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European Journal of Pediatrics Feb 2023Aerococcus urinae (A. urinae) is primarily recognized as a common pathogen in the geriatric population, causing urinary tract infection (UTI), sepsis, and endocarditis,...
Aerococcus urinae (A. urinae) is primarily recognized as a common pathogen in the geriatric population, causing urinary tract infection (UTI), sepsis, and endocarditis, predominantly in female patients. In the paediatric population, only a few case reports exist suggesting A. urinae causes malodorous urine in otherwise healthy boys. In this study, we investigated the spectrum of clinical and laboratory presentations of A. urinae detection in children. A retrospective, single-centre, case series including all patients with the detection of A. urinae during a 7-year study period. Patients with detection of A. urinae only in non-urogenital skin swabs were excluded. A total of 40 samples from 33 patients were identified of which 20 patients were included in the final analysis. The median (IQR) age was 6.8 (2.9-9.5) years; 18 (90%) patients were boys. Four patients were diagnosed with a UTI, six had malodorous urine without UTI, three were diagnosed with balanitis and seven showed A. urinae colonization in the urine culture. Urogenital disorders were present in 12 patients. Additional pathogens were detected in 13 patients. Recurrence of detection during our study period was observed in four (20%) patients. Conclusion: Beyond malodorous urine, A. urinae detection is associated with more severe presentations including UTI in the paediatric population. Pre-existing urogenital disorders were frequent, and therefore, a nephro-urological investigation should be considered in all cases of A. urinae detection in the paediatric population. What is Known: • Aerococcus urinae (A. urinae) is known to be a common pathogen in the geriatric population, causing urinary tract infection (UTI), sepsis, and endocarditis, predominantly in female patients. • In the paediatric population, A. urinae is mainly described as a low-grade pathogen. Some case reports describe A. urinae as the cause of extraordinary malodorous urine in otherwise healthy boys. What is New: • Beyond malodorous urine, A. urinae detection is associated with more severe presentations including UTI in the paediatric population. • A. urinae was mainly detected in boys with pre-existing urogenital disorders; therefore, a nephro-urological investigation should be considered in cases of A. urinae detection in the paediatric population.
Topics: Aged; Male; Humans; Child; Female; Retrospective Studies; Anti-Bacterial Agents; Microbial Sensitivity Tests; Urinary Tract Infections; Aerococcus; Sepsis; Endocarditis; Urinary Tract; Gram-Positive Bacterial Infections
PubMed: 36472648
DOI: 10.1007/s00431-022-04730-2 -
International Journal of Systematic and... Sep 2023Average nucleotide identity analysis, based on whole genome sequences of 115 strains previously identified as , an emerging uropathogen, discriminates at least six...
Average nucleotide identity analysis, based on whole genome sequences of 115 strains previously identified as , 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 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 (type strain ATCC 51268 = CCUG 34223=NCFB 2893) and the names of sp. nov. (ATCC TSD-302 = DSM 115700 = CCUG 76531=NR-58630) sp. nov. (ATCC TSD-301 = DSM 115699 = CCUG 76532=NR-58629) and sp. nov. (ATCC TSD-300 = DSM 115698 = CCUG 76533=NR-58628) for three of the newly identified genomic taxa.
Topics: Aerococcus; Phylogeny; RNA, Ribosomal, 16S; Sequence Analysis, DNA; DNA, Bacterial; Bacterial Typing Techniques; Base Composition; Fatty Acids
PubMed: 37755156
DOI: 10.1099/ijsem.0.006066 -
Journal of Investigative Medicine High... 2018is a rare causative pathogen of infective endocarditis that results in a high risk of embolic events. The mortality rate for endocarditis is high. Old age and...
is a rare causative pathogen of infective endocarditis that results in a high risk of embolic events. The mortality rate for endocarditis is high. Old age and underlying urologic conditions are the best-known risk factors for infection. We report the clinical course of the disease in a 49-year-old man who presented symptoms of a urinary tract infection. A few days later, transthoracic echocardiography showed a conspicuous mitral valve with myxomatous alterations. Following the detection of a cerebral embolism with associated stroke symptoms, as well as at the beginning of cardiac failure, the emergency indication for the surgical treatment of mitral valve endocarditis was given. On the second day following the operation, circulatory collapse rapidly developed. Following an unsuccessful attempt at cardiopulmonary resuscitation, the patient died. From 1991 to 2017, 29 cases of -induced endocarditis have been described in PubMed and Medline. One or 2 new cases are published annually. We review all reported cases of endocarditis, with an emphasis on the predisposing factors, course, and outcomes of the disease. endocarditis is a rare disease primarily affecting elderly men with urinary tract pathologies and comorbidities. The course of the disease is severe, and the outcome is often fatal. A 16S rDNA polymerase chain reaction investigation of bacterial genome provides proof of the presence of . Because of the high risk of embolism, rapid treatment should focus on the diseased heart valve. Based on existing data and the experience gained from handling cases, treatment with β-lactam and aminoglycosides is recommended. It is also recommended that operative therapy take place as soon as possible.
