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Clinical Microbiology and Infection :... Aug 2023
Topics: Humans; Fosfomycin; Aerococcus; Anti-Bacterial Agents; Urinary Tract Infections; Gram-Positive Bacterial Infections
PubMed: 37179008
DOI: 10.1016/j.cmi.2023.04.029 -
IDCases 2023is a bacterium that can cause urinary tract infections and on rare occasions infective endocarditis (IE). The prognosis of IE caused by aerococci is generally...
is a bacterium that can cause urinary tract infections and on rare occasions infective endocarditis (IE). The prognosis of IE caused by aerococci is generally favourable despite that the patients are typically old and have multiple comorbidities. Here we report a case of native valve aortic IE in a 68-year-old man with an underlying urinary tract condition. The infection led to severe aortic valve insufficiency and rapid death before the patient could be subjected to surgery. This demonstrates that IE caused by can be severe and cause valve destruction. In addition to the case report, we provide a review of the current literature on IE.
PubMed: 36926420
DOI: 10.1016/j.idcr.2023.e01732 -
Microbiology Spectrum Feb 2023Aerococcus urinae and Aerococcus sanguinicola have been increasingly recognized as causative agents of urinary tract infection (UTI) during the last decade. Nitroxoline...
Aerococcus urinae and Aerococcus sanguinicola have been increasingly recognized as causative agents of urinary tract infection (UTI) during the last decade. Nitroxoline achieves high urinary concentrations after oral administration and is recommended in uncomplicated UTI in Germany, but its activity against spp. is unknown. The aim of this study was to assess the susceptibility of clinical species isolates to standard antibiotics and to nitroxoline. Between December 2016 and June 2018, 166 and 18 isolates were recovered from urine specimens sent to the microbiology laboratory of the University Hospital of Cologne, Germany. Susceptibility to standard antimicrobials was analyzed by disk diffusion (DD) according to EUCAST methodology, nitroxoline was tested by DD and agar dilution. Susceptibility of spp. to benzylpenicillin, ampicillin, meropenem, rifampicin, nitrofurantoin, and vancomycin was 100% and resistance was documented only against ciprofloxacin (20 of 184; 10.9%). MICs of nitroxoline in isolates were low (MIC 1/2 mg/L) while significantly higher MICs were observed in (MIC 64/128 mg/L). If the EUCAST nitroxoline breakpoint for E. coli and uncomplicated UTI was applied (16 mg/L), 97.6% of isolates would be interpreted as susceptible while all isolates would be considered resistant. Nitroxoline demonstrated high activity against clinical isolates, but low activity against Nitroxoline is an approved antimicrobial for UTI and could be an alternative oral drug to treat urinary tract infection, yet clinical studies are needed to demonstrate this potential . and have been increasingly recognized as causative agents in urinary tract infections. Currently, there are few data available on the activity of different antibiotics against these species and no data on nitroxoline. We demonstrate that clinical isolates in Germany are highly susceptible to ampicillin, while resistance to ciprofloxacin was common (10.9%). Additionally, we show that nitroxoline is highly active against , but not against , which based on the presented data, should be considered intrinsically resistant. The presented data will help to improve the therapy of urinary tract infections by species.
PubMed: 36847493
DOI: 10.1128/spectrum.02763-22 -
American Journal of Obstetrics and... Nov 2020Since the discovery of the bladder microbiome (urobiome), interest has grown in learning whether urobiome characteristics have a role in clinical phenotyping and provide...
BACKGROUND
Since the discovery of the bladder microbiome (urobiome), interest has grown in learning whether urobiome characteristics have a role in clinical phenotyping and provide opportunities for novel therapeutic approaches for women with common forms of urinary incontinence.
OBJECTIVE
This study aimed to test the hypothesis that the bladder urobiome differs among women in the control cohort and women affected by urinary incontinence by assessing associations between urinary incontinence status and the cultured urobiome.
STUDY DESIGN
With institutional review board oversight, urine specimens from 309 adult women were collected through transurethral catheterization. These women were categorized into 3 cohorts (continent control, stress urinary incontinence [SUI], and urgency urinary incontinence [UUI]) based on their responses to the validated Pelvic Floor Distress Inventory (PFDI) questionnaire. Among 309 women, 150 were in the continent control cohort, 50 were in the SUI cohort, and 109 were in the UUI cohort. Symptom severity was assessed by subscale scoring with the Urinary Distress Inventory (UDI), subscale of the Pelvic Floor Distress Inventory. Microbes were assessed by expanded quantitative urine culture protocol, which detects the most common bladder microbes (bacteria and yeast). Microbes were identified to the species level by matrix-assisted laser desorption and ionization time-of-flight mass spectrometry. Alpha diversity indices were calculated for culture-positive samples and compared across the 3 cohorts. The correlations of UDI scores, alpha diversity indices, and species abundance were estimated.
