Urinary Tract Infection Caused by the Novel Pathogen, Lactococcus Garvieae: A Case Report

Abstract

Lactococcus garvieae is a part of the genus Lactococcus which was previously a part of the genus Streptococcus. It has been associated with serious diseases in aquaculture. However, human infections are rare. The most common presentation in humans is infective endocarditis. Urinary tract infection (UTI) is a unique presentation of this pathogen. We report the case of a 70-year-old male with a past history of benign prostatic hyperplasia who presented with confusion. Urinalysis confirmed the growth of L. garvieae. A seven-day treatment course of amoxicillin-clavulanate successfully treated the patient. The risk factors for acquiring the L. garvieae infections include contact with seafood or aquaculture. Other risk factors include immunosuppression, gastric acid suppression, and anatomical or physiological defect in the gastrointestinal tract. Special tests, such as VITEK ® 2, API® 32 strep system, 16S rRNA, or polymerase chain reaction (PCR) testing, are needed for its diagnosis. Hence, we suggest underreporting of the infection may be possible. It is a novel cause of UTI, we suggest a high index of suspicion should be kept, especially in people with associated risk factors or exposure to seafood.

Evidence of pediatric sepsis caused by a drug resistant Lactococcus garvieae contaminated platelet concentrate

“…The cases of L. garvieae infection in humans described so far are characterized by a favourable clinical course and regard manifestations such as endocarditis, septicaemia, urinary tract infection, peritonitis, and liver abscess [ 3 , 9 , 11 ]. L. garvieae was also the cause of bacterial contamination of PCs [ 43 , 44 ], and thus, represents a serious problem in transfusions, as demonstrated by the first case of sepsis caused by this transfusion-transmitted pathogen [ 43 ].…”

“…Lactococci are Gram-positive, catalase-negative, facultative anaerobic cocci in short chains or pairs traditionally considered to be of low virulence to human beings [ 1 ]. Among them, Lactococcus (L.) garvieae species was first described in the 1950s in Japan, when it was discovered in a rainbow trout farm [ 2 , 3 ] . It can be found in a vast variety of environments due to its ability to adapt easily.…”

“…Among the reported cases, majority have been associated with bacteraemia with infective endocarditis among elderly and immunocompromised patients [ 9 ]. Other clinical syndromes include spontaneous septicaemia, liver abscess, bone infections, diverticulitis, and secondary peritonitis [ 3 , 9 , 11 ]. It has also been observed to mainly cause urinary tract infection (UTI) [ 1 ].…”

Lactococcus garvieae: An Uncommon Human Pathogen Causing Infective Endocarditis in a Valve-in-Valve Transcatheter Aortic Valve Replacement

“…Lactococcus garvieae is a gram-positive coccus (Figure 1) and catalase-negative bacterium known for producing fish infection outbreaks in warm waters (rainbow trout) [1][2][3]. Its zoonotic potential was unknown until recently when multiple case reports have shown the spectrum of pathogenic capabilities of this bacterium, capable of causing urinary tract infections, liver abscess, and most importantly infective endocarditis (IE) [3][4][5][6].…”

“…Human consumption of raw seafood seems to be the main contamination source; nonetheless, infection from unpasteurized dairy products has also been described [2][3][4]. Other risk factors for infection are an immunosuppressed state, prior heart valve surgery, and the presence of gastrointestinal diseases that compromise the mucosal lining integrity (polyps, diverticulosis, peptic ulcers, and gastroesophageal reflux disease [GERD]) [2,4].…”