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European Journal of Clinical... May 2022Our objective was to assess the incidence of bacteraemic Aerococcus urinae cases at Helsinki metropolitan area, Finland, from a 6-year study period (2013 to 2018) and to...
Our objective was to assess the incidence of bacteraemic Aerococcus urinae cases at Helsinki metropolitan area, Finland, from a 6-year study period (2013 to 2018) and to further characterize available cases. The study evaluates the outcome of commonly used cefuroxime treatment and determinate a set of A. urinae in vitro antimicrobial susceptibilities for benzylpenicillin, cefuroxime, and ceftriaxone. Clinical records of A. urinae bacteraemic patients were reviewed retrospectively. Antimicrobial susceptibility testing was performed by disk diffusion, gradient test, and broth microdilution for 139-141 clinical A. urinae isolates. Clinical data of 72/77 patients were combined with the in vitro susceptibilities. We found an increasing number of bacteraemic A. urinae cases within 6-year study period (p = 0.01). The patients were mainly elderly males, and all suffered from underlying conditions. A total of 27.3% of cases (21/77) showed polymicrobial blood cultures. Thirty-day mortality was 22.1%. Cefuroxime was the initial empiric antimicrobial agent given for 66/76 of the patients and treatment outcome was favorable for 20/22 patients who received cefuroxime at least up to day 5. All isolates were susceptible to benzylpenicillin and cefuroxime interpreted by EUCAST breakpoints for Aerococci and PK-PD breakpoints, respectively. MIC determinations gave variable results for ceftriaxone, 2.1-2.9% of the isolates were resistant. To conclude, it seems that the number of bacteraemic Aerococcus urinae cases is increasing at Helsinki metropolitan area, Finland, reflecting the growing blood culture sampling. Clinical A. urinae isolates were susceptible to cefuroxime in vitro. Treatment data indicate that empirical cefuroxime started for possibly urinary tract -derived community-acquired bacteraemia covers A. urinae.
Topics: Aerococcus; Aged; Anti-Bacterial Agents; Bacteremia; Ceftriaxone; Cefuroxime; Disease Susceptibility; Finland; Gram-Positive Bacterial Infections; Humans; Male; Microbial Sensitivity Tests; Retrospective Studies
PubMed: 35257275
DOI: 10.1007/s10096-022-04415-6 -
Federal Practitioner : For the Health... Dec 2022(), considered a rare pathogen, has been identified with increasing frequency in urine cultures. Only 8 cases of spondylodiscitis due to have been reported. Optimal...
BACKGROUND
(), considered a rare pathogen, has been identified with increasing frequency in urine cultures. Only 8 cases of spondylodiscitis due to have been reported. Optimal treatment for invasive infection is undefined. However, the reported cases were treated successfully with diverse antibiotic regimen combinations, all including a β-lactam and beginning with at least 2 weeks of IV antibiotics.
CASE PRESENTATION
A 74-year-old man presented to the emergency department after 2 weeks of midthoracic back pain, lower extremity weakness, gait imbalance, fatigue, anorexia, rigors, and subjective fevers. The patient was presumed to have discitis secondary to a urinary tract infection with possible pyelonephritis and was given empiric vancomycin and ceftriaxone. Spinal magnetic resonance imaging with contrast supported spondylodiscitis. Preliminary results from the admission blood and urine cultures showed gram-positive cocci in clusters.
CONCLUSIONS
urinary tract infection in the absence of obvious predisposing factors should prompt evaluation for urinary outflow obstruction. We suspect a review of a US Department of Veterans Affairs population might uncover a higher incidence of infection than previously suspected.
PubMed: 37025983
DOI: 10.12788/fp.0340 -
IDCases 2023is a Gram-positive, catalase-negative coccus, rarely responsible for urinary tract infections and seldom described for musculoskeletal infections like spondylodiscitis....
is a Gram-positive, catalase-negative coccus, rarely responsible for urinary tract infections and seldom described for musculoskeletal infections like spondylodiscitis. An 86-year-old man presented to our hospital for groin pain without fever. Pelvic CT-guided biopsy revealed an pubic symphysis osteomyelitis. He received a treatment by amoxicillin for six weeks, and did not need any surgery. An eight -month- follow-up showed a favorable evolution. Pubic symphysis infection can be induced by a wide variety of pathogens, and may have very different clinical presentations. Some authors recommend systematic surgery, but in case of susceptible pathogen associated with a low level of joint destruction, medical treatment alone should be sufficient to cure and make surgery unnecessary.
PubMed: 37928817
DOI: 10.1016/j.idcr.2023.e01911 -
Journal of Medical Cases Feb 2021is a rare organism infrequently isolated from cultures. Mostly known to cause urinary tract infection, it can cause bacteremia leading to severe urosepsis and infective...
is a rare organism infrequently isolated from cultures. Mostly known to cause urinary tract infection, it can cause bacteremia leading to severe urosepsis and infective endocarditis. Embolization is frequently reported with endocarditis (AUE); hence, the presentation is highly variable. Sequelae such as various central nervous system manifestations, sepsis, valvular regurgitation with heart failure and even coronary artery involvement have been reported. We report a case of a 58-year-old man with AUE of the aortic valve, severe aortic regurgitation and embolic stroke as a result of embolization from AUE and ultimately required aortic valve replacement. Our case highlights this rare cause of endocarditis and offers insight into the variability of patient presentation and risk factors to consider.