RESULTS
Participants had a mean age of 53 years (range 22-90); most were whites (65%). Women with urinary incontinence were slightly older (control, 47; SUI, 54; UUI, 61). By design, UDI symptom scores differed (control, 8.43 [10.1]; SUI, 97.95 [55.36]; UUI, 93.71 [49.12]; P<.001). Among 309 participants, 216 (70%) had expanded quantitative urine culture-detected bacteria; furthermore, the urinary incontinence cohorts had a higher detection frequency than the control cohort (control, 57%; SUI, 86%; UUI, 81%; P<.001). In addition, the most frequently detected species among the cohorts were as follows: continent control, Lactobacillus iners (12.7%), Streptococcus anginosus (12.7%), L crispatus (10.7%), and L gasseri (10%); SUI, S anginosus (26%), L iners (18%), Staphylococcus epidermidis (18%), and L jensenii (16%); and UUI, S anginosus (30.3%), L gasseri (22%), Aerococcus urinae (18.3%), and Gardnerella vaginalis (17.4%). However, only Actinotignum schaalii (formerly Actinobaculum schaalii), A urinae, A sanguinicola, and Corynebacterium lipophile group were found at significantly higher mean abundances in 1 of the urinary incontinence cohorts when compared with the control cohort (Wilcoxon rank sum test; P<.02), and no individual genus differed significantly between the 2 urinary incontinence cohorts. Both urinary incontinence cohorts had increased alpha diversity similar to continent control cohort with indices of species richness, but not evenness, strongly associated with urinary incontinence.
CONCLUSION
In adult women, the composition of the culturable bladder urobiome is associated with urinary incontinence, regardless of common incontinence subtype. Detection of more unique living microbes was associated with worsening incontinence symptom severity. Culturable species richness was significantly greater in the urinary incontinence cohorts than in the continent control cohort.
Topics: Actinomycetaceae; Adult; Aerococcus; Aged; Aged, 80 and over; Biodiversity; Corynebacterium; Cross-Sectional Studies; Female; Gardnerella vaginalis; Humans; Lactobacillus; Lactobacillus crispatus; Lactobacillus gasseri; Microbiota; Middle Aged; Staphylococcus epidermidis; Streptococcus anginosus; Urinary Bladder; Urinary Incontinence, Stress; Urinary Incontinence, Urge; Young Adult
PubMed: 32380174
DOI: 10.1016/j.ajog.2020.04.033 -
American Journal of Health-system... Nov 2018The clinical and microbiological data for urinary tract infections (UTIs) for 6 organisms detected by matrix-assisted laser desorption ionization time-of-flight... (Review)
Review
PURPOSE
The clinical and microbiological data for urinary tract infections (UTIs) for 6 organisms detected by matrix-assisted laser desorption ionization time-of-flight (MALDI-TOF) at community health systems were examined.
SUMMARY
The use of precision microbiological diagnostic testing such as MALDI-TOF and real-time quantitative polymerase chain reaction has increased the ability to detect a wider spectrum of organisms. This has raised questions of the clinical relevance of infrequently encountered organisms, especially when cultured from urine. This article reviews clinical and microbiological data for UTIs for 6 organisms detected by MALDI-TOF at community health systems (, , , , and ). Since little information currently exists, most of the data associating the aforementioned organisms with UTIs were derived from case reports. Although these organisms are more readily identified using precision microbiological diagnostic testing methods, infection should not be assumed based on culture results alone since asymptomatic bacteriuria has been reported. Similar to more common urinary pathogens, clinical correlation is essential. To facilitate treatment, we provide a table of empirical options likely to achieve clinical success based on in vivo and in vitro data. If available, pathogen-specific susceptibility data should be used to direct therapy.
CONCLUSION
Clinical and microbiological data and potential treatment options were presented for 6 traditionally underrecognized organisms that are increasingly being found from urinary specimens. The treatment recommendations should be interpreted cautiously as they were devised through the use of very limited data.
