA, United States of America
| | - Neha Varghese
- Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde/Chirurgie, Bonn, Germany
| | - Natalia Mikhailova
- Department of Energy Joint Genome Institute, Genome Biology Program, Walnut Creek, CA, United States of America
| | - Supratim Mukherjee
- Department of Energy Joint Genome Institute, Genome Biology Program, Walnut Creek, CA, United States of America
| | - T. B. K. Reddy
- Department of Energy Joint Genome Institute, Genome Biology Program, Walnut Creek, CA, United States of America
| | - Chris Daum
- Department of Energy Joint Genome Institute, Genome Biology Program, Walnut Creek, CA, United States of America
| | - Nicole Shapiro
- Department of Energy Joint Genome Institute, Genome Biology Program, Walnut Creek, CA, United States of America
| | - Natalia Ivanova
- Department of Energy Joint Genome Institute, Genome Biology Program, Walnut Creek, CA, United States of America
| | - Tanja Woyke
- Department of Energy Joint Genome Institute, Genome Biology Program, Walnut Creek, CA, United States of America
| | - Nikos C. Kyrpides
- Department of Energy Joint Genome Institute, Genome Biology Program, Walnut Creek, CA, United States of America
| |
Collapse
|
12
|
Bryan A, Kirkpatrick LM, Manaloor JJ, Salipante SJ. 16S rRNA deep sequencing identifies Actinotignum schaalii as the major component of a polymicrobial intra-abdominal infection and implicates a urinary source. JMM Case Rep 2017; 4:e005091. [PMID: 29026619 PMCID: PMC5630961 DOI: 10.1099/jmmcr.0.005091] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 03/23/2017] [Indexed: 11/23/2022] Open
Abstract
Introduction. It can be difficult to catalogue the individual organisms comprising polymicrobial patient infections, both because conventional clinical microbiological culture does not facilitate the isolation and enumeration of all members of a complex microbial community, and because fastidious organisms may be mixed with organisms that grow rapidly in vitro. Empiric antimicrobial treatment is frequently employed based on the anatomical site and the suspected source of the infection, especially when an appropriately collected surgical specimen is not obtained. Case presentation. We present a case of an intra-abdominal infection in a patient with complex anatomy and recurrent urinary tract infections. Imaging did not reveal a clear source of infection, no growth was obtained from urine cultures and initial abdominal fluid cultures were also negative. In contrast, 16S rRNA deep sequencing of abdominal fluid samples revealed mixed bacterial populations with abundant anaerobes, including Actinotignum schaalii (Actinobaculum schaalii). Ultimately, only Enterobacter cloacae complex and meticillin-resistant Staphylococcus aureus, both of which were identified by sequencing, were recovered by culture. Conclusion. The clinical application of 16S rRNA deep sequencing can more comprehensively and accurately define the organisms present in an individual patient's polymicrobial infection than conventional microbiological culture, detecting species that are not recovered under standard culture conditions or that are otherwise unexpected. These results can facilitate effective antimicrobial stewardship and help elucidate the possible origins of infections.
Collapse
Affiliation(s)
- Andrew Bryan
- Department of Laboratory Medicine, University of Washington, Box 357110, 1959 NE Pacific Street, NW120, Seattle, WA, USA
| | - Lindsey M Kirkpatrick
- Ryan White Center for Pediatric Infectious Diseases and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - John J Manaloor
- Ryan White Center for Pediatric Infectious Diseases and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Stephen J Salipante
- Department of Laboratory Medicine, University of Washington, Box 357110, 1959 NE Pacific Street, NW120, Seattle, WA, USA
| |
Collapse
|
13
|
Maraki S, Evangelou G, Stafylaki D, Scoulica E. Actinotignum schaalii subcutaneous abscesses in a patient with hidradenitis suppurativa: Case report and literature review. Anaerobe 2016; 43:43-46. [PMID: 27913316 DOI: 10.1016/j.anaerobe.2016.11.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 11/24/2016] [Accepted: 11/28/2016] [Indexed: 11/19/2022]
Abstract
Actinotignum schaalii (formerly Actinobaculum schaalii) is a Gram-positive, facultative anaerobic rod that is typically involved in urinary tract infections in elderly patients or those with underlying urological pathologies. In contrast, abscess formation caused by A. schaalii is very rare. We present a case of multiple abscesses in the perineal area in a young patient with hidradenitis suppurativa associated with A. schaalii and Prevotella melaninogenica and review the relevant literature on the topic.
