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Revista Argentina de Microbiologia 2022Actinotignum schaalii is an emerging pathogen in elderly patients with urinary tract pathologies. Two cases of A. schaalii bacteremia are described. Case 1: 79-year-old...
Actinotignum schaalii is an emerging pathogen in elderly patients with urinary tract pathologies. Two cases of A. schaalii bacteremia are described. Case 1: 79-year-old patient with a history of benign prostatic hyperplasia. He was admitted to the ward for febrile syndrome, abdominal pain, and dysuria. Case 2: 95-year-old patient with prostatic adenomectomy, urethrostomy due to urethral stricture, and benign prostatic hyperplasia. He was admitted due to febrile syndrome, productive cough, bilateral infiltrates with right paracardiac image, and pleural effusion. In both patients, A. schaalii was isolated in blood cultures, identified by MALDITOF-MS mass spectrometry. Only in case 1 was it confirmed that the focus of bacteremia was urinary. It is important to suspect this emerging pathogen in urinary infections with pathological sediment without developing in traditional culture media to ensure adequate empirical treatment. Since most of the isolates show resistance to ciprofloxacin and trimethoprim-sulfamethoxazole.
Topics: Actinomycetaceae; Aged; Aged, 80 and over; Argentina; Bacteremia; Humans; Male; Prostatic Hyperplasia; Urinary Tract Infections
PubMed: 34903428
DOI: 10.1016/j.ram.2021.10.001 -
International Journal of Systematic and... Sep 2019Two hitherto unknown bacteria (strains 313 and 352) were recovered from the faeces of Tibetan antelopes on the Tibet-Qinghai Plateau, PR China. Cells were rod-shaped and...
Two hitherto unknown bacteria (strains 313 and 352) were recovered from the faeces of Tibetan antelopes on the Tibet-Qinghai Plateau, PR China. Cells were rod-shaped and Gram-stain-positive. The optimal growth conditions were at 37 °C and pH 7. The isolates were closely related to (92.6 % 16S rRNA gene sequence similarity), (92.5 %), (92.4 %), (92.2 %) and (91.6 %). Phylogenetic analyses showed that strains 313 and 352 clustered independently in the vicinity of the genera , and , but could not be classified clearly as a member of any of these genera. Phylogenomic analysis also indicated that strains 313 and 352 formed an independent branch in the family . The major cellular fatty acids of the strains were C and Cω9. The polar lipids comprised diphosphatidylglycerol, phosphatidylinositol mannoside, phosphatidylglycerol, phosphatidylinositol and five unidentified components. The peptidoglycan contained lysine, alanine and glutamic acid. The respiratory quinone was absent. The whole-cell sugars included glucose and rhamnose. The DNA G+C content of strain 313 was 60.6 mol%. Based on the low 16S rRNA gene sequence similarities, its taxonomic position in the phylogenetic and phylogenomic trees and its unique lipid pattern, we propose that strains 313 and 352 represent members of a novel species in a new genus, for which the name gen. nov., sp. nov. is proposed. The type strain is 313 (=CGMCC 4.7453=DSM 106216).
Topics: Actinomycetaceae; Animals; Antelopes; Bacterial Typing Techniques; Base Composition; DNA, Bacterial; Fatty Acids; Feces; Peptidoglycan; Phospholipids; Phylogeny; RNA, Ribosomal, 16S; Sequence Analysis, DNA; Tibet
PubMed: 31334694
DOI: 10.1099/ijsem.0.003586 -
Pathology Dec 2018
Topics: Actinomycetaceae; Actinomycetales Infections; Aged; Aged, 80 and over; Female; Humans; Male
PubMed: 30318165
DOI: 10.1016/j.pathol.2018.08.002 -
American Journal of Obstetrics and... Nov 2020Since the discovery of the bladder microbiome (urobiome), interest has grown in learning whether urobiome characteristics have a role in clinical phenotyping and provide...
BACKGROUND
Since the discovery of the bladder microbiome (urobiome), interest has grown in learning whether urobiome characteristics have a role in clinical phenotyping and provide opportunities for novel therapeutic approaches for women with common forms of urinary incontinence.