Topics: Actinomycetaceae; Actinomycetales Infections; Aerococcus; Anti-Bacterial Agents; Chryseobacterium; Corynebacterium; Corynebacterium Infections; Flavobacteriaceae Infections; Gram-Positive Bacterial Infections; Humans; Microbial Sensitivity Tests; Real-Time Polymerase Chain Reaction; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization; Urinary Tract Infections
PubMed: 30404894
DOI: 10.2146/ajhp180208 -
Revista Clinica Espanola Oct 2018Elderly patients with underlying urological disease have a greater risk of urinary tract infections due to uncommon pathogens. The disease caused by Aerococcus has been...
Elderly patients with underlying urological disease have a greater risk of urinary tract infections due to uncommon pathogens. The disease caused by Aerococcus has been underestimated, but mass spectrometry could be a simple method for identifying this pathogen. In this study, we report 2 cases of urinary tract infection by Aerococcus sanguinicola. A descriptive clinical-microbiological study was conducted on the presence of A. sanguinicola causing urinary tract infections. The presence of A. sanguinicola occurred in elderly patients with previous urological disease and a significant count in urine obtained through bladder catheterisation. Correct identification was achieved through mass spectrometry, and the clinical outcome of administering amoxicillin and cefuroxime was satisfactory. In this study, we also report the pathogenic capacity of A. sanguinicola. When there is a significant number of alpha-haemolytic microorganisms in the urine cultures, A. sanguinicola should be ruled out before reporting a result as urogenital microbiota.
PubMed: 29759804
DOI: 10.1016/j.rce.2018.04.002 -
Food Research International (Ottawa,... Jun 2018The microbiota from artisanal cheeses produced in the Amazonian region is evaluated. Samples of artisanal cheeses were obtained from markets in Conceição do Araguaia...
The microbiota from artisanal cheeses produced in the Amazonian region is evaluated. Samples of artisanal cheeses were obtained from markets in Conceição do Araguaia and Redenção (Pará, Brazil) over rainy and dry seasons, and their biodiversity was assessed by culture-dependent and culture-independent methods. Mean counts of lactic acid bacteria (LAB) in cheeses ranged from 7.32 to 8.84 log CFU/g, for both seasons. Members of genera Lactobacillus, Lactococcus, Weissella, Enterococcus, Pediococcus, and Leuconostoc were predominant. The amplification of the 16S rRNA V6-V9 region, followed by a temporal temperature-gradient gel electrophoresis (TTGE) and sequencing of the TTGE bands revealed important differences in the microbial composition variability between samples from the two seasons and among cheese samples analyzed. TTGE showed the presence of microorganisms that are frequently found in cheese, such as L. lactis subsp. lactis, as well as other non-usual species, such as Macrococcus caseolyticus and Corynebacterium variabile. Moreover, TTGE analysis revealed the presence of microorganisms that have been isolated from other types of foods (Paralactobacillus selangorenses) along with some not usually found in foods, such as Exiguobacterium acetylicum, plus the presence of pathogenic microorganisms (Granulicatella elegans and Aerococcus sanguinicola). The present molecular approaches combined with culture-dependent methods provided a more detailed description of the microbial ecology of traditional cheeses from the Amazonian region in northern Brazil.
Topics: Bacteria; Biodiversity; Brazil; Cheese; Colony Count, Microbial; Food Microbiology; Rain; Rainforest; Ribotyping; Seasons
PubMed: 29735061
DOI: 10.1016/j.foodres.2018.03.060 -
The Journal of Infection Apr 2018Aerococcus urinae and Aerococcus sanguinicola cause urinary tract infections (UTIs) and antibiotic treatment recommendations are solely based on in vitro findings and... (Observational Study)
Observational Study
OBJECTIVES
Aerococcus urinae and Aerococcus sanguinicola cause urinary tract infections (UTIs) and antibiotic treatment recommendations are solely based on in vitro findings and limited clinical experience. Our objective was to investigate the effectiveness of different treatment strategies in aerococcal UTI through a prospective observational study.
METHODS
Urine samples with aerococci were identified and patients were enrolled. The aerococci were subjected to Etests. Information on clinical symptoms, and the treatment given, was collected. Patients were interviewed after the conclusion of treatment to assess clinical cure and a control urine culture assessed the microbiological cure.