PubMed: 29511694
DOI: 10.1177/2324709618758351 -
Proceedings (Baylor University. Medical... 2022is an alpha-hemolytic, gram-positive coccus that is responsible for 54/1,000,000 cases of all urinary tract infections. Risk factors include male gender, advanced age,...
is an alpha-hemolytic, gram-positive coccus that is responsible for 54/1,000,000 cases of all urinary tract infections. Risk factors include male gender, advanced age, and genitourinary tract abnormalities. It has often been misidentified as or due to its morphological similarities. Fewer than 50 cases of infective endocarditis have been reported, most affecting the mitral or aortic valve. We present the case of a 61-year-old woman who presented with recurrent fevers and worsening dyspnea on exertion and was found to have bacteremia. A transesophageal echocardiogram showed evidence of moderate tricuspid valve regurgitation and vegetations involving its posterior and septal leaflets. The patient was successfully treated with intravenous penicillin G for 6 weeks. She was not deemed a candidate for cardiac surgery.
PubMed: 35754564
DOI: 10.1080/08998280.2022.2054042 -
Journal of Medical Microbiology Jun 2023species in particular are increasingly reported as causative agents of bacteraemia, urinary tract infection, sepsis, and endocarditis. We sought to establish the...
Epidemiology and urological pathogenic potential of species in greater Glasgow and Clyde (Descriptive study of in blood culture and urinary samples: clinical importance and potential marker of urinary tract pathology).
species in particular are increasingly reported as causative agents of bacteraemia, urinary tract infection, sepsis, and endocarditis. We sought to establish the epidemiology of in Glasgow hospitals and whether the presence of the organism in clinical isolates could be an indicator of undiagnosed urinary tract pathology. The knowledge gap among clinical staffs on species as emerging pathogens can be filled by understanding its epidemiology and clinical importance. Describe the epidemiology and clinical importance of . We reviewed positive blood cultures with species (2017-2021) and urinary isolates (2021) in Glasgow hospitals. Data were collected from clinical and laboratory database systems. All 22 positive blood cultures were and sensitive to amoxicillin, vancomycin, and ciprofloxacin. The median age was 80.5; the majority was male (18). In total, 15/22 (68 %) were diagnosed with urinary tract infection. Thirteen were treated with amoxicillin. No cases of infective endocarditis were noted. One patient was subsequently diagnosed with bladder carcinoma. All 83 positive urinary isolates in 72 patients were . One was resistant to amoxicillin; two to ciprofloxacin; all sensitive to nitrofurantoin and vancomycin. The majority was female (43/83), the median age was 80. The commonest risk factors were underlying malignancy including bladder cancer (5/18), chronic kidney disease (17) and diabetes (16). Clinical data was unavailable in 24 episodes. Of these, 41/59 (69.5 %) were diagnosed with urinary tract infection. One patient was subsequently diagnosed with metastatic renal cancer while bladder wall lesions were identified in three patients, two of whom were waiting for an urology review at the time of study. Thirteen patients (18 %) had 1 year recurrent bacteriuria and three were not treated on initial episode. are emerging pathogens and are likely to become more common due to advances in laboratory technologies and an ageing population. Clinical teams should be aware of their urological pathogenic potential and not dismiss them as contaminants. Whether infection is a potential indicator for undiagnosed urinary tract malignancy warrants further studies.
Topics: Aged, 80 and over; Female; Humans; Male; Aerococcus; Amoxicillin; Anti-Bacterial Agents; Blood Culture; Ciprofloxacin; Clinical Relevance; Gram-Positive Bacterial Infections; Urinary Bladder; Urinary Tract Infections; Vancomycin
PubMed: 37335077
DOI: 10.1099/jmm.0.001690 -
Infection Jun 2018Aerococccus urinae (AU) is a pathogen mainly identified in male urinary tract infections and responsible for bacteremia and endocarditis. To the best of our knowledge,... (Review)
Review
INTRODUCTION
Aerococccus urinae (AU) is a pathogen mainly identified in male urinary tract infections and responsible for bacteremia and endocarditis. To the best of our knowledge, there are only five patients with osteomyelitis due to AU described in the literature. All of them had urinary tract disease or systemic conditions such as diabetes, and two were associated with an endocarditis.
