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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 -
Journal of General Internal Medicine Feb 2023
Topics: Humans; Abiotrophia; Antibodies, Antineutrophil Cytoplasmic; Endocarditis; Glomerulonephritis; Vasculitis
PubMed: 36460879
DOI: 10.1007/s11606-022-07960-0 -
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 -
The American Journal of Case Reports Oct 2022BACKGROUND Aerococcus species are a rare cause of endocarditis. Micro-organism identification and antibiotic choice can pose significant management challenges to...
BACKGROUND Aerococcus species are a rare cause of endocarditis. Micro-organism identification and antibiotic choice can pose significant management challenges to clinicians who care for patients with this infection. Aerococcus is a gram-positive micro-organism which is commonly misidentified because it shares many similarities with streptococcus and enterococcus species. Aerococcus urinae is usually found to cause urinary tract infections and occurs more frequently in patients with structural urinary tract abnormalities associated with urethral and ureteral obstruction such as kidney stones, phimosis, and prostate hyperplasia. However, it is reported to rarely cause endocarditis. CASE REPORT A 48-year-old man with a history of cocaine abuse and right hip replacement presented to our emergency department with acute encephalopathy. Through a complicated hospital course, he was found to be septic and the bacteria were initially misidentified as an alpha-hemolytic strep before being correctly identified as Aerococcus urinae. He was found to have multiple cerebral, likely septic, embolic infarcts and aortic valve endocarditis. Identification of the micro-organism on blood cultures was challenging, as were decisions about antibiotic choice. He died despite efforts of a multidisciplinary care team. CONCLUSIONS Our case highlights a unique case of Aerococcus endocarditis and shows the difficulty in initially identifying the bacteria. To our knowledge this is the first case reported in the setting of substance abuse. It also highlights the lack of appropriate guideline-directed therapy with regards to antibiotic choices in this group of patients, emphasizing the importance of further research in this regard.
Topics: Aerococcus; Anti-Bacterial Agents; Aortic Valve; Endocarditis; Endocarditis, Bacterial; Gram-Positive Bacterial Infections; Humans; Male; Middle Aged; Sepsis
PubMed: 36251625
DOI: 10.12659/AJCR.937596 -
Frontiers in Bioscience (Elite Edition) Aug 2022spp. and spp. are Gram-positive cocci, formerly known as nutritionally variant or deficient . Their role as causative agents of infective endocarditis (IE) is...
BACKGROUND
spp. and spp. are Gram-positive cocci, formerly known as nutritionally variant or deficient . Their role as causative agents of infective endocarditis (IE) is numerically uncertain, as well as diagnostic and clinical management of this infection. The aim of our study is to describe the clinical, microbiological, therapeutic, and prognosis of patients with IE caused by these microorganisms in a large microbiology department.
METHODS
Retrospective analysis of all the patients with spp. and spp. IE registered in our centre in the period 2004-2021.
RESULTS
Of the 822 IE in the study period, 10 (1.2%) were caused by spp. (7) or spp. (3). The species involved were (7), (2) and (1). Eight patients were male, their mean age was 46 years and four were younger than 21 years. The most frequent comorbidities were congenital heart disease (4; 40%) and the presence of intracardiac prosthetic material (5; 50%). IE occurred on 5 native valves and 5 prosthetic valve or material. Blood cultures were positive in 8/10 patients, within a mean incubation period of 18.07 hours. In the other two patients, a positive 16SPCR from valve or prosthetic material provided the diagnosis. Surgery for IE was performed in seven patients (70%) and in all cases positive PCR and sequencing from valve or prosthetic material was demonstrated. Valves and/or prosthetic removed material cultures were positive in four patients. Nine patients received ceftriaxone (4 in monotherapy and 5 in combination with other antibiotics). The mean length of treatment was 6 weeks and IE-associated mortality was 20% at one year follow-up.