RESULTS
Of 31,629 urine samples, 144 grew aerococci and fulfilled the inclusion criteria. 91 patients gave consent and the 72 patients with UTI were assessed for treatment outcome. 53 patients had A. urinae UTI, while 19 had A. sanguinicola UTI. Nitrofurantoin was most commonly prescribed, achieving clinical and microbiological success in 71/76% of cases of A. urinae UTI, and 42/50% of cases of A. sanguinicola UTI. Pivmecillinam achieved success in patients with A. urinae cystitis and ciprofloxacin in patients with pyelonephritis.
CONCLUSIONS
Our results support that nitrofurantoin is a valid option for the treatment of cystitis caused by A. urinae.
Topics: Aerococcus; Aged; Aged, 80 and over; Anti-Bacterial Agents; Cystitis; Disk Diffusion Antimicrobial Tests; Female; Gram-Positive Bacterial Infections; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Nitrofurantoin; Prospective Studies; Sweden; Treatment Outcome; Urinary Tract Infections
PubMed: 29253561
DOI: 10.1016/j.jinf.2017.12.009 -
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 -
Microbial Pathogenesis Nov 2017Aerococcus sanguinicola and Aerococcus urinae are emerging pathogens in clinical settings mostly being causative agents of urinary tract infections (UTIs), urogenic...
Genomic characterization, phylogenetic analysis, and identification of virulence factors in Aerococcus sanguinicola and Aerococcus urinae strains isolated from infection episodes.
Aerococcus sanguinicola and Aerococcus urinae are emerging pathogens in clinical settings mostly being causative agents of urinary tract infections (UTIs), urogenic sepsis and more seldomly complicated infective endocarditis (IE). Limited knowledge exists concerning the pathogenicity of these two species. Eight clinical A. sanguinicola (isolated from 2009 to 2015) and 40 clinical A. urinae (isolated from 1984 to 2015) strains from episodes of UTIs, bacteremia, and IE were whole-genome sequenced (WGS) to analyze genomic diversity and characterization of virulence genes involved in the bacterial pathogenicity. A. sanguinicola genome sizes were 2.06-2.12 Mb with 47.4-47.6% GC-contents, and 1783-1905 genes were predicted whereof 1170 were core-genes. In case of A. urinae strains, the genome sizes were 1.93-2.44 Mb with 41.6-42.6% GC-contents, and 1708-2256 genes of which 907 were core-genes. Marked differences were observed within A. urinae strains with respect to the average genome sizes, number and sequence identity of core-genes, proteome conservations, phylogenetic analysis, and putative capsular polysaccharide (CPS) loci sequences. Strains of A. sanguinicola showed high degree of homology. Phylogenetic analyses showed the 40 A. urinae strains formed two clusters according to two time periods: 1984-2004 strains and 2010-2015 strains. Genes that were homologs to virulence genes associated with bacterial adhesion and antiphagocytosis were identified by aligning A. sanguinicola and A. urinae pan- and core-genes against Virulence Factors of Bacterial Pathogens (VFDB). Bacterial adherence associated gene homologs were present in genomes of A. sanguinicola (htpB, fbpA, lmb, and ilpA) and A. urinae (htpB, lap, lmb, fbp54, and ilpA). Fifteen and 11-16 CPS gene homologs were identified in genomes of A. sanguinicola and A. urinae strains, respectively. Analysis of these genes identified one type of putative CPS locus within all A. sanguinicola strains. In A. urinae genomes, five different CPS loci types were identified with variations in CPS locus sizes, genetic content, and structural organization. In conclusion, this is the first study dealing with WGS and comparative genomics of clinical A. sanguinicola and A. urinae strains from episodes of UTIs, bacteremia, and IE. Gene homologs associated with antiphagocytosis and bacterial adherence were identified and genetic variability was observed within A. urinae genomes. These findings contribute with important knowledge and basis for future molecular and experimental pathogenicity study of UTIs, bacteremia, and IE causing A. sanguinicola and A. urinae strains.
Topics: Adolescent; Adult; Aerococcus; Aged; Aged, 80 and over; Bacteremia; Bacterial Adhesion; Bacterial Capsules; Base Composition; Base Sequence; Chaperonin 60; Child; DNA, Bacterial; Denmark; Endocarditis, Bacterial; Female; Genes, Bacterial; Genome Size; Genomics; Gram-Positive Bacterial Infections; Humans; Male; Middle Aged; Phylogeny; Polysaccharides; Proteome; RNA, Ribosomal, 16S; Sepsis; Sequence Analysis; Urinary Tract Infections; Virulence Factors; Young Adult
PubMed: 28943151
DOI: 10.1016/j.micpath.2017.09.042