<i>Actinobaculum schaalii</i>, a Common Uropathogen in Elderly Patients, Denmark

Bank, Steffen; Jensen, A. S.; Hansen, Thomas; Søby, Karen Marie; Prag, Jørgen

doi:10.3201/eid1601.090761

Cited by 70 publications

(75 citation statements)

References 8 publications

(12 reference statements)

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“…schaalii was first described in 1997 and since then many reports have been published indicating A. schaalii as a causative agent for urinary tract infections [1,3]. The common risk factors are prostatic hyperplasia, urinary catheter, and urethral stenosis [3,14].…”

Section: Discussionmentioning

confidence: 99%

“…schaalii can cause urinary tract infections (UTIs) but due to its slow growth it may be easily overgrown by other pathogens and therefore not be identified and be a more common urinary tract pathogen than previously described [1].…”

Section: Introductionmentioning

confidence: 96%

“…This pathogen has been reported to be responsible for UTIs mainly in elderly patients with underlying urological predisposing factors [1,2] and also in pediatric patients [3]. Two other species from the genus Actinobaculum, A. massiliae and A. urinale, have also been detected in urine and other clinical specimens such as blood and pus from a superficial skin infection [4,5,6].…”

Section: Introductionmentioning

confidence: 99%

“…Two other species from the genus Actinobaculum, A. massiliae and A. urinale, have also been detected in urine and other clinical specimens such as blood and pus from a superficial skin infection [4,5,6]. Besides UTIs, other infections have been reported with A. schaalii as the causative agent, including bacteremia, vertebral osteomyelitis and perineal necrotizing cellulitis [7,8,9], A. schaalii appears to be an emerging pathogen, in relation with UTIs in the last decade [1,2,3,10].…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

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

Barberis

Cittadini

Castillo

et al. 2014

J Infect Dev Ctries

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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

Barberis

Cittadini

Castillo

et al. 2014

J Infect Dev Ctries

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“…Urinary tract infections caused by A. schaalii in adults can progress to urosepsis. Other serious illnesses attributed to A. schaalii include osteomyelitis, endocarditis, necrotizing fasciitis, bacteremia, abscesses, and epididymitis (4,5,6,7,8). A. schaalii infections, particularly in the urinary tract in both adult and pediatric populations, are frequently reported as polymicrobial (4, 9, 10).…”

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confidence: 99%

Answer to November 2015 Photo Quiz

Burd

Rebolledo

2015

J Clin Microbiol

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The Gram stain of material from the abscess showed many Gram-positive cocci and Gram-negative coccobacilli. The organism that grew in aerobic culture initially presented as a pleomorphic Gram-positive organism with both coccoid and rod-shaped forms. After extended incubation, the Gram stain morphology appeared more consistently diphtheroid-like, with some branching. Based on the Gram stain morphology, the negative result for catalase, and the negative results for pyrrolidonyl arylamidase (PYR) and leucine aminopeptidase (LAP), the isolate was presumptively identified as Actinobaculum species. Matrixassisted laser desorption ionization-time of flight (MALDI-TOF) mass spectroscopy using the Vitek MS RUO system with Saramis SuperSpectra database version 4.09 (bioMérieux, Durham, NC) provided a good identification of Actinobaculum schaalii, with an 80.5% confidence value and a reference species proposed as a single choice. The identification was corroborated at the Georgia Public Health Laboratory using DNA sequence analysis of a 401-bp segment of the 16S rRNA gene, which yielded 99.6% homology with A. schaalii strain NR_040859.1 (http://www.ncbi .nlm.nih.gov/GenBank/index.html).The genus Actinobaculum was first described in 1997, at which time A. schaalii was designated the type species and Actinobaculum suis (formerly Actinomyces suis) was transferred from the genus Actinomyces. Actinobaculum urinale and Actinobaculum massiliense were added in 2003 and 2006, respectively. The phylogenetic relationships of Actinobaculum are not yet clearly established, but existing phylogenetic studies show the genus to be closely related to the genera Actinomyces, Arcanobacterium, Trueperella, and Mobiluncus (1). Actinobaculum grows best under anaerobic or microaerophilic conditions and requires at least 5% CO 2 . These Gram-positive coccoid rods have a tendency to branch and may decolorize on a Gram stain. Actinobaculum grows very slowly, producing pinpoint gray colonies Ͻ1 mm in diameter, and may show weak beta-hemolysis on agar containing 5% horse or sheep blood after 2 to 5 days of incubation.A. suis is known to cause actinomycosis of the mammary gland, urinary tract infections, and abortions in sows. The Actinobaculum species that have been found in humans probably belong to the commensal flora of the oral cavity and genitourinary tract and may be present on surrounding skin (2). The elderly appear to be at the greatest risk for colonization (2). Prevalence of infection and pathogenic potential are undoubtedly underestimated, and there are increasing numbers of reports of Actinobaculum infections appearing in peer-reviewed literature. A few reports implicate A. urinale and A. massiliense as causes of chronic cystitis in elderly women. In addition, A. massiliense has been reported as a cause of superficial skin infection (3).A. schaalii is the most frequently reported species and has primarily been recovered from urine, typically as a cause of unexplained pyuria or urinary tract infection unresponsive to treatment with ciprofl...

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Actinobaculum schaalii: identification with MALDI-TOF

Tuuminen

Suomala²,

Harju

2014

New Microbes and New Infections

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Actinobaculum schaalii is an emerging uropathogen. So far, its identification has been performed with 16S rRNA gene sequencing or PCR. The diagnosis has often been delayed due to fastidious growth and identification problems. Eleven clinical isolates of A. schaalii from bloodstream infections that were initially identified with 16S rRNA sequencing analysis were recovered and later identified with matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF). We present a review of bacteriological data of these patients, an algorithm for fast laboratory work-up and advocate the use of sensitized culture of urine to allow better recovery of A. schaalii in susceptible patients.

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Actinobaculum schaalii, a Common Uropathogen in Elderly Patients, Denmark

Abstract: This organism is identified more often by PCR than by cultivation.

Cited by 70 publications

References 8 publications

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

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

Answer to November 2015 Photo Quiz

Actinobaculum schaalii: identification with MALDI-TOF

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