Collapse
Affiliation(s)
- Sofia Maraki
- Department of Clinical Microbiology, Parasitology, Zoonoses and Geographical Medicine, University Hospital of Heraklion, Crete, Greece.
| | - George Evangelou
- Department of Dermatology, University Hospital of Heraklion, Heraklion, Crete, Greece
| | - Dimitra Stafylaki
- Department of Clinical Microbiology, Parasitology, Zoonoses and Geographical Medicine, University Hospital of Heraklion, Crete, Greece
| | - Efstathia Scoulica
- Laboratory of Clinical Bacteriology and Molecular Microbiology, School of Medicine, University of Crete, Heraklion, Crete, Greece
| |
Collapse
|
14
|
Siller Ruiz M, Hernández Egido S, Calvo Sánchez N, Muñoz Bellido JL. Unusual clinical presentations of Actinotignum (Actinobaculum) schaalii infection. Enferm Infecc Microbiol Clin 2016; 35:197-198. [PMID: 27810121 DOI: 10.1016/j.eimc.2016.09.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Revised: 08/31/2016] [Accepted: 09/07/2016] [Indexed: 11/19/2022]
Affiliation(s)
- María Siller Ruiz
- Servicio de Microbiología, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain; Instituto de Investigación Biomédica de Salamanca (IBSAL-CSIC), Salamanca, Spain
| | - Sara Hernández Egido
- Servicio de Microbiología, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain; Instituto de Investigación Biomédica de Salamanca (IBSAL-CSIC), Salamanca, Spain
| | - Noelia Calvo Sánchez
- Servicio de Microbiología, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
| | - Juan Luis Muñoz Bellido
- Servicio de Microbiología, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain; Instituto de Investigación Biomédica de Salamanca (IBSAL-CSIC), Salamanca, Spain; Unidad de Investigación Consolidada de Castilla y León UIC-079, Spain; Departamento de Ciencias Biomédicas y del Diagnóstico, Universidad de Salamanca, Salamanca, Spain.
| |
Collapse
|
15
|
Actinotignum (formerly Actinobaculum) schaalii: a review of MALDI-TOF for identification of clinical isolates, and a proposed method for presumptive phenotypic identification. Pathology 2016; 48:367-71. [PMID: 27131934 DOI: 10.1016/j.pathol.2016.03.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Revised: 03/12/2016] [Accepted: 03/21/2016] [Indexed: 12/21/2022]
Abstract
Actinotignum schaalii is a recognised cause of urinary tract infection. Following a case of urosepsis, 20 isolates of A. schaalii were collected over an initial 18 month period from urine and blood culture. An additional 25 isolates were collected over the following 13 months. Actinotignum schaalii had likely been overlooked or dismissed as a contaminant in our laboratory prior to this study period. It grows slowly on blood agar with supplemental CO2 or anaerobically. It may not grow on MacConkey agar or chromogenic agars used for routine urine culture. Repeated attempts at identification by matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry (MALDI-TOF MS) may be required as the optimal age of cultures for testing is unclear. Utilising its characteristic antibiogram may assist phenotypic identification of this organism which is otherwise difficult to distinguish from other actinomycetes.
Collapse
|
16
|
Prigent G, Perillaud C, Amara M, Coutard A, Blanc C, Pangon B. Actinobaculum schaalii: A truly emerging pathogen?: Actinobaculum schaalii: un pathogène réellement émergent? New Microbes New Infect 2016; 11:8-16. [PMID: 27014462 PMCID: PMC4789325 DOI: 10.1016/j.nmni.2015.10.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Revised: 10/25/2015] [Accepted: 10/26/2015] [Indexed: 10/31/2022] Open
Abstract
Actinobaculum schaalii is a Gram-positive facultative anaerobe bacillus. It is a commensal organism of the genitourinary tract. Its morphology is nonspecific. Aerobic culture is tedious, and identification techniques have long been inadequate. Thus, A. schaalii has often been considered as a nonpathogen bacterium or a contaminant. Its pathogenicity is now well described in urinary tract infections, and infections in other sites have been reported. This pathogen is considered as an emerging one following the growing use of mass spectrometry identification. In this context, the aim of our study was to evaluate the number of isolations of A. schaalii before and after the introduction of mass spectrometry in our hospital and to study the clinical circumstances in which isolates were found.