OBJECTIVE
This study aimed to test the hypothesis that the bladder urobiome differs among women in the control cohort and women affected by urinary incontinence by assessing associations between urinary incontinence status and the cultured urobiome.
STUDY DESIGN
With institutional review board oversight, urine specimens from 309 adult women were collected through transurethral catheterization. These women were categorized into 3 cohorts (continent control, stress urinary incontinence [SUI], and urgency urinary incontinence [UUI]) based on their responses to the validated Pelvic Floor Distress Inventory (PFDI) questionnaire. Among 309 women, 150 were in the continent control cohort, 50 were in the SUI cohort, and 109 were in the UUI cohort. Symptom severity was assessed by subscale scoring with the Urinary Distress Inventory (UDI), subscale of the Pelvic Floor Distress Inventory. Microbes were assessed by expanded quantitative urine culture protocol, which detects the most common bladder microbes (bacteria and yeast). Microbes were identified to the species level by matrix-assisted laser desorption and ionization time-of-flight mass spectrometry. Alpha diversity indices were calculated for culture-positive samples and compared across the 3 cohorts. The correlations of UDI scores, alpha diversity indices, and species abundance were estimated.
RESULTS
Participants had a mean age of 53 years (range 22-90); most were whites (65%). Women with urinary incontinence were slightly older (control, 47; SUI, 54; UUI, 61). By design, UDI symptom scores differed (control, 8.43 [10.1]; SUI, 97.95 [55.36]; UUI, 93.71 [49.12]; P<.001). Among 309 participants, 216 (70%) had expanded quantitative urine culture-detected bacteria; furthermore, the urinary incontinence cohorts had a higher detection frequency than the control cohort (control, 57%; SUI, 86%; UUI, 81%; P<.001). In addition, the most frequently detected species among the cohorts were as follows: continent control, Lactobacillus iners (12.7%), Streptococcus anginosus (12.7%), L crispatus (10.7%), and L gasseri (10%); SUI, S anginosus (26%), L iners (18%), Staphylococcus epidermidis (18%), and L jensenii (16%); and UUI, S anginosus (30.3%), L gasseri (22%), Aerococcus urinae (18.3%), and Gardnerella vaginalis (17.4%). However, only Actinotignum schaalii (formerly Actinobaculum schaalii), A urinae, A sanguinicola, and Corynebacterium lipophile group were found at significantly higher mean abundances in 1 of the urinary incontinence cohorts when compared with the control cohort (Wilcoxon rank sum test; P<.02), and no individual genus differed significantly between the 2 urinary incontinence cohorts. Both urinary incontinence cohorts had increased alpha diversity similar to continent control cohort with indices of species richness, but not evenness, strongly associated with urinary incontinence.
CONCLUSION
In adult women, the composition of the culturable bladder urobiome is associated with urinary incontinence, regardless of common incontinence subtype. Detection of more unique living microbes was associated with worsening incontinence symptom severity. Culturable species richness was significantly greater in the urinary incontinence cohorts than in the continent control cohort.
Topics: Actinomycetaceae; Adult; Aerococcus; Aged; Aged, 80 and over; Biodiversity; Corynebacterium; Cross-Sectional Studies; Female; Gardnerella vaginalis; Humans; Lactobacillus; Lactobacillus crispatus; Lactobacillus gasseri; Microbiota; Middle Aged; Staphylococcus epidermidis; Streptococcus anginosus; Urinary Bladder; Urinary Incontinence, Stress; Urinary Incontinence, Urge; Young Adult
PubMed: 32380174
DOI: 10.1016/j.ajog.2020.04.033 -
JMM Case Reports May 2017It can be difficult to catalogue the individual organisms comprising polymicrobial patient infections, both because conventional clinical microbiological culture does...
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 . 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. 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 (). Ultimately, only complex and meticillin-resistant , both of which were identified by sequencing, were recovered by culture. 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.
