The clinical significance of Alloscardovia omnincolens in the urinary tract has not been thoroughly evaluated. In this study, 15 patients with A. omnincolens present in their urine cultures were identified. A. omnincolens is only rarely associated with urinary tract symptoms and in some patients may play a commensal role. With the widespread adoption of matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS), bacteria are now identified with greater accuracy than with conventional phenotypic methods (1). This is particularly true for identification of bacteria that were difficult to distinguish or identify and would have been previously classified into broad categories such as urogenital flora. These organisms can now be identified to the species level with great accuracy. Although beneficial in most circumstances, the improved ability to rapidly identify most bacteria forces clinical microbiologists and infectious disease practitioners to interpret the clinical significance of unfamiliar organisms.Alloscardovia omnincolens is one such organism. Prior to implementation of MALDI-TOF MS, this organism, a member of the Bifidobacteriaceae family, was difficult to identify in the absence of 16S rRNA sequencing (2). Appearing as small, pinpoint, alpha-hemolytic colonies on blood agar, A. omnincolens would have most likely been considered urogenital flora since it is a catalase-and oxidase-negative, Gram-positive rod that could not be accurately identified using phenotypic methods (2). This organism has been isolated and identified in urine, saliva, and blood specimens; however, its clinical significance is yet to be determined (3-6).This study was prompted by the observation that A. omnincolens was being isolated from urine cultures in pure or predominant growth with unknown clinical presentations. To better understand the significance of this organism, both a 10-month retrospective review and prospective evaluation of Ͼ3,000 urine cultures were performed. In total, the laboratory results and clinical information of 15 patients with A. omnincolens were reviewed to assess the clinical significance and colonization frequency of this organism. MATERIALS AND METHODSIdentification of isolates and cases. This study consisted of both retrospective and prospective analyses. In the retrospective analysis, the laboratory information system was used to evaluate all urine cultures submitted to our laboratory between June 2013 and April 2014. This search was conducted to identify any culture that yielded significant growth of A. omnincolens. A threshold of 10 4 CFU/ml was used to determine significant growth.To establish the rate of colonization, a prospective analysis was performed between 12 August 2014 and 26 March 2015. In this analysis, 3,395 noncontinuous urine specimens submitted for routine bacterial culture were plated (0.01 ml) to 5% sheep blood (sBAP) and MacConkey agars; sBAPs were incubated for up to 48 h at 35°C in 5% CO 2 and prospectively examined for the growth of any amount of ...
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