CASE REPORT
We described the first case of isolated spondylodiscitis without general or local predisposing condition, excepted age > 65 years.
Topics: Aerococcus; Aged, 80 and over; Anti-Bacterial Agents; Discitis; Gram-Positive Bacterial Infections; Humans; Male; Treatment Outcome
PubMed: 29453766
DOI: 10.1007/s15010-017-1106-0 -
The American Journal of Case Reports May 2020BACKGROUND Initially presumed as nonpathogenic, the bacterial genus aerococcus now includes 7 distinct virulent and avirulent species. Aerococcus urinae first isolated... (Review)
Review
BACKGROUND Initially presumed as nonpathogenic, the bacterial genus aerococcus now includes 7 distinct virulent and avirulent species. Aerococcus urinae first isolated in 1992 is an uncommon cause of urinary tract infection (UTI) and is seen in only 0.15% to 0.8% of cases. A. urinae associated invasive bacteremia and systemic infection are extremely rare entities. Less than 50 cases of A. urinae associated with infective endocarditis (IE) have been reported in the literature, with the prevalence being 3 per 1 million. CASE REPORT A 59-year-old male presented to our hospital with exertional dyspnea and new-onset atrial flutter. Prior to his current admission patient was treated for A. urinae associated UTI with levofloxacin for 10 days. A transthoracic echocardiogram revealed severe aortic regurgitation with aortic valve endocarditis, which was subsequently confirmed on transesophageal echocardiogram. Blood cultures displayed gram-positive cocci in clusters, ultimately identified as A. urinae. The patient was treated with intravenous vancomycin and underwent surgical aortic valve replacement along with patch repair for underlying aortic wall ulcer. CONCLUSIONS To the best of our knowledge, this is the first-ever reported case of A. urinae associated IE complicated by an aortic wall ulcer. Male gender, age >65 years, and preexisting urinary tract pathology have all been implicated as risk factors for aerococcus infection. A. urinae is almost always sensitive to penicillin, carbapenem, and aminoglycosides.
Topics: Aerococcus; Aortic Valve; Aortic Valve Insufficiency; Atrial Fibrillation; Dyspnea; Echocardiography; Echocardiography, Transesophageal; Endocarditis; Humans; Male; Middle Aged; Risk Factors; Ulcer
PubMed: 32437335
DOI: 10.12659/AJCR.920974 -
Enfermedades Infecciosas Y... Nov 2020
Topics: Aerococcus; Endocarditis, Bacterial; Humans
PubMed: 32143892
DOI: 10.1016/j.eimc.2020.01.015 -
The Open Microbiology Journal 2017and are relatively newcomers and emerging organisms in clinical and microbiological practice. Both species have worldwide been associated with urinary tract...
BACKGROUND
and are relatively newcomers and emerging organisms in clinical and microbiological practice. Both species have worldwide been associated with urinary tract infections. More rarely cases of bacteremia/septicemia and infective endocarditis have been reported. Treatment options are therefore important. Just recently, European recommendations on susceptibility testing and interpretive criteria have been released.
OBJECTIVE
In this investigation 120 and isolates were tested for susceptibility to six antimicrobial agents: Penicillin, cefotaxime, meropenem, vancomycin, linezolid, and rifampicin.
METHODS
Three susceptibility testing methods were used; disk diffusion according to The European Committee on Antimicrobial Susceptibility Testing (EUCAST) standardized disk diffusion methodology and MIC determination with Etest and broth microdilution (BMD). All testing was performed with EUCAST media for fastidious organisms.
RESULTS
Data obtained in this study were part of the background data for establishing EUCAST breakpoints. MIC values obtained by Etest and BMD were well correlated with disk diffusion results.
CONCLUSION
All isolates were found susceptible to all six antimicrobial agents: penicillin, cefotaxime, meropenem, vancomycin, linezolid, and rifampicin.
PubMed: 29151992
DOI: 10.2174/1874285801711010160 -
Journal of Medical Case Reports Nov 2022Aerococcus 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...
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.
Topics: Male; Humans; Aged, 80 and over; Aerococcus; Abscess; Gram-Positive Bacterial Infections; Endocarditis, Bacterial; Endocarditis; Urinary Tract Infections; Stomatognathic Diseases
PubMed: 36397095
DOI: 10.1186/s13256-022-03564-8