Collapse
Affiliation(s)
- G Prigent
- Service de biologie, Unité de microbiologie, Le Chesnay, France
| | - C Perillaud
- Service de biologie, Unité de microbiologie, Le Chesnay, France
| | - M Amara
- Service de biologie, Unité de microbiologie, Le Chesnay, France
| | - A Coutard
- Service de biologie, Unité de microbiologie, Le Chesnay, France
| | - C Blanc
- Service de médecine interne, maladies infectieuses et tropicales, Centre Hospitalier de Versailles, Le Chesnay, France
| | - B Pangon
- Service de biologie, Unité de microbiologie, Le Chesnay, France
| |
Collapse
|
17
|
Lotte R, Lotte L, Ruimy R. Actinotignum schaalii (formerly Actinobaculum schaalii): a newly recognized pathogen-review of the literature. Clin Microbiol Infect 2015; 22:28-36. [PMID: 26577137 DOI: 10.1016/j.cmi.2015.10.038] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2015] [Revised: 10/14/2015] [Accepted: 10/29/2015] [Indexed: 11/19/2022]
Abstract
The genus Actinotignum contains three species, Actinotignum schaalii (formerly Actinobaculum schaalii), Actinotignum urinale and Actinotignum sanguinis. A. schaalii is the species most frequently involved in human infections, with 172 cases, mostly urinary tract infections (UTIs), reported so far. Invasive infections have also been described. This facultative anaerobic Gram-positive rod is part of the urinary microbiota of healthy patients. It is responsible for UTIs, particularly in elderly men and young children. A. schaalii is an underestimated cause of UTIs because of its fastidious growth on usual media and difficulties associated with its identification using phenotypic methods. Indeed, this slow-growth bacterium requires blood-enriched media and an incubation time of 48 hours under anaerobic or 5% CO2 atmosphere. Furthermore, only matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF) or molecular-based methods allow the accurate identification of this bacteria. MALDI-TOF using Microflex LT with the Biotyper database (Bruker Daltonics, Bremen, Germany) is the most reliable technology for the routine identification of A. schaalii. The identification of this uropathogen is all the more important because it is resistant to trimethoprim/sulfamethoxazole and second-generation quinolones that are widely used in the treatment of UTIs. Antimicrobial therapy using β-lactams prolonged for up to 2 weeks is the most efficient treatment and should be recommended. Microbiologists should assess the presence of A. schaalii in urine using appropriate culture and identification methods in the case of a direct examination that is positive for small coccoid rods, a negative nitrite urinary stick associated with leukocyturia, treatment failure with trimethoprim/sulfamethoxazole or fluoroquinolones, or undocumented, repeated UTIs.
Collapse
Affiliation(s)
- R Lotte
- Department of Bacteriology at Nice Academic Hospital, Nice, France; Nice Medical University, Nice-Sophia Antipolis University, Nice, France; INSERM U1065 (C3M), Bacterial Toxins in Host Pathogen Interactions, C3M, Bâtiment Universitaire Archimed, Nice, France.
| | - L Lotte
- Department of Bacteriology at Nice Academic Hospital, Nice, France; Nice Medical University, Nice-Sophia Antipolis University, Nice, France
| | - R Ruimy
- Department of Bacteriology at Nice Academic Hospital, Nice, France; Nice Medical University, Nice-Sophia Antipolis University, Nice, France; INSERM U1065 (C3M), Bacterial Toxins in Host Pathogen Interactions, C3M, Bâtiment Universitaire Archimed, Nice, France
| |
Collapse
|
18
|
Answer to November 2015 Photo Quiz. J Clin Microbiol 2015. [DOI: 10.1128/jcm.02429-13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
19
|
A validation of the Danish microbiology database (MiBa) and incidence rate of Actinotignum schaalii (Actinobaculum schaalii) bacteraemia in Denmark. Clin Microbiol Infect 2015; 21:1097.e1-4. [PMID: 26319901 DOI: 10.1016/j.cmi.2015.08.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Revised: 08/05/2015] [Accepted: 08/17/2015] [Indexed: 11/22/2022]
Abstract
Actinotignum schaalii (former named Actinobaculum schaalii) can cause urinary tract infections (UTIs) and bacteraemia, mainly in the elderly. A. schaalii is difficult to identify with conventional biochemical tests, and it is often overlooked if the urine is only cultured in ambient air. The aim of this study was to validate data from the nationwide Danish microbiology database (MiBa) with data from the laboratory information system (LIS) at the local department of microbiology in Viborg-Herning, and to evaluate the incidence rate of bacteraemia caused by A. schaalii in Denmark by using data from the MiBa. All departments of microbiology in Denmark report data to the MiBa. All microbiological samples with A. schaalii in Denmark were extracted for a period of 5 years from the MiBa and from the local LISs. All data obtained from our local LIS were also found in the MiBa, except for data on real-time PCR, which were not registered, owing to missing ID codes in the MiBa. From 2010 to 2014, there was a significant increase in the incidence rate of blood cultures with A. schaalii, from 1.8 to 6.8 cases per million, which was probably due to coincident implementation of matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) in routine diagnostics. We found that A. schaalii caused bacteraemia and UTIs mainly in the elderly. In conclusion, the MiBa can be a useful source of nationwide microbiological data in Denmark. Our results suggest that the incidence rate of A. schaalii as a cause of bacteraemia has been underestimated, and that culture of urine in CO2 can improve the detection of A. schaalii.
