Actinobaculum schaalii causing urinary tract infections: report of four cases from Argentina

Barberis, Claudia; Cittadini, R.; Castillo, Marcelo Del; Acevedo, Pablo; Roig, Cristian García; Ramírez, María Soledad; Pérez, S.; Almuzara, Marisa; Vay, Carlos

doi:10.3855/jidc.3748

Cited by 16 publications

(16 citation statements)

References 20 publications

(25 reference statements)

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“…Clinically, agents such as amoxicillin, amoxicillin-clavulanate, clindamycin, cefuroxime, gentamicin, ceftriaxone and piperacillin-tazobactam have been used successfully in treating A. schaalii [5,7,13e16]. Optimal duration of antibiotic therapy is not clearly defined, but a duration of more than two weeks has been suggested because of documented clinical failure with one-week regimens [1,17].…”

Section: Discussionmentioning

confidence: 99%

Actinobaculum schaalii bacteremia: A report of two cases

et al. 2015

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Section: Discussionmentioning

confidence: 99%

Actinobaculum schaalii bacteremia: A report of two cases

et al. 2015

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“…A. schaalii has already been recognized as an emerging human uropathogen [7], [8], [9], [10]. Increased risk of A. schaalii infection has been reported for the elderly, especially those with diseases of the genitourinary region, and for newborns using diapers [10], [13].…”

Section: Discussionmentioning

confidence: 99%

“…As of 2015, the genus Actinobaculum was divided into Actinotignum and Actinobaculum [6]. A. schaalii is currently considered to be an emerging uropathogen because it has been associated with urinary tract infections (UTIs) in many cases [7], [8], [9], [10]. In contrast to that of A. schaalii, the pathogenicity of P. lymphophilum remains poorly defined.…”

Section: Introductionmentioning

confidence: 99%

Propionimicrobium lymphophilum and Actinotignum schaalii bacteraemia: a case report

Ikeda

Kobayashi

Suzuki

et al. 2017

New Microbes and New Infections

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Propionimicrobium lymphophilum 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 Actinotignum schaalii, 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.

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“…CAN or CAP) should be seeded and incubated under an anaerobic atmosphere. Few recommendations and clarifications have been made to inform urologists and biologists of how and when to investigate the presence of A. schaalii [11,[48][49][50]. Traditional phenotypic tests, such as the API system, are not reliable for the identification of A. schaalii because this species is not included in their database.…”

Section: Methods Of Culture and Identificationmentioning

confidence: 99%

“…UTIs related to A. schaalii appear to be associated with old age and urologic-related predisposing conditions such as bladder cancer, urinary incontinence, catheterization, benign prostatic hyperplasia, neurologic bladder, urethral stenosis, prostate cancer and chronic renal failure, as well as with immunodepression [8][9][10][11][12][13][15][16][17][19][20][21]27,28,[28][29][30]34,35]. Interestingly, A. schaalii has been proved to be involved in invasive infections such as bacteraemia [12,13,[17][18][19][20][21]26,27], endocarditis [23], discitis [13,24], and hidradenitis suppurativa [47].…”

Section: Clinical Manifestationsmentioning

confidence: 99%

Actinotignum schaalii (formerly Actinobaculum schaalii ): a newly recognized pathogen—review of the literature

Lotte

Ruimy

2016

Clinical Microbiology and Infection

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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.

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Actinobaculum schaalii causing urinary tract infections: report of four cases from Argentina

Abstract: Actinobaculum schaalii may be a more common urinary tract pathogen than previously described. Here we report four cases of A. schaalii UTIs and we also propose a simple identification scheme to be used in the conventional microbiology laboratory based on standard biochemical tests.

Cited by 16 publications

References 20 publications

Actinobaculum schaalii bacteremia: A report of two cases

Actinobaculum schaalii bacteremia: A report of two cases

Propionimicrobium lymphophilum and Actinotignum schaalii bacteraemia: a case report

Actinotignum schaalii (formerly Actinobaculum schaalii ): a newly recognized pathogen—review of the literature

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