Nine of 10 strains of Actinobaculum schaalii caused urinary tract infections in predisposed individuals. Identification included 16S rRNA gene sequence analysis and use of the API Coryne and Rapid ID32A test systems. A. schaalii is easily overlooked due to its slow growth in ambient air and its resemblance to the normal bacterial flora on skin and mucosa.The genus Actinobaculum, first described in 1997, includes the Actinobaculum suis and Actinobaculum schaalii species. A. suis is an important cause of urinary tract infections (UTIs) and abortions in sows and was formerly assigned to a variety of genera, including Corynebacterium, Eubacterium, and Actinomyces (9, 17). A. schaalii is a new species recovered from human blood and urine and is suspected to cause UTIs (9, 12). Two newly described species, Actinobaculum massiliae and Actinobaculum urinale, were recovered from the urine of elderly women with chronic cystitis (6, 7). A. massiliae is also described as a new cause of superficial skin infections (16). Problems with identifying Actinobaculum spp. with traditional phenotypic tests have obscured their pathological role for many years. We describe 10 cases of A. schaalii infections.Nine strains of A. schaalii were available for growth, biochemical, and susceptibility tests. The strains were cultured on nine different culture media at 35°C in ambient air, in air with 5% CO 2 , and anaerobically. The media were 5% Columbia sheep blood agar (Becton Dickinson [BD], Heidelberg, Germany), 5% and 10% horse blood agar (Statens Serum Institut [SSI], Copenhagen, Denmark), chocolate agar (SSI), Brucella blood agar with hemin and vitamin K1 (BD), anaerobic plates (SSI), nutrient agar plates (SSI), semisolid agar containing pepsin blood and thioglycolate (SSI), and serum broth (SSI). The CAMP reaction was performed on CAMP plates containing sheep erythrocytes (SSI) with a streak of a beta-hemolytic strain of Staphylococcus aureus. The strains were characterized by using the API Coryne and Rapid ID32A systems in accordance with the manufacturer's instructions (API bioMérieux, Marcy l'Etoile, France). Carbohydrate fermentation reactions were read after 24 and 48 h of incubation.A Quantitect SYBR green kit (QIAGEN) was used with real-time PCR mixtures (50-l total volume) containing 1ϫ PCR buffer and a 200 M concentration of each primer. The primers used for amplification of the 16S rRNA gene, BSF-8 (5Ј-AGAGTTTGATCCTGGCTCAG-3Ј) and BSR-534 (5Ј-ATTACCGCGGCTGCTGGC-3Ј), produced a 526-bp fragment of the 16S rRNA gene. Samples of 1 and 5 l were tested by PCR. PCRs were performed by using an Opticon DNA engine (MJ Research). The amplification profile included incubation at 95°C for 15 min followed by 40 cycles at 94°C for 30 s, 55°C for 30 s, and 72°C for 30 s. PCR samples were spin column purified using Microcon YM-100 filter units (Millipore) for DNA sequencing. DNA strands of the amplicons were sequenced on an ABI PRISM 3100 Avant genetic analyzer (Applied Biosystems) using BSF-8 and BSR-534 as sequencing primers and a BigDye v....

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In the present study, the intra-individual variance was greater for cystatin C than for creatinine in both healthy subjects and in patients with impaired renal function. Accordingly, serum creatinine is the preferred marker for serial monitoring of renal function in individuals with stable muscle mass.

BackgroundA marked reduction in serum levels of bioactive insulin-like growth factor-I (IGF-I) has been observed in fasting hemodialysis (HD) patients during a 4-h HD session. The aim of the present study was to investigate the beneficial effect of hyperinsulinemia during HD on bioactive IGF-I and inflammatory biomarkers.MethodsIn a randomized cross-over study, 11 non-diabetic HD patients received a standardised HD session with either: 1) no treatment, 2) glucose infusion (10% glucose, 2.5 mL/kg/h), or 3) glucose-insulin infusion (10% glucose added 30 IU NovoRapid® per litre, 2.5 mL/kg/h). Each experiment consisted of three periods: pre-HD (−120 to 0 min), HD (0 to 240 min), and post-HD (240 to 360 min). A meal was served at baseline (−120 min); infusions were administered from baseline to 240 min. The primary outcome was change in bioactive IGF-I during the experiment. Secondary outcomes were changes in high-sensitivity C-reactive protein, interleukin-1β, interleukin-6, and tumor necrosis factor α. Comparisons were performed using mixed-model analysis of variance for repeated measures.ResultsFrom baseline to the end of study, no significant differences were observed in the changes in either serum bioactive IGF-I or total IGF-I between study days. Overall, serum bioactive IGF-I levels rose above baseline at 120 to 300 min with a maximum increase of 20% at 120 min (95% confidence interval (CI), 9 to 31%; p < 0.001), whereas total IGF-I levels rose above baseline at 180 to 300 min with a maximum increase of 5% at 240 min (95% CI, 2 to 9%; p = 0.004). A significant difference was observed in the changes in serum IGF-binding protein-1 (IGFBP-1) between study days (p = 0.008), but differences were only significant in the post-HD period. From baseline to the end of HD, no significant difference was observed in the changes in serum IGFBP-1 levels between study days, and in this time period overall serum IGFBP-1 levels were below baseline at all time points with a maximum decrease of 51% at 180 min (95% CI, 45 to 57%; p < 0.001). None of the investigated inflammatory biomarkers showed any differences in the changes over time between study days.ConclusionsPostprandial insulin secretion stimulated the IGF-system during HD with no further effect of adding glucose or glucose-insulin infusion. Hyperinsulinemia during HD had no effect on biomarkers of inflammation.Trial registrationClinicalTrials.gov registry: NCT01209403

Complete genome sequencing of the emerging uropathogen Actinobaculum schaalii indicates that an important mechanism of its virulence is attachment pili, which allow the organism to adhere to the surface of animal cells, greatly enhancing the ability of this organism to colonize the urinary tract.