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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 -
Biochemistry Insights 2019() and () are gram-positive bacteria belonging to the family Aerococcaceae and colonize the human immunocompromised and catheterized urinary tract. We identified both...
() and () are gram-positive bacteria belonging to the family Aerococcaceae and colonize the human immunocompromised and catheterized urinary tract. We identified both pathogens in polymicrobial urethral catheter biofilms (CBs) with a combination of 16S rDNA sequencing, proteomic analyses, and microbial cultures. Longitudinal sampling of biofilms from serially replaced catheters revealed that each species persisted in the urinary tract of a patient in cohabitation with 1 or more gram-negative uropathogens. The and proteomes revealed active glycolytic, heterolactic fermentation, and peptide catabolic energy metabolism pathways in an anaerobic milieu. A few phosphotransferase system (PTS)-based sugar uptake and oligopeptide ABC transport systems were highly expressed, indicating adaptations to the supply of nutrients in urine and from exfoliating squamous epithelial and urothelial cells. Differences in the vs metabolisms pertained to citrate lyase and utilization and storage of glycogen (evident only in proteomes) and to the enzyme Xfp that degrades d-xylulose-5'-phosphate and the biosynthetic pathways for 2 protein cofactors, pyridoxal 6'-phosphate and 4'-phosphopantothenate (expressed only in proteomes). A predicted ZnuA-like transition metal ion uptake system was identified for while expressed 2 LPXTG-anchored surface proteins, one of which had a predicted pilin D adhesion motif. While these proteins may contribute to fitness and virulence in the human host, it cannot be ruled out that and fill a niche in polymicrobial biofilms without being the direct cause of injury in urothelial tissues.
PubMed: 31555049
DOI: 10.1177/1178626419875089 -
IDCases 2019can cause severe invasive infections emanating from the urinary tract especially in older males with comorbidities. Here we describe a case of an 80 year-old man with...
can cause severe invasive infections emanating from the urinary tract especially in older males with comorbidities. Here we describe a case of an 80 year-old man with multiple comorbidities presenting with a peri-penile abscess and signs of severe infection. Upon incision was isolated in pure culture and the infection was cured by a combination of drainage and antimicrobials. This case demonstrates the potential of to cause severe soft tissue infections in predisposed individuals.
PubMed: 31367520
DOI: 10.1016/j.idcr.2019.e00590 -
Case Reports in Cardiology 2019(AU) is a rare pathogen, identified as gram-positive, catalase-negative coccus that grows in pairs and clusters which has been reported to mainly cause urinary tract...
(AU) is a rare pathogen, identified as gram-positive, catalase-negative coccus that grows in pairs and clusters which has been reported to mainly cause urinary tract infections (UTI), especially in elderly males. Treatment for this microorganism is usually with beta-lactams although cultures with antibiotic susceptibility testing are imperative. We present a case of AU endocarditis initially treated with IV antibiotics; nevertheless, the patient required emergent mitral valve replacement due to severe mitral insufficiency and perforation. We also present an analysis with high-yield points summarizing epidemiology, risk factors, microbiology, clinical features, diagnostic workup, and management of AU in general and AU endocarditis. Finally, we post a literature review of relevant cases and the impact of different variables associated with it.
PubMed: 31281678
DOI: 10.1155/2019/5496851 -
Journal of Investigative Medicine High... 2019
PubMed: 31170831
DOI: 10.1177/2324709619852773 -
Proteomes Dec 2018, a Gram-positive anaerobic coccoid rod colonizing the human urinary tract, belongs to the taxonomic class of Actinobacteria. We identified as a cohabitant of urethral...
, a Gram-positive anaerobic coccoid rod colonizing the human urinary tract, belongs to the taxonomic class of Actinobacteria. We identified as a cohabitant of urethral catheter biofilms (CB). The CBs also harbored more common uropathogens, such as and , supporting the notion that is adapted to a life style in polymicrobial biofilms. We isolated a clinical strain from a blood agar colony and used 16S rRNA gene sequencing and shotgun proteomics to confirm its identity as . We characterized this species by quantitatively comparing the bacterial proteome derived from in vitro growth with that of four clinical samples. The functional relevance of proteins with emphasis on nutrient import and the response to hostile host conditions, showing evidence of neutrophil infiltration, was analyzed. Two putative subtilisin-like proteases and a heme/oligopeptide transporter were abundant in vivo and are likely important for survival and fitness in the biofilm. Proteins facilitating uptake of xylose/glucuronate and oligopeptides, also highly expressed in vivo, may feed metabolites into mixed acid fermentation and peptidolysis pathways, respectively, to generate energy. A polyketide synthase predicted to generate a secondary metabolite that interacts with either the human host or co-colonizing microbes was also identified. The product of the PKS enzyme may contribute to fitness and persistence in the CBs.