CONCLUSIONS
spp. or spp. IE were infrequent but not exceptional in our environment and particularly affected patients with congenital heart disease or prosthetic material. Blood cultures and molecular methods allowed the diagnosis. Most of them required surgery and the associated mortality, in spite of a mean age of 46 years, was high.
Topics: Abiotrophia; Anti-Bacterial Agents; Carnobacteriaceae; Ceftriaxone; Endocarditis; Endocarditis, Bacterial; Female; Humans; Male; Middle Aged; RNA, Ribosomal, 16S; Retrospective Studies; Streptococcus
PubMed: 36137991
DOI: 10.31083/j.fbe1403023 -
Frontiers in Cellular and Infection... 2022The brain development of preterm infants is easily affected by various adverse extrauterine factors and complications, resulting in abnormal neurological and cognitive...
BACKGROUND
The brain development of preterm infants is easily affected by various adverse extrauterine factors and complications, resulting in abnormal neurological and cognitive development. Recent studies have found that there is a significant correlation between intestinal microbial changes and cognitive behavior. Nevertheless, the correlation between the cognitive impairment and abnormal changes of intestinal microflora in the preterm newborn has been rarely elucidated.
AIM
To analyze the differences of fecal intestinal flora, short chain fatty acids (SCFAs) and microbiota-gut-brain axis (MGBA)-related serum factors between preterm birth with and without cognitive impairment.
METHODS
Healthy female rats (body weight 410 ± 40 g) of 16-17 days of gestation were selected for the establishment of preterm cognitive impairment model and screened by Morris water maze navigation experiments. The pathological change of rat hippocampus was confirmed by HE staining. The abundance of fecal intestinal microflora was determined by 16sRNA sequencing, while the contents of fecal SCFAs were examined by gas chromatography.
RESULTS
Compared with the control group, the cognitive impairment group had decreased abundance and diversity of intestinal microflora and increased abundance of at the level of phylum. While the abundances of , , , and decreased significantly at the level of order, family, and genus, the abundances of , , , and increased significantly. Moreover, the levels of total SCFAs and acetic acid in the disease group were significantly lower. The fecal abundance of acetic acid was positively correlated with that of or , and negatively correlated with that of , and in disease rats. Furthermore, cognitive impairment caused significantly decreased levels of 5-HT, GABA, and BDNF, and increased levels of GR, CRH, IL-6, and TNF-α in rat blood.
CONCLUSION
Alterations in intestinal microflora structure and the abundances of SCFAs contributed substantially to the cognitive impairment in preterm rats, which was associated with significant changes in MGBA-related soluble factors.
Topics: Animals; Cognitive Dysfunction; Fatty Acids, Volatile; Female; Gastrointestinal Microbiome; Humans; Infant, Newborn; Infant, Premature; Premature Birth; Rats
PubMed: 36061856
DOI: 10.3389/fcimb.2022.945851 -
Frontiers in Cellular and Infection... 2022Parkinson's disease (PD) is a common neurodegenerative disorder, accompanied by motor deficits as well as gastrointestinal dysfunctions. Recent studies have proved that...
BACKGROUND
Parkinson's disease (PD) is a common neurodegenerative disorder, accompanied by motor deficits as well as gastrointestinal dysfunctions. Recent studies have proved that the disturbance of gut microbiota and metabolism contributes to the pathogenesis of PD; however, the mechanisms underlying these effects have yet to be elucidated. Curcumin (CUR) has been reported to provide neuroprotective effects on neurological disorders and modulate the gut flora in intestinal-related diseases. Therefore, it is of significant interest to investigate whether CUR could exert a protective effect on PD and whether the effect of CUR is dependent on the intestinal flora and subsequent changes in metabolites.