PubMed: 34434432
DOI: 10.14740/jmc3612 -
International Journal of Medical... Nov 2019Aerococcus urinae is an emerging pathogen that causes urinary tract infections, bacteremia and infective endocarditis. The mechanisms through which A. urinae cause...
Aerococcus urinae is an emerging pathogen that causes urinary tract infections, bacteremia and infective endocarditis. The mechanisms through which A. urinae cause infection are largely unknown. The aims of this study were to describe the surface proteome of A. urinae and to analyse A. urinae genomes in search for genes encoding surface proteins. Two proteins, denoted Aerococcal surface protein (Asp) 1 and 2, were through the use of mass spectrometry based proteomics found to quantitatively dominate the aerococcal surface. The presence of these proteins on the surface was also shown using ELISA with serum from rabbits immunized with the recombinant Asp. These proteins had a signal sequence in the amino-terminal end and a cell wall-sorting region in the carboxy-terminal end, which contained an LPATG-motif, a hydrophobic domain and a positively charged tail. Twenty-three additional A. urinae genomes were sequenced using Illumina HiSeq technology. Six different variants of asp genes were found (denoted asp1-6). All isolates had either one or two of these asp-genes located in a conserved locus, designated Locus encoding Aerococcal Surface Proteins (LASP). The 25 genomes had in median 13 genes encoding LPXTG-proteins (range 6-24). For other Gram-positive bacteria, cell wall-anchored surface proteins with an LPXTG-motif play a key role for virulence. Thus, it will be of great interest to explore the function of the Asp proteins of A. urinae to establish a better understanding of the molecular mechanisms by which A. urinae cause disease.
Topics: Aerococcus; Amino Acid Motifs; Amino Acid Sequence; Animals; Bacterial Proteins; Base Sequence; Cell Wall; Enzyme-Linked Immunosorbent Assay; Genome, Bacterial; Membrane Proteins; Protein Sorting Signals; Proteome; Rabbits; Recombinant Proteins; Virulence
PubMed: 31257068
DOI: 10.1016/j.ijmm.2019.06.005 -
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 -
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 -
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 -
Diagnostic Microbiology and Infectious... Dec 2005A retrospective chart review was performed on 54 patients with positive urine cultures during a 1-year period to assess the clinical significance of Aerococcus urinae.... (Review)
Review
A retrospective chart review was performed on 54 patients with positive urine cultures during a 1-year period to assess the clinical significance of Aerococcus urinae. Based on predetermined criteria, patients were classified into 2 groups: those with urinary tract infections (UTIs) and those who were considered colonized. The majority of the patients were > or =65 years old and were female. Only 31% of patients with UTI and 45% of colonized patients had A. urinae isolated in pure cultures. Both groups had significant but similar underlying medical conditions, with urologic conditions being predominant. Significantly more patients in the UTI group had urinary catheters (P < .01). No direct complications or invasive disease was recognized in either group regardless of whether patients were treated with antibiotics. Apparently, A. urinae is a relatively avirulent organism when cultured from urine.
Topics: Age Factors; Aged; Female; Gram-Positive Bacterial Infections; Humans; Male; Middle Aged; Retrospective Studies; Sex Factors; Streptococcaceae; Urinary Catheterization; Urinary Tract Infections; Urine
PubMed: 16269223
DOI: 10.1016/j.diagmicrobio.2005.06.021 -
Infection Oct 2002Aerococcus urinae is a rare cause of urinary tract infections, mainly in elderly men with underlying urinary tract pathologies. In addition, it has been described as a... (Review)
Review
Aerococcus urinae is a rare cause of urinary tract infections, mainly in elderly men with underlying urinary tract pathologies. In addition, it has been described as a pathogen in balanitis, soft tissue infections, septicemia and endocarditis. To date ten cases of A. urinae endocarditis have been reported in the literature with a high rate of mortality (7/10) and morbidity, as two out of three survivors suffered from neurovascular complications. Here we present the case of an additional patient who was successfully treated with surgical valve replacement and antibiotic therapy consisting of ceftriaxone and netilmicin for 6 weeks. Furthermore, we review all reported cases of A. urinae endocarditis with emphasis on predisposing factors and therapeutic options.
Topics: Aged; Anti-Bacterial Agents; Combined Modality Therapy; Drug Therapy, Combination; Echocardiography, Transesophageal; Endocarditis, Bacterial; Follow-Up Studies; Gram-Positive Bacterial Infections; Heart Valve Prosthesis; Humans; Male; Prosthesis-Related Infections; Risk Assessment; Streptococcaceae; Treatment Outcome
PubMed: 12382093
DOI: 10.1007/s15010-002-3106-x