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Clinical Microbiology and Infection :... Jan 2016Aerococci have often been misidentified as streptococci in microbiology laboratories, leading to an underestimation of these bacteria as causes of human infections. An... (Review)
Review
Aerococci have often been misidentified as streptococci in microbiology laboratories, leading to an underestimation of these bacteria as causes of human infections. An increased awareness of aerococci and the introduction of matrix-assisted laser desorption ionization time-of-flight mass spectrometry, has led to an increased isolation of Aerococcus urinae and Aerococcus sanguinicola from human urine and blood. The two species are found in human urine and can cause urinary tract infections (UTI). Aerococcus urinae can, in older males with underlying urinary tract conditions, cause invasive infections such as urosepsis or infective endocarditis. The prognosis of invasive aerococcal infections appears to be relatively favourable despite the old age of patients and their many comorbidities. Though clinical breakpoints are still not in place, aerococci seem to be sensitive to penicillins, carbapenems and vancomycin. There is synergy between penicillin and aminoglycosides against some A. urinae isolates and this combination is often used in aerococcal infective endocarditis. The treatment of complicated aerococcal UTI is not obvious as many isolates are resistant to fluoroquinolones. In addition, A. urinae is resistant to sulphamethoxazole, and there are methodological problems in the determination of trimethoprim sensitivity. In complicated UTI, ampicillin is probably a safe treatment option, whereas nitrofurantoin is probably effective in uncomplicated UTI. Treatment studies in aerococcal infections are needed as is a better understanding of the natural niches for aerococci and the pathogenesis and clinical course of aerococcal infections.
Topics: Aerococcus; Anti-Bacterial Agents; Blood; Endocarditis, Bacterial; Gram-Positive Bacterial Infections; Humans; Microbial Sensitivity Tests; Sepsis; Urinary Tract Infections; Urine
PubMed: 26454061
DOI: 10.1016/j.cmi.2015.09.026 -
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 -
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 -
Journal of Clinical Microbiology Jun 2003This report describes the clinical sources and phenotypic characterization of 16 isolates of Aerococcus sanguinicola. Sixteen conventional tests were used to describe...
This report describes the clinical sources and phenotypic characterization of 16 isolates of Aerococcus sanguinicola. Sixteen conventional tests were used to describe and differentiate the 16 isolates of A. sanguinicola from 30 strains of Aerococcus viridans, 27 strains of Aerococcus urinae, and a single strain each of Aerococcus christensenii and Aerococcus urinaehominis. The phenotypic characterizations of the type strains for each species and 14 A. sanguinicola isolates were also compared in the two reference laboratories. A. sanguinicola are catalase-negative, vancomycin-susceptible, gram-positive cocci arranged in clusters and tetrads, as are all Aerococcus species except A. christensenii (which is arranged in short chains). All 16 isolates of A. sanguinicola were leucine aminopeptidase and pyrrolidonylarylamidase positive, which is unique to this species among the aerococci. All A. sanguinicola isolates grew in broth containing 6.5% NaCl, hydrolyzed hippurate, and were variable in the bile-esculin test. None of the isolates deaminated arginine or were Voges-Proskauer positive. The type strain of A. sanguinicola was isolated from a blood culture of a patient living in Denmark. Seven additional isolates were from patients living in Canada, all with urinary tract infections (six were female). Eight isolates were from patients living in five different states in the United States; five were from patients with urinary tract infections, and three were from blood cultures of one patient each with pneumonia, suspected endocarditis, and unknown clinical conditions. The antimicrobial susceptibility patterns were unremarkable; all isolates tested were susceptible to penicillin, amoxicillin, cefotaxime, cefuroxime, erythromycin, chloramphenicol, vancomycin, quinupristin-dalfopristin (Synercid), rifampin, linezolid, and tetracycline. Six of the 15 cultures were resistant to ciprofloxacin and levofloxacin, but all 15 strains were susceptible to sparfloxacin. High-level resistance was detected for meropenem (2 strains) and trimethoprim-sulfamethonazole (1 strain). Intermediate resistance was detected for trimethoprim-sulfamethoxazole (10 strains) and clindamycin (3 strains).
Topics: Anti-Bacterial Agents; Bacterial Proteins; Bacterial Typing Techniques; Gram-Positive Bacterial Infections; Humans; Microbial Sensitivity Tests; Phenotype; RNA, Ribosomal, 16S; Reagent Kits, Diagnostic; Sequence Analysis, DNA; Streptococcaceae
PubMed: 12791884
DOI: 10.1128/JCM.41.6.2587-2592.2003 -
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 -
Open Forum Infectious Diseases Mar 2014Since Aerococcus sanguinicola was designated as a species in 2001, only a few cases of bacteremia have been reported. The aim with this study was to describe the...
BACKGROUND
Since Aerococcus sanguinicola was designated as a species in 2001, only a few cases of bacteremia have been reported. The aim with this study was to describe the clinical presentation of A sanguinicola bacteremia and to determine the antibiotic susceptibility and the capacity of the bacteria to form biofilm and to induce platelet aggregation.
METHODS
Isolates of A sanguinicola from blood cultures were retrospectively identified from 2 clinical microbiology laboratories for 2006 to 2012. Species identity was confirmed through sequencing of the 16S rRNA gene. The medical charts of patients were reviewed. The minimum inhibitory concentration (MIC) for relevant antibiotics was determined. Biofilm formation was measured as the amount of crystal violet absorbed. Platelet aggregation was determined by aggregometry.
RESULTS
Eleven cases of A sanguinicola bacteremia were identified. All patients were male and the median age was 82 years (range 67-93). Nine patients fulfilled criteria for severe sepsis, and 2 patients died at hospital. Two patients were diagnosed with infective endocarditis. Most patients had underlying urinary tract diseases or an indwelling urinary tract catheter. Five patients suffered from dementia. None of the patients was treated with immunosuppressive medications. The MIC values of the isolates were in line with previous reports, with low MICs for penicillin, cefotaxime, and vancomycin. All 11 isolates produced biofilms but not all could induce platelet aggregation.
CONCLUSIONS
A sanguinicola can cause severe infections in elderly men with urinary tract abnormalities and the bacteria possess potential virulence mechanisms.
PubMed: 25734098
DOI: 10.1093/ofid/ofu025 -
Genome Announcements Apr 2016Strains belonging to the genus Aerococcus are causative agents of human and animal infections, including urogenital infections, bacteremia/septicemia, and infective...
Complete Genome Sequences of Aerococcus christensenii CCUG 28831T, Aerococcus sanguinicola CCUG 43001T, Aerococcus urinae CCUG 36881T, Aerococcus urinaeequi CCUG 28094T, Aerococcus urinaehominis CCUG 42038 BT, and Aerococcus viridans CCUG 4311T.
Strains belonging to the genus Aerococcus are causative agents of human and animal infections, including urogenital infections, bacteremia/septicemia, and infective endocarditis. This study reports the first fully closed and complete genome sequences of six type strains belonging to the genus Aerococcus using a combination of Illumina HiSeq and PacBio sequencing technologies.
PubMed: 27103727
DOI: 10.1128/genomeA.00302-16 -
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