METHODS
In this study, we investigated the neuroprotective effects of CUR on a mouse model of PD induced by 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). 16S rRNA sequencing was performed to explore the profile of the gut microbiota among controls, MPTP-treated mice and CUR-treated mice. Then, antibiotic treatment (ABX) and fecal microbiota transplantation (FMT) experiments were conducted to examine the role of intestinal microbes on the protective effects of CUR in PD mice. Furthermore, ultra-high-performance liquid chromatography-mass spectrometry (UHPLC-MS)-based metabolomics analysis was used to identify the landscape of the CUR-driven serum metabolome. Finally, Pearson's analysis was conducted to investigate correlations between the gut flora-metabolite axis and CUR-driven neuroprotection in PD.
RESULTS
Our results showed that CUR intervention effectively improved motor deficits, glial cell activation, and the aggregation of α-synuclein (α-syn) in MPTP-treated mice. 16S rRNA sequencing showed elevated abundances of , , and but depleted abundances of and in CUR-treated mice when compared with MPTP mice. ABX and FMT experiments further confirmed that the gut microbiota was required for CUR-induced protection in PD mice. Serum metabolomics analysis showed that CUR notably upregulated the levels of tyrosine, methionine, sarcosine and creatine. Importantly, strong correlations were identified among crucial taxa (, , , , and ), pivotal metabolites (tyrosine, methionine, sarcosine and creatine) and the motor function and pathological results of mice. CUR treatment led to a rapid increase in the brain levels of tyrosine and levodopa (dopa) these changes were related to the abundances of and .
CONCLUSIONS
CUR exerts a protective effect on the progression of PD by modulating the gut microbiota-metabolite axis. and , along with key metabolites such as tyrosine and dopa play a dominant role in CUR-associated neuroprotection in PD mice. Our findings offer unique insights into the pathogenesis and potential treatment of PD.
Topics: 1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine; Animals; Creatine; Curcumin; Disease Models, Animal; Gastrointestinal Microbiome; Levodopa; Metabolome; Methionine; Mice; Mice, Inbred C57BL; Neuroinflammatory Diseases; Neuroprotective Agents; Parkinson Disease; RNA, Ribosomal, 16S; Sarcosine
PubMed: 36034698
DOI: 10.3389/fcimb.2022.887407 -
Journal of Global Antimicrobial... Jun 2022Identification and classification of microorganisms is one of the most important but difficult and challenging issues in microbiology. Whole genome sequencing (WGS),...
OBJECTIVES
Identification and classification of microorganisms is one of the most important but difficult and challenging issues in microbiology. Whole genome sequencing (WGS), which can give a thorough understanding for the genome of bacteria strain, has been universally used for studying bacterial classification, evolution, and drug-related resistant genes. We in this study aimed to identify a Gram-positive, microaerophilic, catalase-negative cocci strain named AV208, which has shown resistance to vancomycin, by whole genome's average nucleotide identity (ANI) and high-throughput sequencing technology.
METHODS
The AV208 strain was identified by following commercially available identification systems, including API 20 Strep system and Vitek 2 Compact Gram-positive identification system for biochemical phenotypic test. Matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF-MS) and 16S rRNA gene sequencing were used for confirmation identification. The whole genome of AV208 was sequenced by using high throughput sequencing technology and ANI between AV208, and its phylogenetic neighbours were analysed by the Orthologous Average Nucleotide Identity Tool (OAT) software. Polymerase chain reaction (PCR) and DNA sequencing were used to investigate the potential molecular mechanism for vancomycin resistance.
RESULTS
The AV208 strain was isolated from an ascites sample from a patient with chronic kidney disease who showed extensive resistance to the drugs detected, such as vancomycin with MIC >256 μg/mL. With combination of biochemical phenotypic test, MALDI-TOF-MS and 16S rRNA gene sequencing, the AV208 strain was tentatively identified as an Aercoccus viridans. By using complete genome sequence, we found a 96.24% ANI between strain AV208 and Aerococcus urinaeequi CCUG 28094, which was higher than that with A. viridans CCUG4311 (94.9%). The consistency of 16S rRNA sequence of strain AV208 was 100% with A. urinaeequi CCUG 28094 and 99.9% with A. viridans CCUG4311, with only one base difference between them. PCR and sequencing for van genes revealed that AV208 was positive for the vanA gene. A Tn1546 transposon-like structure with vanA gene was found in the genome, which was predicted locating in plasmid, causing vancomycin resistance phenotypes.
