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Clinical Microbiology and Infection :... Jan 2016The genus Actinotignum contains three species, Actinotignum schaalii (formerly Actinobaculum schaalii), Actinotignum urinale and Actinotignum sanguinis. A. schaalii is... (Review)
Review
The genus Actinotignum contains three species, Actinotignum schaalii (formerly Actinobaculum schaalii), Actinotignum urinale and Actinotignum sanguinis. A. schaalii is the species most frequently involved in human infections, with 172 cases, mostly urinary tract infections (UTIs), reported so far. Invasive infections have also been described. This facultative anaerobic Gram-positive rod is part of the urinary microbiota of healthy patients. It is responsible for UTIs, particularly in elderly men and young children. A. schaalii is an underestimated cause of UTIs because of its fastidious growth on usual media and difficulties associated with its identification using phenotypic methods. Indeed, this slow-growth bacterium requires blood-enriched media and an incubation time of 48 hours under anaerobic or 5% CO2 atmosphere. Furthermore, only matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF) or molecular-based methods allow the accurate identification of this bacteria. MALDI-TOF using Microflex LT with the Biotyper database (Bruker Daltonics, Bremen, Germany) is the most reliable technology for the routine identification of A. schaalii. The identification of this uropathogen is all the more important because it is resistant to trimethoprim/sulfamethoxazole and second-generation quinolones that are widely used in the treatment of UTIs. Antimicrobial therapy using β-lactams prolonged for up to 2 weeks is the most efficient treatment and should be recommended. Microbiologists should assess the presence of A. schaalii in urine using appropriate culture and identification methods in the case of a direct examination that is positive for small coccoid rods, a negative nitrite urinary stick associated with leukocyturia, treatment failure with trimethoprim/sulfamethoxazole or fluoroquinolones, or undocumented, repeated UTIs.
Topics: Actinomycetaceae; Aerobiosis; Anaerobiosis; Anti-Bacterial Agents; Bacteriological Techniques; Drug Resistance, Bacterial; Gram-Positive Bacterial Infections; Humans; Molecular Diagnostic Techniques; Sepsis; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization; Urinary Tract Infections
PubMed: 26577137
DOI: 10.1016/j.cmi.2015.10.038 -
Journal of Surgical Case Reports Oct 2019and are two facultative anaerobes that are common contaminants of human flora; namely the urinary tract, the female genital tract and the gastrointestinal tract. has...
and are two facultative anaerobes that are common contaminants of human flora; namely the urinary tract, the female genital tract and the gastrointestinal tract. has been linked with abscesses, decubitus ulcers and purulent urethritis, while has been associated with urinary tract infections, bacteremia and Fournier's gangrene. Here we present a case report of an 84-year-old female patient found to have a necrotizing soft tissue infection caused by and To our knowledge, this is the first case report that documents as a causal agent of a necrotizing infection.
PubMed: 31636892
DOI: 10.1093/jscr/rjz286 -
Microorganisms Mar 2021an emerging, opportunistic pathogen and its connection to non-infectious diseases and conditions, such as prostate or bladder cancer, or chronic inflammation has been...
an emerging, opportunistic pathogen and its connection to non-infectious diseases and conditions, such as prostate or bladder cancer, or chronic inflammation has been proposed. Here, we analyzed 297 urine, ureteral and urinary catheter samples from 128 patients by Polymerase Chain Reaction followed by Denaturing Gradient Gel Electrophoresis and Sequencing (PCR-DGGE-S), and culture, and 29 of these samples also by Illumina sequencing, to establish 's prevalence in urinary tract-related samples, its relation to other bacteria, and its potential association with patients' conditions and samples' characteristics. -positive samples were significantly more diverse than . negative and between-group diversity was higher than intra-group. sp., sp., and sp. were significantly more often present in -positive samples; thus, we suggest these species are concomitants, while and Staphylococcaceae were more often identified in -negative samples; therefore, we propose and these species are mutually exclusive. Additionally, a significantly higher prevalence in patients with ureter stricture associated hydronephrosis ( = 0.020) was noted. We suggest that could be an early polybacterial biofilm colonizer, together with concomitant species, known for pro-inflammatory features.
