A Case Report of Aerococcus urinae Urinary Tract Infection in an Elderly Male with Multimorbidity (original) (raw)

Aerococcus urinae in urinary tract infections

Journal of clinical microbiology, 2000

Aerococcus urinae is a rarely reported pathogen, possibly due to difficulties in the identification of the organism. A. urinae is a gram-positive coccus that grows in pairs and clusters, produces alpha-hemolysis on blood agar, and is negative for catalase and pyrrolidonyl aminopeptidase. Some of these characteristics and its being absent from the databases of most commercial identification systems could allow A. urinae to be misidentified as a streptococcus, enterococcus, or staphylococcus. We report two cases of urinary tract infection (UTI) caused by A. urinae and characterize these isolates by morphology, biochemical testing, whole-cell fatty acid analysis, 16S rRNA gene sequencing, and antibiotic susceptibilities. Most patients infected with A. urinae are elderly males with predisposing conditions who present initially with UTI. Because A. urinae is resistant to sulfonamides, treatment could be inappropriate, with infections resulting in serious complications, including death. I...

An initially unidentified case of urinary tract infection due to Aerococcus urinae

The new microbiologica, 2017

Aerococcus urinae is a microorganism responsible for urinary tract and blood stream infections which are rarely reported in clinical practice. However, it has been proposed that the infrequency of such reports may be partially due to difficulties related to pathogen identification. We present here a case of an elderly male patient with urinary tract infection where A. urinae was initially not identified by a private microbiology laboratory. Our report highlights the need to consider A. urinae as a causative agent of urinary tract infections because if not identified and properly treated it may lead to endocarditis or septicemia.

[Aerococcus urinae and urinary tract infection]

Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række, 2002

Bacteriological investigation of urine often shows the presence of alpha-haemolytic streptococci, but the clinical significance of this finding may be unclear. Among the alpha-haemolytic streptococci found in urine is Aerococcus urinae, which is pathogenic. We present a prospective study of the prevalence and antibiotic susceptibility of A urinae in urine samples sent to a microbiology laboratory in Norway. Seven out of 27 alpha-haemolytic streptococcal isolates were A urinae. This represents 0.3% of all urine isolates from our laboratory. Appropriate methods for identification and resistance determination are described. Microbiological laboratories should include identification of A urinae in their diagnostic repertoire. Recommended treatment against A urinae is ampicillin or nitrofurantoin.

Three Cases of Serious Infection Caused by Aerococcus urinae

European Journal of Clinical Microbiology and Infectious Diseases, 1999

Three cases of serious infection caused by Aerococcus urinae are presented: a patient with endocarditis and two patients with soft-tissue infection (phlegmon and balanitis respectively). The literature on Aerococcus urinae infections is reviewed and the antibiotic therapy discussed. Aerococcus urinae is a pathogen isolated primarily from urine specimens of elderly patients with local or systemic predisposing conditions. Most infections are mild, but serious infections such as endocarditis and septicemia/urosepsis have been described. Penicillin or ampicillin in combination with an aminoglycoside and close monitoring of the patient's clinical status and laboratory results would seem to be the best strategy for management of cases of serious infection.

Urinary tract infections withAerococcus urinae in the South of the Netherlands

European Journal of Clinical Microbiology & Infectious Diseases, 1997

Aerococcus urinae is an uncommon urinary tract pathogen that causes infections predominantly in elderly persons with local or general predisposing conditions. During a one-year study, the clinical features of Aerococcus urinae urinary tract infections (_> 105 cfu/ml) were investigated in two large medical microbiology laboratories in the Netherlands. The incidence of Aerococcus urinae urinary tract infections ranged between 0.31 and 0.44% for the two laboratories. The median age (range 35-95 years) of patients with this infection was 82.5 years for women and 77.5 for men. Men had significantly (p < 0.01) more local predisposing conditions than did women. Underlying systemic diseases such as diabetes mellitus, malignancy, and dementia were found in 67.5% of patients. Most patients (97.5%) had the classic signs of a urinary tract infection, but none of them developed serious symptoms. All isolates tested were susceptible to penicillin, amoxicillin, and nitrofurantoin, 78.3% were susceptible to norfloxacin, and all were resistant to sulfonamides. The majority of patients were treated with amoxicillin, amoxicillin with clavulanic acid, or norfloxacin.

Urinary tract infection by Aerococcus sanguinicola. An emerging opportunistic pathogen

Revista Clínica Española (English Edition), 2018

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 catheterization. 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-hemolytic microorganisms in the urine cultures, A. sanguinicola should be ruled out before reporting a result as urogenital microbiota.

Identification of Aerococcus urinae in urine samples

Clinical Microbiology and Infection, 2003

To evaluate procedures for the identi®cation of Aerococcus urinae, we examined 24 a-hemolytic non-enterococcal bacterial isolates from 4373 urine samples. Published procedures were compared with 16s rRNA sequencing and biochemical pro®ling (BBL-Crystal-GP). 16s rRNA sequencing and BBL-Crystal-GP identi®ed the same 13 isolates as A. urinae. Published tests failed to distinguish the 13 A. urinae isolates from eight non-A. urinae isolates; several tests exhibited no discrimination. Cipro¯oxacin and trimethoprim susceptibility and growth at 45 8C improved discrimination. For urinary isolates, standard procedures for identi®cation of A. urinae are redundant and insuf®ciently discriminatory, and may need revision. BBL-Crystal-GP is an accurate alternative.

Necrotizing Urethritis due to Aerococcus urinae

Case Reports in Urology, 2015

A 49-year-old male presented to the emergency with hematuria and pain in the shaft of the penis for one day. The patient was found to be in a state of shock. The shaft of the penis and the scrotum were swollen and tender. No skin necrosis was observed and no crepitus was palpable. Serum white count (WBC) was 29.5 × 103/μL. A CT scan showed gas in the corpus spongiosum. Antibiotics were started with IV metronidazole, vancomycin, and piperacillin/tazobactam. Metronidazole was then replaced by clindamycin. Exploration was performed but no necrotic tissue was identified. Cystourethroscopy revealed dusky looking urethra. A suprapubic tube and a urethral catheter were placed in the bladder. WBC trended down to 13.9 × 103/μL on the fourth postoperative day. Urine culture grewAerococcus urinaeand blood cultures grewAlpha Hemolytic Streptococcus.On the sixth day, the patient was feeling worse and WBC increased. MRI revealed absent blood flow to the corpus spongiosum. Urethroscopy revealed ne...