<i>Actinobaculum schaalii</i>, a cause of urinary tract infections in children?

Andersen, Lise Bols; Bank, Steffen; Hertz, Birgitte; Søby, Karen Marie; Prag, Jørgen

doi:10.1111/j.1651-2227.2011.02586.x

Cited by 28 publications

(24 citation statements)

References 9 publications

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“…All of the reported children were either using diapers or had enuresis. In two children a second pathogen was isolated: Klebsiella pneumoniae in a 3-year-old girl with recurrent UTI [21] and non-hemolytic streptococci in a 9-month-old girl with intradural abscess [10]. Further clinical details of all pediatric cases are summarized in the Table 1.…”

Section: Discussionmentioning

confidence: 99%

“…For example, in asymptomatic patients above 60 years of age with negative results in a urine dipstick test, a real-time quantitative PCR assay detected A. schaalii in 22% of urine samples [2]. Similarly, in children suspected for UTI and negative results in urine dipstick test from midstream urine samples, PCR for A. schaalii from urine was positive in 36% (5 of 14) of children below three years of age but negative in all 15 children tested between 3 and 15 years of age [21]. …”

Section: Discussionmentioning

confidence: 99%

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Actinobaculum schaalii an emerging pediatric pathogen?

et al. 2012

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BackgroundActinobaculum schaalii was first described as a causative agent for human infection in 1997. Since then it has mainly been reported causing urinary tract infections (UTI) in elderly individuals with underlying urological diseases. Isolation and identification is challenging and often needs molecular techniques. A. schaalii is increasingly reported as a cause of infection in humans, however data in children is very limited.Case presentationWe present the case of an 8-month-old Caucasian boy suffering from myelomeningocele and neurogenic bladder who presented with a UTI. An ultrasound of the urinary tract was unremarkable. Urinalysis and microscopy showed an elevated leukocyte esterase test, pyuria and a high number of bacteria. Empiric treatment with oral co-trimoxazole was started.Growth of small colonies of Gram-positive rods was observed after 48 h. Sequencing of the 16S rRNA gene confirmed an A. schaalii infection 9 days later. Treatment was changed to oral amoxicillin for 14 days. On follow-up urinalysis was normal and urine cultures were negative.ConclusionsA.schaalii is an emerging pathogen in adults and children. Colonization and subsequent infection seem to be influenced by the age of the patient. In young children with high suspicion of UTI who use diapers or in children who have known abnormalities of their urogenital tract, infection with A. schaalii should be considered and empiric antimicrobial therapy chosen accordingly.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Actinobaculum schaalii an emerging pediatric pathogen?

et al. 2012

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“…These infections most often occur in elderly individuals and those with underlying urologic conditions such as chronic renal failure or urologic obstruction [261]. In clinical cases of A. schaalii UTI, Gram-positive bacteria are often evident by direct microscopy, and yet, typical aerobic urine culture often produces a negative result [266, 268]. Cases of apparent urosepsis where A. schallii was isolated using anaerobic blood culture techniques were documented only after culture conditions were altered, eventually leading to the identification of A. schaalii in urine.…”

Section: Rare Emerging and Under-reported Gram-positive And Polymicmentioning

confidence: 99%

Gram-Positive Uropathogens, Polymicrobial Urinary Tract Infection, and the Emerging Microbiota of the Urinary Tract

2016

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Gram-positive bacteria are a common cause of urinary tract infection (UTI), particularly among individuals who are elderly, pregnant, or who have other risk factors for UTI. Here we review the epidemiology, virulence mechanisms, and host response to the most frequently isolated Gram-positive uropathogens: Staphylococcus saprophyticus, Enterococcus faecalis, and Streptococcus agalactiae. We also review several emerging, rare, misclassified, and otherwise underreported Gram-positive pathogens of the urinary tract including Aerococcus, Corynebacterium, Actinobaculum, and Gardnerella. The literature strongly suggests that urologic diseases involving Gram-positive bacteria may be easily overlooked due to limited culture-based assays typically utilized for urine in hospital microbiology laboratories. Some UTIs are polymicrobial in nature, often involving one or more Gram-positive bacteria. We herein review the risk factors and recent evidence for mechanisms of bacterial synergy in experimental models of polymicrobial UTI. Recent experimental data has demonstrated that, despite being cleared quickly from the bladder, some Gram-positive bacteria can impact pathogenic outcomes of co-infecting organisms. When taken together, the available evidence argues that Gram-positive bacteria are important uropathogens in their own right, but that some can be easily overlooked because they are missed by routine diagnostic methods. Finally, a growing body of evidence demonstrates that a surprising variety of fastidious Gram-positive bacteria may either reside in or be regularly exposed to the urinary tract and further suggests that their presence is widespread among women, as well as men. Experimental studies in this area are needed; however, there is a growing appreciation that the composition of bacteria found in the bladder could be a potentially important determinant in urologic disease, including susceptibility to UTI.

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“…Interestingly, considerable proportions of individuals without symptoms can also be positive for this organism; urine specimens from 13% of 38 healthy controls (aged between 63 and 81 years) proved to be positive by real-time PCR (255), and 22% of 55 culture-positive elderly subjects were characterized as having asymptomatic bacteriuria (256). A. schaalii is thus considered a uropathogen in the elderly, but the significance of this species in children is receiving attention (258,259). Cystitis, pyelonephritis, and urosepsis are the major forms of Actinotignum (formerly Actinobaculum)-associated infections; however, other types of infections, especially with A. schaalii, are increasingly being reported, including bacteremia, abscesses, cellulitis, spondylodiscitis, bladder necrosis, epididymitis, and endocarditis (16,(260)(261)(262)(263)(264).…”

Section: Actinotignum (Formerly Actinobaculum) Species In the Urogenimentioning

confidence: 99%

Actinomyces and Related Organisms in Human Infections

2015

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SUMMARY Actinomyces israelii has long been recognized as a causative agent of actinomycosis. During the past 3 decades, a large number of novel Actinomyces species have been described. Their detection and identification in clinical microbiology laboratories and recognition as pathogens in clinical settings can be challenging. With the introduction of advanced molecular methods, knowledge about their clinical relevance is gradually increasing, and the spectrum of diseases associated with Actinomyces and Actinomyces -like organisms is widening accordingly; for example, Actinomyces meyeri , Actinomyces neuii , and Actinomyces turicensis as well as Actinotignum (formerly Actinobaculum ) schaalii are emerging as important causes of specific infections at various body sites. In the present review, we have gathered this information to provide a comprehensive and microbiologically consistent overview of the significance of Actinomyces and some closely related taxa in human infections.

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Actinobaculum schaalii, a cause of urinary tract infections in children?

Abstract: Actinobaculum schaalii is CO(2)-dependent. Therefore, if there are clinical symptoms and/or a negative culture despite the presence of leucocytes in the urine, Gram staining and incubation in 5% CO(2) or species-specific real-time PCR should be performed to identify A. schaalii.

Cited by 28 publications

References 9 publications

Actinobaculum schaalii an emerging pediatric pathogen?

Actinobaculum schaalii an emerging pediatric pathogen?

Gram-Positive Uropathogens, Polymicrobial Urinary Tract Infection, and the Emerging Microbiota of the Urinary Tract

Actinomyces and Related Organisms in Human Infections

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