PubMed: 33807120
DOI: 10.3390/microorganisms9030669 -
Heliyon Apr 2024affects elderly people and is associated with individuals with urological-related predispositions, but can be found in a variety of locations, such as cutaneous,...
affects elderly people and is associated with individuals with urological-related predispositions, but can be found in a variety of locations, such as cutaneous, intraabdominal, genitourinary and surgical infections. Disseminated infections occur less frequently and are by and large related to urinary tract colonisation. This pathogen is often neglected due to growth requirements, especially in urinary tract infections. We present 107 isolated from genitourinary samples (80.4%), from skin and soft tissue infections (13.1%), from bone and deep tissue infection (4.7%) and from blood cultures (1.9%). The automated system Alfred 60/AST was paramount for the isolation of 77.6% of the UTI. All the isolates tested were susceptible to penicillin, ampicillin, linezolid, vancomycin, teicoplanin, rifampicin and tetracycline. In conclusion, we present a large series of infections. This pathogen is hard to isolate, and is resistant to commonly used empirical antimicrobials.
PubMed: 38590897
DOI: 10.1016/j.heliyon.2024.e28589 -
New Microbes and New Infections Jul 2017is an anaerobic Gram-positive bacillus that exists in human skin and urinary tract. The pathogenicity is, however, not well known. Only two cases of urinary tract...
is an anaerobic Gram-positive bacillus that exists in human skin and urinary tract. The pathogenicity is, however, not well known. Only two cases of urinary tract infection have been described recently. In the case presented here, the bacterium was isolated, concomitant with from blood culture of a patient with fever and difficulty of urination. The bacteria were identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry and 16S rRNA sequencing. The case was successfully treated with ampicillin/sulbactam.
PubMed: 28491325
DOI: 10.1016/j.nmni.2017.03.004 -
PloS One 2017The permanent draft genome sequence of Actinotignum schaalii DSM 15541T is presented. The annotated genome includes 2,130,987 bp, with 1777 protein-coding and 58...
The permanent draft genome sequence of Actinotignum schaalii DSM 15541T is presented. The annotated genome includes 2,130,987 bp, with 1777 protein-coding and 58 rRNA-coding genes. Genome sequence analysis revealed absence of genes encoding for: components of the PTS systems, enzymes of the TCA cycle, glyoxylate shunt and gluconeogensis. Genomic data revealed that A. schaalii is able to oxidize carbohydrates via glycolysis, the nonoxidative pentose phosphate and the Entner-Doudoroff pathways. Besides, the genome harbors genes encoding for enzymes involved in the conversion of pyruvate to lactate, acetate and ethanol, which are found to be the end products of carbohydrate fermentation. The genome contained the gene encoding Type I fatty acid synthase required for de novo FAS biosynthesis. The plsY and plsX genes encoding the acyltransferases necessary for phosphatidic acid biosynthesis were absent from the genome. The genome harbors genes encoding enzymes responsible for isoprene biosynthesis via the mevalonate (MVA) pathway. Genes encoding enzymes that confer resistance to reactive oxygen species (ROS) were identified. In addition, A. schaalii harbors genes that protect the genome against viral infections. These include restriction-modification (RM) systems, type II toxin-antitoxin (TA), CRISPR-Cas and abortive infection system. A. schaalii genome also encodes several virulence factors that contribute to adhesion and internalization of this pathogen such as the tad genes encoding proteins required for pili assembly, the nanI gene encoding exo-alpha-sialidase, genes encoding heat shock proteins and genes encoding type VII secretion system. These features are consistent with anaerobic and pathogenic lifestyles. Finally, resistance to ciprofloxacin occurs by mutation in chromosomal genes that encode the subunits of DNA-gyrase (GyrA) and topisomerase IV (ParC) enzymes, while resistant to metronidazole was due to the frxA gene, which encodes NADPH-flavin oxidoreductase.
