Aerococcus urinae Aortitis: A Case Report

Abstract

Background Aerococcus urinae is a Gram-positive coccus that is increasingly recognized as a urinary pathogen since the introduction of mass spectrometry for identification of bacteria. We report a case of abdominal aortitis (with aneurysm) caused by A urinae in a male with recurrent urinary tract infections and recently treated A urinae bacteremia. A 63-year-old gentleman with a history of A urinae urosepsis 7 weeks prior, presented to the Emergency Department with thoracolumbar back pain radiating bilaterally into the groin. Radiological and surgical findings were consistent with infective infrarenal aortitis with aneurysm.MethodsThe patient successfully underwent open surgical debridement and reconstruction of the infrarenal aorta with autologous vein graft. Results Aerococcus urinae was isolated from excised tissue. The patient completed a 4-week course of intravenous antimicrobial therapy.Conclusions Aurinae is a urinary pathogen with the ability to cause severe invasive disease including endovascular infections.

A mouse model displays host and bacterial strain differences in Aerococcus urinae urinary tract infection

“…Aerococcus urinae has also been detected in patients without clinically-defined UTI ( Sierra-Hoffman et al, 2005 ), and was more frequently detected in urine from postmenopausal women with urgency urinary incontinence (UUI) compared to asymptomatic controls (74% UUI, 28% non-UUI; P =0.002; n =118) ( Pearce et al, 2014 ). In addition to colonization and infection of the urinary tract, A. urinae can cause invasive infections like bacteremia ( Senneby et al, 2016 ), urosepsis ( Kim et al, 2017 ), endocarditis ( Tai et al, 2021 ; Ludhwani et al, 2020 ), aortitis ( Chhibber et al, 2019 ), and spondylodiscitis ( Rougier et al, 2018 ; Lyagoubi et al, 2020 ), as well as other musculoskeletal infections ( Greco et al, 2018 ) and soft tissue infections ( Forsvall et al, 2019 ). The urinary tract is often implicated as the source of these disseminated infections because A. urinae is concurrently detected in urine ( Senneby et al, 2016 ; Lyagoubi et al, 2020 ).…”