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Clinical Microbiology and Infection :... Jan 2016Aerococci have often been misidentified as streptococci in microbiology laboratories, leading to an underestimation of these bacteria as causes of human infections. An... (Review)
Review
Aerococci have often been misidentified as streptococci in microbiology laboratories, leading to an underestimation of these bacteria as causes of human infections. An increased awareness of aerococci and the introduction of matrix-assisted laser desorption ionization time-of-flight mass spectrometry, has led to an increased isolation of Aerococcus urinae and Aerococcus sanguinicola from human urine and blood. The two species are found in human urine and can cause urinary tract infections (UTI). Aerococcus urinae can, in older males with underlying urinary tract conditions, cause invasive infections such as urosepsis or infective endocarditis. The prognosis of invasive aerococcal infections appears to be relatively favourable despite the old age of patients and their many comorbidities. Though clinical breakpoints are still not in place, aerococci seem to be sensitive to penicillins, carbapenems and vancomycin. There is synergy between penicillin and aminoglycosides against some A. urinae isolates and this combination is often used in aerococcal infective endocarditis. The treatment of complicated aerococcal UTI is not obvious as many isolates are resistant to fluoroquinolones. In addition, A. urinae is resistant to sulphamethoxazole, and there are methodological problems in the determination of trimethoprim sensitivity. In complicated UTI, ampicillin is probably a safe treatment option, whereas nitrofurantoin is probably effective in uncomplicated UTI. Treatment studies in aerococcal infections are needed as is a better understanding of the natural niches for aerococci and the pathogenesis and clinical course of aerococcal infections.
Topics: Aerococcus; Anti-Bacterial Agents; Blood; Endocarditis, Bacterial; Gram-Positive Bacterial Infections; Humans; Microbial Sensitivity Tests; Sepsis; Urinary Tract Infections; Urine
PubMed: 26454061
DOI: 10.1016/j.cmi.2015.09.026 -
Cureus Apr 2022is a gram-positive organism frequently found in the urinary tract. It is often mistaken for and based on its appearance. It commonly causes urinary tract infections...
is a gram-positive organism frequently found in the urinary tract. It is often mistaken for and 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 infective endocarditis and discuss echocardiographic imaging findings and management approach.
PubMed: 35547451
DOI: 10.7759/cureus.23947 -
The American Journal of Case Reports May 2019BACKGROUND Aerococcus viridans are Gram-positive, catalase and oxidase-negative, microaerophilic, and non-motile bacteria species that are rarely associated with human... (Review)
Review
BACKGROUND Aerococcus viridans are Gram-positive, catalase and oxidase-negative, microaerophilic, and non-motile bacteria species that are rarely associated with human infections such as arthritis, bacteremia, endocarditis, and meningitis. The bacteria are also fastidious (i.e., have complex nutritional requirements) and often confused with Streptococci species or treated as a contaminant. CASE REPORT We report a case of Aerococcus septicemia in an 85-year-old female patient, who transferred from a nursing home to an acute care hospital in Washington DC, USA. She had a 2-day history of worsening mental status, fever of 38.9°C (102°F), and tachycardia. Urinalysis revealed numerous white blood cells and bacteria. Laboratory tests revealed a white blood cell count of 14 000 cells/mL (85% neutrophils, 8% lymphocytes, 5% bands, and 2% monocytes), hemoglobin of 12.6 g/dL, and serum creatinine of 0.8 mg/dL. Blood and urine cultures obtained during admission grew penicillin-resistant A. viridans, identified via matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF) on day 3 of admission. The patient received empiric vancomycin with piperacillin-tazobactam, and we deescalated to vancomycin monotherapy to complete a 14-day treatment course. CONCLUSIONS This case report highlights the role of MALDI-TOF for identifying fastidious organisms, and we were able to form a better clinical correlation between patient symptoms and causative organisms. We believe that antimicrobial therapy (in accordance with susceptibility results) should be initiated in symptomatic patients who have A. viridans isolated in significant amounts in urine or from a sterile site.
