Emerging Presence of Culturable Microorganisms in Clinical Samples of the Genitourinary System: Systematic Review and Experience in Specialized Care of a Regional Hospital

Abstract

The detection of emerging pathogens responsible for genitourinary infections has increased with technological advances. We conducted a systematic review of publications on the involvement of these microorganisms in genitourinary samples, and we also investigated their presence and antibiotic susceptibility in samples from patients at our regional hospital (Granada, Spain). The MEDLINE database was searched up to 31 December 2020, and a cross-sectional descriptive study was performed of results obtained in urine samples and genital exudates from January 2016 through December 2019. The review highlighted the frequent involvement of Neisseria meningitidis in genital infections, while the data on other microorganisms were consistent with findings in our patient series. The emerging microorganisms most often responsible for urinary tract infections were Streptococcus bovis (58.5%) and Gardnerella vaginalis (23.6%) in females, and S. bovis (32.3%), Aerococcus urinae (18.6%), and Corynebacterium spp. (16.9%) in males; those most frequently reported in genital infections were S. viridans (36.4%) in females and C. glucuronolyticum (32.2%) and G. vaginalis (35.6%) in males. In general, emerging pathogens are resistant to conventional antibiotics such as penicillin. However, there has also been an increase in beta-lactam resistance by the S. bovis group and Corynebacterium spp. The systematic review showed that emerging microorganisms are responsible for only a small percentage of genitourinary infections but are of major clinical interest, with a predominance of the S. bovis group, G. vaginalis, Lactobacillus spp., Aerococcus spp., and Corynebacterium spp. in urine samples and of G. vaginalis and C. glucuronolyticum in genital samples. Given the increasing resistance to antibiotics empirically prescribed in patients with genitourinary infections, it is recommended to create an antibiogram in all cases.

Infections by Alloscardovia omnicolens and Associated Clinical Conditions: A Systematic Review

“…There is a scarcity of research on the pathogenic potential of Alloscardovia omnicolens in the current scientific literature. Some reasons for this include the recent description of the bacterium, misdiagnosis of the actual infecting agent due to phenotypic similarity to other bacteria or inaccuracies in biochemical methods [15], the low incidence of the bacterium both as a microbiota component and as an opportunistic infectious agent [4,6,7,9,14,15,16,17,29], and the difficulty of diagnosis through traditional laboratory routines [4,[29][30][31][32]. Klein et al [31] highlight that the laboratory automation process in bacterial culture has demonstrated a significant increase in the detection rate of Alloscardovia omnicolens -ten times higher than the incidence recorded before laboratory routine changes -suggesting that this species may be underestimated as a causative pathogen of urinary tract infections.…”

“…The colonies are small (less than 1 mm), and signs of hemolysis may sometimes be observed after 48 hours of cultivation [1,[3][4][5]. Studies indicate that although it is rarely found colonizing humans, it is part of the gastrointestinal tract microbiota [6], urinary tract [6][7][8][9], vaginal mucosa [10][11][12][13], and oral cavity [4,[14][15][16][17]. The species has been found in dental biofilms associated with dental plaques, suggesting a potential role in their formation [18,19].…”

Gardnerella vaginalis: Is it an Underestimated Cause of Urinary Symptoms in Males?

“…On the other hand, G. vaginalis was detected in three of 38 (14%) male patients with urethritis in a Japanese study using the PCR method ( 10 ). Furthermore, in a very recent systematic review, among male patients with urethritis evaluated by real-time multiplex PCR, G. vaginalis was highlighted as the most frequent emerging microorganism with a 35.6% detection rate ( 12 ). In line with these studies, G. vaginalis was detected as the most frequent microorganism (16%) in our study.…”

“…Aside from the discussion of being the causative agent of urethritis, recent studies have shown that rare microorganisms, including G. vaginalis , may be the causative agent of urinary infection. The most important reasons why these microorganisms have not been held responsible for a urinary infection until now are misclassification because of the lack of specific phenotypic criteria and the inadequacy of conventional methods in the diagnosis of these microorganisms due to slow growth ( 12 , 14 ). There are individually reported cases of genitourinary tract infections caused by G. vaginalis , such as a 43-year-old male with prostatitis and a 36-year-old male with urinary tract infection along with bacteremia ( 15 , 16 ).…”

Antibiotic Resistances of Enterobacteriaceae with Chromosomal Ampc in Urine Cultures: Review and Experience of a Spanish Hospital

“…No exclusion criteria were applied. Sample processing always followed the standard laboratory protocol of our hospital [ 15 ]. Matrix-assisted laser desorption ionization (MALDI) Biotyper (Bruker Daltonics, Billerica, MA, USA) or MicroScan (Beckman Coulter, Barcelona, Spain) systems were employed to identify microorganisms grown in culture, and MicroScan was used to evaluate their antibiotic susceptibility.…”