CONCLUSION
Average nucleotide identity analysis based on whole genome sequence is an accurate and effective method for identification of bacteria, especially for strains that are not discernible by existing methods such as Aerococcus.
Topics: Aerococcus; Bacterial Typing Techniques; Humans; Nucleotides; Phylogeny; RNA, Ribosomal, 16S; Vancomycin; Whole Genome Sequencing
PubMed: 35477007
DOI: 10.1016/j.jgar.2022.04.013 -
Internal Medicine (Tokyo, Japan) Nov 2022To our knowledge, there have been no reports of right-sided infective endocarditis (RSIE) with ventricular free wall vegetation caused by Abiotrophia defectiva. We...
To our knowledge, there have been no reports of right-sided infective endocarditis (RSIE) with ventricular free wall vegetation caused by Abiotrophia defectiva. We herein report a case of RSIE caused by A. defectiva with ventricular free wall vegetation in a 27-year-old man with ventricular septal defect (VSD). Computed tomography showed multiple bilateral pulmonary nodular shadows. Transesophageal echocardiography (TEE) demonstrated right ventricular free wall vegetation at the jet stream. Blood culture revealed A. defectiva. These findings are consistent with a diagnosis of infective endocarditis and septic pulmonary embolism. Treatment with ceftriaxone and gentamicin and subsequent surgical VSD closure improved the patient's condition without recurrence.
Topics: Male; Humans; Adult; Abiotrophia; Endocarditis, Bacterial; Heart Septal Defects, Ventricular; Heart Ventricles; Endocarditis
PubMed: 35431307
DOI: 10.2169/internalmedicine.9374-22 -
Journal of Nutritional Science 2022Colostrum quality is of paramount importance in the management of optimal ruminant growth and infectious disease prevention in early life. Live yeast supplementation...
A live yeast supplementation to gestating ewes improves bioactive molecule composition in colostrum with no impact on its bacterial composition and beneficially affects immune status of the offspring.
Colostrum quality is of paramount importance in the management of optimal ruminant growth and infectious disease prevention in early life. Live yeast supplementation effect during the last month of gestation was evaluated on ewes' colostrum composition. Two groups of ewes ( = 14) carrying twin lambs were constituted and twins were separated into groups (mothered or artificially fed) 12 h after birth. Nutrient, oligosaccharides (OS), IgG and lactoferrin concentrations were measured over 72 h after lambing, and bacterial community was described in colostrum collected at parturition (T0). Immune passive transfer was evaluated through IgG measurement in lamb serum. In both groups, colostral nutrient, OS concentrations and IgG concentrations in colostrum and lamb serum decreased over time ( < 0⋅01), except for lactose, which slightly increased ( < 0⋅001), and lactoferrin, which remained stable. Bacterial population was stable over time with high relative abundances of Aerococcaceae, Corynebacteriaceae, Moraxellaceae and Staphylococcaceae in T0 colostrum. No effect of supplementation was observed in nutrient and lactoferrin concentrations. In supplemented ewes, the level of colostral IgG was higher at T0 and a higher level of serum IgG was observed in lambs born from supplemented mothers and artificially fed, while no effect of supplementation was observed in the mothered lamb groups. Using a metabolomic approach, we showed that supplementation affected OS composition with significantly higher levels of colostral Neu-5Gc compounds up to 5 h after birth. No effect of supplementation was observed on bacterial composition. Our data suggest that live yeast supplementation offsets the negative impact of early separation and incomplete colostrum feeding in neonate lambs.
Topics: Animals; Colostrum; Dietary Supplements; Female; Pregnancy; Saccharomyces cerevisiae; Sheep
PubMed: 35291274
DOI: 10.1017/jns.2022.3