Collapse
|
20
|
Abstract
Actinomyces israelii has long been recognized as a causative agent of actinomycosis. During the past 3 decades, a large number of novel Actinomyces species have been described. Their detection and identification in clinical microbiology laboratories and recognition as pathogens in clinical settings can be challenging. With the introduction of advanced molecular methods, knowledge about their clinical relevance is gradually increasing, and the spectrum of diseases associated with Actinomyces and Actinomyces-like organisms is widening accordingly; for example, Actinomyces meyeri, Actinomyces neuii, and Actinomyces turicensis as well as Actinotignum (formerly Actinobaculum) schaalii are emerging as important causes of specific infections at various body sites. In the present review, we have gathered this information to provide a comprehensive and microbiologically consistent overview of the significance of Actinomyces and some closely related taxa in human infections.
Collapse
|
21
|
Le Brun C, Robert S, Tanchoux C, Bruyere F, Lanotte P. Urinary tract infection caused by Actinobaculum schaalii: a urosepsis pathogen that should not be underestimated. JMM Case Rep 2015. [DOI: 10.1099/jmmcr.0.000030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Cécile Le Brun
- Laboratoire de Bactériologie–Virologie, CHRU de Tours, Hôpital Bretonneau, 37000 Tours, France
| | - Sylvie Robert
- Laboratoire de Bactériologie–Virologie, CHRU de Tours, Hôpital Bretonneau, 37000 Tours, France
| | - Colas Tanchoux
- Service d'Urologie, CHRU de Tours, Hôpital Bretonneau, 37000 Tours, France
| | - Franck Bruyere
- Service d'Urologie, CHRU de Tours, Hôpital Bretonneau, 37000 Tours, France
| | - Philippe Lanotte
- Laboratoire de Bactériologie–Virologie, CHRU de Tours, Hôpital Bretonneau, 37000 Tours, France
| |
Collapse
|
22
|
Le Brun C, Robert S, Bruyere F, Lanotte P. [Emerging uropathogens: Point for urologists and biologists]. Prog Urol 2015; 25:363-9. [PMID: 25726694 DOI: 10.1016/j.purol.2015.01.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Revised: 01/24/2015] [Accepted: 01/30/2015] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Technological advances during the last years in bacterial identification by molecular biology and mass spectrometry, or Matrix Assisted Laser Desorption Ionisation-Time of Flight (MALDI-TOF) have allowed identifying new bacteria involved in urinary tract infections. The purpose of this review is to familiarize clinicians with these bacteria so that they can look at a particular target population and help biologists to suspect and identify them. METHOD A bibliographic research was performed using the Medline database concerning the keywords Aerococcus, Actinobaculum, Alloscardovia, Trueperella. RESULTS If Aerococcus sp. is now well known, Actinobaculum sp., Alloscardovia sp. and Trueperella sp. remain rarely isolated and unknown from clinicians. Importance of these germs could be underestimated because of the identifying and isolation difficulties which existed beforehand. They are particularly found in a population of elderly people with underlying conditions or urological risk factors of urinary tract infection. Actinobaculum schaalii is also found more frequently in young children. CONCLUSION Aerococcus sp. et A. schaalii are true uropathogens not to be underestimated. Further studies are still needed to confirm the specific involvement of Trueperella and Alloscardovia in urinary diseases.
Collapse
Affiliation(s)
- C Le Brun
- Laboratoire de bactériologie-virologie, hôpital Bretonneau, CHRU de Tours, 2, boulevard Tonnelé, 37044 Tours cedex, France.