Topics: Actinomycetaceae; Anti-Bacterial Agents; Carbohydrate Metabolism; Drug Resistance, Microbial; Fermentation; Genome, Bacterial; Genotype; Lipid Metabolism; Oxidative Stress; Phenotype; Phylogeny; Pyruvic Acid
PubMed: 29216246
DOI: 10.1371/journal.pone.0188914 -
Microbiology Spectrum Dec 2022Actinotignum schaalii is an underrecognized Gram-positive bacillus that is associated with urinary tract infections and cutaneous abscesses. The role of A. schaalii in...
Actinotignum schaalii is an underrecognized Gram-positive bacillus that is associated with urinary tract infections and cutaneous abscesses. The role of A. schaalii in invasive infections continues to be unappreciated because the bacteria can be isolated from a diverse spectrum of clinical specimens, ranging from being a single pathogen in urine and blood cultures to being deemed a colonizer in polymicrobial anaerobic cultures of sterile fluids and tissues. We conducted a microbiological analysis of clinical isolates obtained from 2012 through 2019. A total of 86 isolates were analyzed; 37 (43%) were from blood cultures, 35 (41%) were from deep wounds and abscesses, 6 (7%) were from urine samples, and the rest were recovered from peritoneal, kidney, and scrotal fluid samples. Urinary tract infections were clinically identified as the source of most cases of bacteremia, although no simultaneous urine cultures yielded positive results. The 16S rRNA gene sequences were available for 32 isolates (37%). Phylogenetic analysis revealed that AS.1/AS.2 strains caused a larger proportion of bloodstream infections (BSIs) (100% versus 52% [ = 0.01]) and trended toward a higher rate of hospitalization (91% versus 76% [ = 0.18]) but had a lower clindamycin MIC (0.12 versus >256 μg/mL). Our study emphasizes the emergence of A. schaalii as a pathogen in human urine samples, BSIs, and skin and soft tissue infections. It highlights the pitfalls of current laboratory methods in recovering and identifying this organism from clinical specimens, particularly urine samples. Phylogenetic analysis showed unique genotypic sequences for A. schaalii AS.1/AS.2 strains causing urosepsis, which requires further study to identify potential virulence factors. Actinotignum schaalii is an underrecognized Gram-positive bacillus due to its special growth requirements and prior phenotypic identification methods, and it is often mistaken as a contaminant. It has been associated with various clinical syndromes, from urinary tract infections to cutaneous infections. The widespread use of molecular diagnostic methods allowed for improved detection. However, its role in invasive infections remains underappreciated. We conducted a detailed microbiological analysis to improve our understanding of this organism's genotypic and phenotypic characteristics. Our results highlight the pitfalls of clinical laboratory recovery, particularly from urine cultures. Although most BSIs were caused by urinary tract infections, no simultaneous urine cultures identified A. schaalii, largely due to the failure of phenotypic methods to reliably isolate and identify this organism. Additionally, this is the first study demonstrating A. schaalii strains with differences in clinical and microbiological characteristics, raising the possibility of potential bacterial virulence factors contributing to invasive infections.
Topics: Humans; Abscess; RNA, Ribosomal, 16S; Phylogeny; Canada; Urinary Tract Infections; Sepsis; Bacteria, Anaerobic
PubMed: 36409090
DOI: 10.1128/spectrum.03442-22 -
Germs Sep 2022is a small Gram-positive facultative anaerobic coccoid rod that was reclassified in 1997 from the genus and is difficult to culture with usual microbiological...
INTRODUCTION
is a small Gram-positive facultative anaerobic coccoid rod that was reclassified in 1997 from the genus and is difficult to culture with usual microbiological techniques, as it is slowly growing. is an emerging human pathogen that is most commonly implicated in urinary tract infections (UTIs), but has also been isolated less frequently from abscesses of various sites (such as the skin, the genitourinary tract, surgical sites or intraabdominal).
METHODS
All cases where was identified during a 6-year period (January 2016 - January 2022) in the University Hospital of Heraklion were reviewed.
