A rare case of histopathological bladder necrosis associated with Actinobaculum schaalii: The incremental value of an accurate microbiological diagnosis using 16S rDNA sequencing

Lotte, Romain; Durand, Matthieu; Mbeutcha, Aurélie; Pulcini, Céline; Degand, Nicolas; Loeffler, Joyce; Ruimy, Raymond; Amiel, J.

doi:10.1016/j.anaerobe.2014.01.005

Cited by 12 publications

(15 citation statements)

References 6 publications

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“…Today, MALDI-TOF using Microflex LT with the Biotyper 2.3 database (Bruker Daltonics, Bremen, Germany) of colonies is probably the most accurate and rapid method for the routine identification of A. schaalii [35,[48][49][50]. Indeed, its utilization is faster and easier than 16S rRNA gene sequencing, and several studies have shown its efficiency [14,28,35,50]. For example, Tuuminen et al [50] and Non et al [35] both used the Microflex LT with the Biotyper database (Bruker Daltonics) to identify 11 and two strains, respectively, of A. schaalii and obtained reliable identifications to the species level (log score value 2) using an extraction step with 70% formic acid.…”

Section: Methods Of Culture and Identificationmentioning

confidence: 99%

“…UTIs related to A. schaalii appear to be associated with old age and urologic-related predisposing conditions such as bladder cancer, urinary incontinence, catheterization, benign prostatic hyperplasia, neurologic bladder, urethral stenosis, prostate cancer and chronic renal failure, as well as with immunodepression [8][9][10][11][12][13][15][16][17][19][20][21]27,28,[28][29][30]34,35]. Interestingly, A. schaalii has been proved to be involved in invasive infections such as bacteraemia [12,13,[17][18][19][20][21]26,27], endocarditis [23], discitis [13,24], and hidradenitis suppurativa [47].…”

Section: Clinical Manifestationsmentioning

confidence: 99%

“…Nielsen et al [19] reported that 28% (21/76) of strains were mecillinam resistant using the tablet diffusion method but did not report either the detailed diameters of the inhibitory zone or the references used to categorized the strains. A. schaalii is susceptible to tetracyclines [14,[16][17][18]24,29], to vancomycin and teicoplanin [14][15][16]21,22,24,28,54], to linezolid [14,28,29,54], to rifampicin [14,15,24,28] and to nitrofurantoin [14,17,18,54]. A single strain has been reported to be resistant to nitrofurantoin [29].…”

Section: Antimicrobial Susceptibilitymentioning

confidence: 99%

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Actinotignum schaalii (formerly Actinobaculum schaalii ): a newly recognized pathogen—review of the literature

Lotte

Ruimy

2016

Clinical Microbiology and Infection

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The genus Actinotignum contains three species, Actinotignum schaalii (formerly Actinobaculum schaalii), Actinotignum urinale and Actinotignum sanguinis. A. schaalii is the species most frequently involved in human infections, with 172 cases, mostly urinary tract infections (UTIs), reported so far. Invasive infections have also been described. This facultative anaerobic Gram-positive rod is part of the urinary microbiota of healthy patients. It is responsible for UTIs, particularly in elderly men and young children. A. schaalii is an underestimated cause of UTIs because of its fastidious growth on usual media and difficulties associated with its identification using phenotypic methods. Indeed, this slow-growth bacterium requires blood-enriched media and an incubation time of 48 hours under anaerobic or 5% CO2 atmosphere. Furthermore, only matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF) or molecular-based methods allow the accurate identification of this bacteria. MALDI-TOF using Microflex LT with the Biotyper database (Bruker Daltonics, Bremen, Germany) is the most reliable technology for the routine identification of A. schaalii. The identification of this uropathogen is all the more important because it is resistant to trimethoprim/sulfamethoxazole and second-generation quinolones that are widely used in the treatment of UTIs. Antimicrobial therapy using β-lactams prolonged for up to 2 weeks is the most efficient treatment and should be recommended. Microbiologists should assess the presence of A. schaalii in urine using appropriate culture and identification methods in the case of a direct examination that is positive for small coccoid rods, a negative nitrite urinary stick associated with leukocyturia, treatment failure with trimethoprim/sulfamethoxazole or fluoroquinolones, or undocumented, repeated UTIs.

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Section: Methods Of Culture and Identificationmentioning

confidence: 99%

Section: Clinical Manifestationsmentioning

confidence: 99%

Section: Antimicrobial Susceptibilitymentioning

confidence: 99%

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Actinotignum schaalii (formerly Actinobaculum schaalii ): a newly recognized pathogen—review of the literature

Lotte

Ruimy

2016

Clinical Microbiology and Infection

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“…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). In a case of Fournier's gangrene, only A. schaalii was detected by 16S rRNA gene sequencing (265).…”

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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“…Actinotignum schaalii has been associated with urinary tract infections [6, 7] but can also cause invasive infections, such as Fournier’s gangrene, urinary bladder necrosis, bacteremia, and endocarditis [8–11]. The characteristics of infections with A. schaalii have been described in two recent reviews [5, 12].…”

Section: Introductionmentioning

confidence: 99%

Clinical and microbiological features of Actinotignum bacteremia: a retrospective observational study of 57 cases

Pedersen

Senneby

Rasmussen

2016

Eur J Clin Microbiol Infect Dis

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The purpose of this study was to investigate the incidence, clinical presentation, and prognosis of Actinotignum bacteremia in southern Sweden. Actinotignum isolates in blood cultures were identified retrospectively between 1st January 2012 and 31st March 2016 through searches in the clinical microbiology laboratory database. The population covered by this laboratory is approximately 1.3 million. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) was used for species determination. Etests were used for minimum inhibitory concentration (MIC) determination. The patients’ medical charts were reviewed. Fifty-eight episodes in fifty-seven patients with Actinotignum bacteremia were identified (A. schaalii = 53, A. sanguinis = 1, A. urinale = 2, and Actinotignum species = 3), which corresponds to an incidence of 11 cases per million inhabitants. Fifty-one percent of the isolates were in pure culture. The MICs were low for β-lactam antibiotics, whereas high MICs were recorded for ciprofloxacin and trimethoprim. Patients had a median age of 82 years, 72% were male, and a majority had underlying urological conditions. Thirty-six of the patients were diagnosed with a focus from the urinary tract. Thirty-one patients developed severe sepsis and nine patients died during the hospital stay. Our study is the largest of Actinotignum bacteremia and demonstrates that it is a condition with a significant fatality that affects elderly persons with underlying conditions. β-Lactams represent a rational treatment option.

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A rare case of histopathological bladder necrosis associated with Actinobaculum schaalii: The incremental value of an accurate microbiological diagnosis using 16S rDNA sequencing

Cited by 12 publications

References 6 publications

Actinotignum schaalii (formerly Actinobaculum schaalii ): a newly recognized pathogen—review of the literature

Actinotignum schaalii (formerly Actinobaculum schaalii ): a newly recognized pathogen—review of the literature

Actinomyces and Related Organisms in Human Infections

Clinical and microbiological features of Actinotignum bacteremia: a retrospective observational study of 57 cases

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