Facklamia hominis pyelonephritis in a pediatric patient: first case report and review of the literature

Abstract

Background Pyelonephritis is one of the most serious bacterial illnesses during childhood. Gram-negative organisms account for up to 90% of the cases. Gram-positive bacteria are uncommon causes of urinary tract infections, and only a few cases caused by Facklamia hominis have been reported in the literature. Case presentation A five-year-old girl with tracheostomy and gastrostomy and past medical history of congenital lymphangioma presented with a two-week history of with intermittent fever, frequent urination, and vesical tenesmus. Diagnosis of pyelonephritis was made. Urine culture reported colonies with alpha-hemolysis in blood agar at 48-h of incubation and Facklamia hominis was identified by MALDI-TOF. The patient was successfully treated with gentamicin. Conclusions This is the first reported case of pyelonephritis by Facklamia hominis in a child, and the second involving infection in a pediatric patient. Although this pathogen is uncommon, current treatment of F. hominis is a challenge for physicians. This case illustrates the requirement to standardize identification and treatment of care to avoid treatment failure and antimicrobial resistance.

Dynamics of the Gut Microbiome in Shigella -Infected Children during the First Two Years of Life

“…Two other taxa, Facklamia hominis and Holdemanella biformis , both part of the Firmicutes phylum, were also increased after Shigella- associated diarrheal infection. F. hominis is an uncommon pathogen that has been reported in a few cases of human infections ( 67 ). H. biformis was found to be reduced in the microbiota of patients with colorectal adenomas, and it also produces SCFAs that reduce tumor cell proliferation ( 68 ).…”

Presence and Relevance of Emerging Microorganisms in Clinical Genitourinary Samples

“…Seven isolates of F. hominis were detected in the present series, including three related to immunosuppression, although five of them were interpreted as contamination. This species is rarely implicated in human infections but has been associated with sepsis, bacteremia, genitourinary infections [24,25] and even prosthetic infections [26]. Moraxella osloensis has rarely been implicated in genitourinary infections, but two isolates were detected at genital level in patients with permanent catheter [27].…”

“…Isolates corresponded to SBG in 21 (70%) of the 30 urinary episodes, 17 (56.7%) of which were symptomatic. Urine analyses were conducted in 25 In relation to immunosuppressive factors, the percentage of solid organ transplantation patients was significantly higher in episodes of Gardnerella spp. (28; 47.5%) and significantly lower in episodes of SBG (13; 13.8%) (p < 0.001).…”

Beyond the usual suspects: emerging uropathogens in the microbiome age

“…Thus, F. hominis is an underrecognized pathogen that has been isolated from a variety of clinical specimens, including bacteremia associated with brain and soft tissue abscesses, endocarditis, necrotizing gangrene, and ischemic stroke symptoms (151). It also has been associated with pediatric pyelonephritis (152), acute cystitis and urosepsis (152), as well as bacteremia associated with transurethral resection of the prostate (153). Despite isolation from vaginal specimens and urine, especially in adult females with UUI (Table 1), the role of F. hominis as a commensal and the transition to opportunistic pathogen has yet to be explored (151).…”