Bacteraemic spondylodiscitis caused by Enterococcus hirae

Canalejo, Eduardo; Ballesteros, Rafaél; Cabezudo, J.M.; García-Arata, M. Isabel; Moreno, Juan González

doi:10.1007/s10096-008-0476-8

Cited by 26 publications

(19 citation statements)

References 17 publications

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“…Most enterococcal strains isolated from clinical samples belong to two species, Enterococcus faecalis and Enterococcus faecium. Enterococcus hirae causes infections mainly in various animal species (2, 3), and only three cases of human infection have been reported to date (1,4,11). In these three reports, E. hirae was responsible for septicemia, spondylodiscitis, and native valve endocarditis.…”

Section: Case Reportmentioning

confidence: 99%

Relapse of Enterococcus hirae Prosthetic Valve Endocarditis

et al. 2011

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Enterococcus hirae, a Gram-positive bacterium, is a rare isolate in clinical specimens. We report an unusual case of a relapse of prosthetic valve endocarditis due to E. hirae 6 months after the initial episode. Clonal relationship was proven by genomic analysis. CASE REPORTIn April 2008, a 78 year-old woman presented with a 5-month history of fever, generalized weakness, and a 7-kg weight loss. She had a history of diabetes mellitus and hypertension and had undergone in 2001 an aortic valve replacement with a bioprosthetic valve. On admission, her temperature was 38°C, and cardiac examination revealed a 3/6 systolic murmur. Transthoracic and transesophageal echocardiographies showed no evidence of endocarditis.Five blood cultures yielded colonies of Gram-positive cocci with a morphology typical of Streptococcus. On blood agar culture, colonies were circular and smooth and reached 0.2 to 0.5 mm after 24 to 48 h of incubation in the presence of 5% CO 2 . The strain was identified by phenotypic determination and genetic analysis. The phenotypic identification was based upon colony and Gram stain morphologies and a negative catalase reaction. The cocci reacted with both Lancefield group F and D antisera (Streptex; Diamondial, Sees, France). The biochemical identification remained difficult even by a semiautomated system. Accurate identification to the species level was not possible with the IDGP N052 card (bioMérieux, Marcy l'Etoile, France) due to low discrimination (50.52% for Enterococcus durans and 49.48% for Enterococcus faecium). The Rapid ID 32 Strep identification system (bioMérieux) failed, producing an unacceptable profile for Enterococcus gallinarum with the current database.The strain was correctly identified to the species level as Enterococcus hirae by genetic methods using 16S rRNA and sodA int gene sequencing (where "int" represents "internal") as previously described (5, 12). Sequence analysis of this strain yielded 99.81% and 99.76% identities with the sequences of the 16S rRNA gene (GenBank accession no. AB362598) of type strain of E. hirae and the sodA gene (GenBank accession no. AJ387916) of E. hirae, respectively. As the growth was deficient, antibiotic susceptibility testing was performed with an agar diffusion technique using a Mueller-Hinton agar supplemented with 5% horse blood (bioMérieux). The strain was susceptible to amoxicillin (MIC, 0.032 g/ml, as measured by the Etest technique), moxifloxacin, vancomycin, teicoplanin, erythromycin, and rifampin but resistant to clindamycin, tetracycline, and fosfomycin and exhibited low-level resistance to streptomycin, kanamycin, and gentamicin.Despite our patient's normal echocardiography, a diagnosis of possible infective endocarditis was established (Table 1), and intravenous amoxicillin (200 mg per kg of body weight per day) and gentamicin (3 mg per kg per day) were initiated. After 2 weeks, gentamicin was discontinued and rifampin (20 mg per kg per day) was initiated. Antimicrobial treatment was administered for 6 weeks. The patient improved c...

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Section: Case Reportmentioning

confidence: 99%

Relapse of Enterococcus hirae Prosthetic Valve Endocarditis

et al. 2011

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“…There have been only three cases of E hirae bacteremic infection reported in the literature. These were found in patients with end-stage renal disease [14], native valve endocarditis [15], and spondylodiscitis [16]. The first case was reported in 1998 when a 49-year-old male undergoing renal replacement therapy was found to have a positive blood culture.…”

Section: Discussionmentioning

confidence: 97%

Enterococcus hirae‐related acute pyelonephritis and cholangitis with bacteremia: An unusual infection in humans

Chan

Suk

et al. 2011

The Kaohsiung J of Med Scie

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Very few reports are available from the literature related to Enterococcus hirae infection in humans, which is more frequently seen in animals and birds. We report two patients with E hirae bacteremia caused by acute pyelonephritis and acute cholangitis. The clinical courses have been smooth on use of sensitive antibiotic therapy. In both cases, the primary sources and portals of entry are clearly identified.

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“…Enterococcus species can cause urinary tract infections, endocarditis, and bacteremia; E. faecalis and E. faecium are reported to be the causative agents in 90% of these cases. Conversely, E. hirae is suspected in 1-3% of cases of enterococcal infections, making it a rare human pathogen [1]. Since there is limited information and experience in handling E. hirae infections, treatment for E. hirae-related pyelonephritis can be difficult.…”

Section: Discussionmentioning

confidence: 99%

“…We changed ceftriaxone to ciprofloxacin, which is not an ampicillin-based regimen, and had the same successful outcome. Except in cases of urinary tract infections, E. hirae infections were treated using cefmetazole (bacteremia with cholangitis) [7]; ampicillin combination therapy comprising gentamicin and levofloxacin (spondylodiscitis) [1]; vancomycin (hemodialysis with bacteremia); three combination regimens with either vancomycin and gentamicin, amoxicillin and gentamicin, or ampicillin and rifampin (infective endocarditis); ampicillin combination therapy comprising piperacillin/tazobactam and levofloxacin (splenic abscess), and ampicillin (peritonitis). Each of the treatment had an average therapeutic duration of 2 weeks, with a maximum duration of 8 weeks [8].…”

Section: Discussionmentioning

confidence: 99%

Acute Pyelonephritis with Enterococcus hirae and Literature Review

Lee¹,

Lee

et al. 2017

Urogenit Tract Infect

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To control for acute infectious disease, identification of the causative agent and determining the antibiotic susceptibility of the pathogen are crucial. If a particular organism is rare and relevant etiological information is scarce, it becomes difficult to determine appropriate antibiotic and therapy duration. Enterococcus hirae is a pathogen that infects animals, but rarely causes human infections. We present two cases of E. hirae-related pyelonephritis with successful treatment. Herein, our experience is discussed with relevant literature review.

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Bacteraemic spondylodiscitis caused by Enterococcus hirae

Cited by 26 publications

References 17 publications

Relapse of Enterococcus hirae Prosthetic Valve Endocarditis

Relapse of Enterococcus hirae Prosthetic Valve Endocarditis

Enterococcus hirae‐related acute pyelonephritis and cholangitis with bacteremia: An unusual infection in humans

Acute Pyelonephritis with Enterococcus hirae and Literature Review

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