RESULTS
was isolated in 11 cultures from 10 patients. The site of infection was skin and soft tissue in nine out of eleven cultures (81.8%) and the bone was the site of infection in two patients (18.2%). Most cultures were polymicrobial. The median age of patients was 55.5 years (interquartile range 34-63 years), and 80% (n=8) were male. was susceptible to beta-lactams, quinolones and vancomycin, but resistant to clindamycin, erythromycin and metronidazole. Moreover, two cases of diabetic patients diagnosed with polymicrobial diabetic foot osteomyelitis from this organism are presented in detail. Both patients were successfully managed with targeted antimicrobial treatment and prompt surgical management.
CONCLUSIONS
is an emerging pathogen that is likely under-reported due to difficulties in isolation and identification. Herein two cases of diabetic foot osteomyelitis are also presented in detail, successfully managed with targeted antimicrobial therapy and surgical debridement.
PubMed: 37680677
DOI: 10.18683/germs.2022.1343 -
Clinical Microbiology and Infection :... Dec 2015Actinotignum schaalii (former named Actinobaculum schaalii) can cause urinary tract infections (UTIs) and bacteraemia, mainly in the elderly. A. schaalii is difficult...
Actinotignum schaalii (former named Actinobaculum schaalii) can cause urinary tract infections (UTIs) and bacteraemia, mainly in the elderly. A. schaalii is difficult to identify with conventional biochemical tests, and it is often overlooked if the urine is only cultured in ambient air. The aim of this study was to validate data from the nationwide Danish microbiology database (MiBa) with data from the laboratory information system (LIS) at the local department of microbiology in Viborg-Herning, and to evaluate the incidence rate of bacteraemia caused by A. schaalii in Denmark by using data from the MiBa. All departments of microbiology in Denmark report data to the MiBa. All microbiological samples with A. schaalii in Denmark were extracted for a period of 5 years from the MiBa and from the local LISs. All data obtained from our local LIS were also found in the MiBa, except for data on real-time PCR, which were not registered, owing to missing ID codes in the MiBa. From 2010 to 2014, there was a significant increase in the incidence rate of blood cultures with A. schaalii, from 1.8 to 6.8 cases per million, which was probably due to coincident implementation of matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) in routine diagnostics. We found that A. schaalii caused bacteraemia and UTIs mainly in the elderly. In conclusion, the MiBa can be a useful source of nationwide microbiological data in Denmark. Our results suggest that the incidence rate of A. schaalii as a cause of bacteraemia has been underestimated, and that culture of urine in CO2 can improve the detection of A. schaalii.
Topics: Actinomycetaceae; Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Bacteremia; Child; Child, Preschool; Databases, Factual; Denmark; Female; Humans; Incidence; Infant; Infant, Newborn; Male; Middle Aged; Urinary Tract Infections; Young Adult
PubMed: 26319901
DOI: 10.1016/j.cmi.2015.08.006 -
Case Reports in Nephrology and Dialysis 2022Accurate diagnosis and treatment of febrile urinary tract infections (UTI) during childhood are important for the prevention of renal parenchymal damage and functional...
Accurate diagnosis and treatment of febrile urinary tract infections (UTI) during childhood are important for the prevention of renal parenchymal damage and functional loss, and detection of underlying diseases related to chronic kidney disease (CKD). ()-related febrile UTI in children is rare, and its incidence and risk factors remain unclear. A 3-year-old boy with a history of UTI presented with fever and vomiting. Although the culture of his urine specimen in air was negative, was observed in a 5% carbon dioxide (CO) culture condition, as well as an anaerobic one. A diagnosis of febrile UTI was made, and he recovered with antibiotic therapy. He was found to have CKD associated with vesicoureteral reflux (VUR) after further investigations. is one of the causative agents of febrile UTI in children with urinary tract abnormalities. Although the culture in the air could show negative results, urine culture in 5% CO and anaerobic conditions is useful for diagnosis. Our case is the youngest and the first known case of -related febrile UTI associated with VUR in children.
PubMed: 36518361
DOI: 10.1159/000526398