PubMed: 29026619
DOI: 10.1099/jmmcr.0.005091 -
Clinical Microbiology and Infection :... Apr 2016
Observational Study
Topics: Actinomycetaceae; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Female; Gram-Positive Bacterial Infections; Humans; Male; Middle Aged; Prospective Studies; Treatment Outcome; Urinary Tract Infections; Young Adult
PubMed: 26551841
DOI: 10.1016/j.cmi.2015.10.030 -
APMIS : Acta Pathologica,... Feb 2018We report a case of aortic native valve endocarditis due to Actinotignum schaalii in an 89-year-old man with prostatism history but no signs of urinary infection....
We report a case of aortic native valve endocarditis due to Actinotignum schaalii in an 89-year-old man with prostatism history but no signs of urinary infection. Actinotignum schaalii was isolated not only from positive blood culture but also from cardiac valve culture using mass spectrometry and 16S rDNA sequencing. Actinotignum schaalii is recognized as commensal of genitourinary tract, but it was underdiagnosed. The advances in bacterial identification such as MALDI-TOF MS probably explain the increasing described cases of infections due to A. schaalii these last years.
Topics: Actinomycetaceae; Aged, 80 and over; Aortic Valve; Endocarditis, Bacterial; Heart Valve Diseases; Humans; Male; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization
PubMed: 29700913
DOI: 10.1111/apm.12803 -
Infection and Drug Resistance 2023This study compared microbial compositions of midstream and catheter urine specimens from patients with suspected complicated urinary tract infections to determine if...
Emerging and Fastidious Uropathogens Were Detected by M-PCR with Similar Prevalence and Cell Density in Catheter and Midstream Voided Urine Indicating the Importance of These Microbes in Causing UTIs.
INTRODUCTION
This study compared microbial compositions of midstream and catheter urine specimens from patients with suspected complicated urinary tract infections to determine if emerging and fastidious uropathogens are infecting the bladder or are contaminants.
METHODS
Urine was collected by in-and-out catheter (n = 1000) or midstream voiding (n = 1000) from 2000 adult patients (≥60 years of age) at 17 DispatchHealth sites across 11 states. The two groups were matched by age (mean 81 years), sex (62.1% female, 37.9% male), and ICD-10-CM codes. Microbial detection was performed with multiplex polymerase chain reaction (M-PCR) with a threshold for "positive detection" ≥ 10,000 cells/mL for bacteria or any detection for yeast. Results were divided by sex.
RESULTS
In females, 28 of 30 microorganisms/groups were found by both collection methods, while in males 26 of 30 were found by both. There were significant overlaps in the detection and densities of classical uropathogens including , and , as well as emerging uropathogens including and . In females, detection rates were slightly higher in midstream voided compared to catheter-collected (p = 0.0005) urine samples, while males showed the opposite trend (p < 0.0001). More polymicrobial infections were detected in midstream voided compared to catheter-collected samples (64.4% vs 45.7%, p < 0.0001) in females but the opposite in males (35.6% vs 47.0%, p = 0.002).
DISCUSSION
In-and-out catheter-collected and midstream voided urine specimens shared significant similarities in microbial detections by M-PCR, with some differences found for a small subset of organisms and between sexes.
CONCLUSION
Non-invasive midstream voided collection of urine specimens for microbial detection and identification in cases of presumed UTI does not result in significantly more contamination compared to in-and-out catheter-collected specimens. Additionally, organisms long regarded as contaminants should be reconsidered as potential uropathogens.
PubMed: 38148772
DOI: 10.2147/IDR.S429990 -
Frontiers in Pediatrics 2021A 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...
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 , and . 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.
PubMed: 34900875
DOI: 10.3389/fped.2021.775468 -
The Journal of Antimicrobial... Sep 2016
Topics: Actinomycetaceae; Actinomycetales Infections; Anti-Bacterial Agents; Communicable Diseases, Emerging; Drug Resistance, Bacterial; Genome, Bacterial; High-Throughput Nucleotide Sequencing; Humans; Integrases; Integrons; Sulfonamides
PubMed: 27261268
DOI: 10.1093/jac/dkw197