Musculoskeletal infections caused by Aerococcus urinae: a case-based review

Abstract

Aerococcus are Gram-positive bacteria that have been historically misidentified using standard techniques. We report a case of a 63-year-old man with septic oligoarthritis caused by Aerococcus urinae (isolated in two ankle synovial fluid cultures and in two blood cultures). Due to the lack of evidence found in a search performed to identify similar cases, a systematic review was conducted with the objective to identify and analyze all documented cases of musculoskeletal infections caused by Aerococcus urinae. A total of 8 cases were selected: 6 spondylodiscitis, 1 periarticular hip abscess, and 1 prosthetic hip infection. Similarly, as in other Aerococcus urinae invasive infections, these were presented predominantly in older males with history of urinary tract disease, being identified mostly by sequencing of the 16S rRNA or by matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS), with an increasing incidence in the last years and generally with good sensitivity to beta-lactams (aminoglycosides were associated in some cases due to its synergistic effect). Additionally, 4 cases of musculoskeletal infections caused by Aerococcus viridans and 4 cases of Aerococcus urinae with ammoniacal and pervasive malodorous urine were identified; the last was a symptom also present in our case. In this review, we identify a recent increase of musculoskeletal infections caused by Aerococcus urinae, which as well as in series of other invasive infections could be well correlated with an increasing use of more sensible diagnosis methods in clinical laboratories. Therefore, we suggest that these probably will be more frequently diagnosed in the future.

Association between indoor microbiota, home environment characteristics, and frailty status of elderly residents

“…Moreover, frail individuals are at a higher risk of developing urinary tract infections due to an immunocompromised status [39], and infectious arthritis compared to younger adults [40,41]. Brevibacterium and Aerococcus are common pathogens in urinary tract infections [42], of which Aerococcus is also a common pathogen causing joint infections [43]. Therefore, these results indicate that most of the potentially dangerous bacteria we have identi ed may have the potential to promote frailty.…”

Primary septic arthritis of the knee caused by Neisseria meningitidis serogroup B in an elderly patient. Case report and review of the literature

“…This issue is critical for genus and species showing high diversity and frequent horizontal DNA exchanges, such as the genus Neisseria [52][53]. Among the 40 cases of PMA that we retrieved in literature, none were identi ed through MALDI-TOF MS: we found only some examples of its application in the eld of septic arthritis of the native joints [54][55] and periprosthetic infection [56][57][58]. Molecular methods bring signi cant improvements in diagnostic sensitivity, especially in the case of unusual presentations, such as PMA [59].…”

Actinotignum schaalii and Aerococcus urinae as Etiology of Infected Kidney Cyst: A Diagnostic Challenge

“…It has primarily been implicated in less than 1% of all symptomatic urinary tract infections, especially in elderly men [7], causing severe and invasive infections including urosepticemia and infective endocarditis [3,4]. Sporadic cases of soft tissue infections mostly, but not exclusively, with relation to the urinary tract have been reported [8,9]. Both species mentioned are thought to be part of the urogenital microbiota.…”