| | - S Robert
- Laboratoire de bactériologie-virologie, hôpital Bretonneau, CHRU de Tours, 2, boulevard Tonnelé, 37044 Tours cedex, France
| | - F Bruyere
- Service d'urologie, hôpital Bretonneau, CHRU de Tours, 2, boulevard Tonnelé, 37044 Tours cedex, France
| | - P Lanotte
- Laboratoire de bactériologie-virologie, hôpital Bretonneau, CHRU de Tours, 2, boulevard Tonnelé, 37044 Tours cedex, France
| |
Collapse
|
23
|
Scodavolpe S, Christiaens A, Weitten T, Vaché B, Devémy F. [Actinobaculum schaalii infection]. Med Mal Infect 2014; 44:334-5. [PMID: 25022889 DOI: 10.1016/j.medmal.2014.05.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Revised: 05/08/2014] [Accepted: 05/26/2014] [Indexed: 11/29/2022]
Affiliation(s)
- S Scodavolpe
- Pharmacie hospitalière, CHICAS de Gap, 1, place Auguste-Muret, 05000 Gap, France
| | - A Christiaens
- Service de médecine interne, CHICAS de Gap, 1, place Auguste-Muret, 05000 Gap, France
| | - T Weitten
- Service de médecine interne, CHICAS de Gap, 1, place Auguste-Muret, 05000 Gap, France
| | - B Vaché
- Service de biologie médicale, CHICAS de Gap, 1, place Auguste-Muret, 05000 Gap, France
| | - F Devémy
- Service de médecine interne, CHICAS de Gap, 1, place Auguste-Muret, 05000 Gap, France.
| |
Collapse
|
24
|
Skin and soft-tissue infections caused by Actinobaculum schaalii: report of two cases and literature review. Anaerobe 2014; 28:95-7. [PMID: 24923266 DOI: 10.1016/j.anaerobe.2014.05.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Revised: 05/20/2014] [Accepted: 05/21/2014] [Indexed: 11/24/2022]
Abstract
Skin and soft-tissue infections (SSTIs) caused by Actinobaculum spp. are very rare. In the present study, we report two cases and review the literature. The first case was an immunocompromised patient with an extensive cellulitis secondary to an inguinal abscess, and the second case was a patient with a pilonidal abscess. Clinical outcomes of both patients were good after surgical drainage and treatment with cloxacillin. The review of the literature showed that SSTIs caused by Actinobaculum spp. are usually located on the perineal and inguinal regions and can be severe, particularly in immunocompromised patients. SSTIs caused by Actinobaculum spp. can be overlooked because identification is often difficult and they can be considered as contaminants.
Collapse
|
25
|
Patanè S. Is there a need for bacterial endocarditis prophylaxis in patients undergoing urological procedures? J Cardiovasc Transl Res 2014; 7:369-71. [PMID: 24566724 DOI: 10.1007/s12265-014-9550-z] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Accepted: 02/12/2014] [Indexed: 02/03/2023]
Abstract
Heart valve repair or replacement is a serious problem.The focused update on infective endocarditis of American College of Cardiology/American Heart Association 2008 (ACC/AHA guidelines) and Guidelines on the prevention, diagnosis, and treatment of infective endocarditis (new version 2009) of the European Society of Cardiology (ESC guidelines) describe prophylaxis against infective endocarditis as not recommended for urinary tract procedures in the absence of active infection. A statistical association has been recently shown between urological procedures and the development of infective endocarditis. New evidences concerning infective endocarditis due to Actinobaculum schaalii, Neisseria gonorrhoeae, Streptococcus agalactiae, Enterococcus faecalis, Pseudomonas aeruginosa, Aerococci and Staphylococcus aureus, and new findings indicate there is a need for bacterial endocarditis prophylaxis in patients undergoing urological procedures especially in elderly patients and in cancer and immunocompromised patients, to avoid serious consequences.
Collapse
Affiliation(s)
- Salvatore Patanè
- Cardiologia Ospedale San Vincenzo, Taormina (Me) Azienda Sanitaria Provinciale di Messina, Contrada Sirina, 98039, Taormina, Messina, Italy, patane-@libero.it
| |
Collapse
|
26
|
Bank S, Cattoir V, Lienhard R, Grisold AJ, Thomsen TR, Reinhard M, Olsen AB, Christensen JJ, Søby KM, Prag J. Recommendations for optimal detection and identification ofActinobaculum schaaliiin urine. APMIS 2014; 122:1043-4. [DOI: 10.1111/apm.12233] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Steffen Bank
- Department of Clinical Microbiology; Viborg Regional Hospital; Viborg Denmark
| | | | | | - Andrea J. Grisold
- Institute of Hygiene, Microbiology and Environmental Medicine; Medical University of Graz; Graz Austria
| | - Trine R. Thomsen
- Department of Biotechnology; Aalborg University and Section for Medical Biotechnology; The Danish Technological Institute; Taastrup Denmark
| | - Mark Reinhard
- Department of Internal Medicine; Viborg Regional Hospital; Viborg Denmark
| | | | | | - Karen Marie Søby
- Department of Clinical Microbiology; Viborg Regional Hospital; Viborg Denmark
| | - Jørgen Prag
- Department of Clinical Microbiology; Viborg Regional Hospital; Viborg Denmark
| |
Collapse
|