Topics: Aerococcus; Aged, 80 and over; Female; Gram-Positive Bacterial Infections; Humans; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization
PubMed: 31089069
DOI: 10.12659/AJCR.914866 -
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 -
Enfermedades Infecciosas Y... Nov 2020
Topics: Aerococcus; Endocarditis, Bacterial; Humans
PubMed: 32143892
DOI: 10.1016/j.eimc.2020.01.015 -
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 -
International Journal of Systematic and... Nov 2023A non-spore-forming, Gram-stain-positive, short rod-shaped strain, designated SJQ22, was isolated from a paddy soil sample collected in Shanghai, PR China. A comparative...
A non-spore-forming, Gram-stain-positive, short rod-shaped strain, designated SJQ22, was isolated from a paddy soil sample collected in Shanghai, PR China. A comparative analysis of 16S rRNA gene sequences showed that strain SJQ22 fell within the genus , forming a clear cluster with the type strains of (98.6 % sequence similarity) and (98.5 % sequence similarity). Strain SJQ22 grew at 30-45 °C (optimum, 30 °C), pH 6.0-8.0 (optimum, pH 7.0) and with a NaCl concentration of 0-4 % (optimum, 1 %). Cells were negative for oxidase and catalase activity. Chemotaxonomic analysis showed that strain SJQ22 possessed C and C ω9 as the predominant fatty acids. The DNA G + C content was 39.0 mol%. Strain SJQ22 exhibited DNA-DNA relatedness levels of 13±2 % with ATCC 11563 and 9±2 % with IFO 12173. Based on the data obtained, strain SJQ22 represents a novel species of the genus , for which the name sp. nov. is proposed. The type strain is SJQ22 (=JCM 33111=CCTCC AB 2018283).
Topics: Fatty Acids; Soil Microbiology; Aerococcus; RNA, Ribosomal, 16S; DNA, Bacterial; Nucleic Acid Hybridization; Base Composition; China; Phylogeny; Bacterial Typing Techniques; Sequence Analysis, DNA
PubMed: 37909297
DOI: 10.1099/ijsem.0.006069 -
Journal of Microscopy and Ultrastructure 2021is a Gram-positive, catalase- and oxidase-negative, microaerophilic, nonmotile bacteria species rarely associated with human infections such as arthritis, bacteremia,...
INTRODUCTION
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 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 isolates were identified over the study period of 9 years. Of these, was isolated in 10 (50%), in 6 (30%), and (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 (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 , and the other 2 each with and 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 infection. Recent advances in diagnostic technology have led to an increase in detection of -related infections. The rare occurrence of in human infections and resultant lack of randomized control trials have resulted in a significant degree of clinical uncertainty in the management of IE.
PubMed: 33850708
DOI: 10.4103/JMAU.JMAU_61_19 -
Journal of the Pediatric Infectious... Nov 2019Aerococcus 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... (Review)
Review
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.
Topics: Aerococcus; Aneurysm, Infected; Anti-Bacterial Agents; Child; Computed Tomography Angiography; Endocarditis, Subacute Bacterial; Gram-Positive Bacterial Infections; Humans; Male; Penicillin G; Pulmonary Artery; Thoracotomy; Treatment Outcome
PubMed: 30892601
DOI: 10.1093/jpids/piz016 -
Open Forum Infectious Diseases Dec 2019is 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...
BACKGROUND
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 in a male with recurrent urinary tract infections and recently treated bacteremia. A 63-year-old gentleman with a history of 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
was isolated from excised tissue. The patient completed a 4-week course of intravenous antimicrobial therapy.
CONCLUSIONS
is a urinary pathogen with the ability to cause severe invasive disease including endovascular infections.
PubMed: 31850388
DOI: 10.1093/ofid/ofz453