PubMed: 30544882
DOI: 10.3390/proteomes6040052 -
BMC Infectious Diseases Oct 2018Aerococcus urinae is a gram-positive, alpha-hemolytic coccus bacterium primarily implicated in less than 1 % of all symptomatic urinary tract infections. Risk factors... (Review)
Review
BACKGROUND
Aerococcus urinae is a gram-positive, alpha-hemolytic coccus bacterium primarily implicated in less than 1 % of all symptomatic urinary tract infections. Risk factors for disease include male gender, advanced age, and comorbid genitourinary tract pathology. Infections beyond the genitourinary tract are rare, though spondylodiscitis, perineal abscesses, lymphadenitis, bacteremia, meningitis, and endocarditis have been reported. Less than fifty cases of A. urinae infective endocarditis (IE) have been described in the literature. The rare occurrence of A. urinae in human infections and resultant lack of randomized controlled trials have resulted in a significant degree of clinical uncertainty in the management of A. urinae IE.
CASE PRESENTATION
We present an unusual case of a forty-three year-old male with A. urinae infective endocarditis (IE) who was successfully treated with mitral valve replacement and six weeks of penicillin/gentamicin therapy. In addition, we include a comprehensive review of all reported cases of IE due to A. urinae with specific attention to therapeutic regimens and treatment durations.
CONCLUSION
Recent advances in diagnostic technology have led to an increase in the frequency A. urinae is diagnosed. Reviewing cases of Aerococcus urinae infections, their clinical courses and subsequent management can assist future healthcare providers and their patients.
Topics: Adult; Aerococcus; Anti-Bacterial Agents; Comorbidity; Endocarditis, Bacterial; Gram-Positive Bacterial Infections; Humans; Male; Mitral Valve; Survival Analysis
PubMed: 30333008
DOI: 10.1186/s12879-018-3414-0 -
F1000Research 2017Infective endocarditis (IE) is a serious and life-threatening cardiac condition, most commonly caused by staphylococci, Streptococcus viridans, and enterococci. However,...
Infective endocarditis (IE) is a serious and life-threatening cardiac condition, most commonly caused by staphylococci, Streptococcus viridans, and enterococci. However, in special settings, IE can be caused by rare organisms. Here we present a case of IE caused by in a 75-year-old man with a bioprosthetic aortic valve. is a gram-positive, catalase-negative microorganism and is usually an isolate of complicated urinary tract infections in the elderly male population. Improvements in diagnostic testing including use of matrix-assisted laser desorption ionization- a time of flight mass spectrometry (MALDI-TOF MS) have played an important role in recognition of
PubMed: 29707195
DOI: 10.12688/f1000research.12776.3 -
Case Reports in Infectious Diseases 2018has lately been acknowledged as a cause of infective endocarditis (IE) especially in older males with underlying urinary tract disorders. In this population, cardiac...
BACKGROUND
has lately been acknowledged as a cause of infective endocarditis (IE) especially in older males with underlying urinary tract disorders. In this population, cardiac implanted electronical devices (CIED) are not uncommon, but despite the capacity of to form biofilm , no cases of aerococcal CIED infections have been reported to date.
CASE PRESENTATION
An 84-year-old male with pacemaker was admitted with dysuria one month after a transurethral procedure for urinary bladder cancer. was isolated from urine and blood. Transesophageal echocardiography (TEE) was without signs of vegetation on valves or pacing cables. The patient was treated with a twelve-day course of -lactam antibiotics. Forty days after the initial admission, the patient was readmitted due to malaise, general pain of the joints, chills, and renewed blood cultures grew . TEE demonstrated a 10 × 5 mm vegetation on either the tricuspid valve or one of the pacing cables. The pacemaker system was completely removed and demonstrated macroscopic signs of infection. A temporary system was implanted, and after 14 days of penicillin G treatment, a new system permanent system was implanted. Total treatment time was 40 days. Recovery was uneventful.
CONCLUSION
This report demonstrates that can cause CIED infection. In patients with bacteremia and a CIED, this risk must be considered, especially if bacteremia reoccurs.
PubMed: 29692938
DOI: 10.1155/2018/9128560 -
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