Emerging pathogens <i>Aerococcus urinae</i> and <i>Aerococcus sanguinicola</i> from a Canadian tertiary care hospital
Creators: name: Kakodkar, Pramath
name: Scott, Joel
name: Tariq, Javera
name: Du, Liqin
name: Wu, Fang
name: Mehta, Ninad
name: Hamula, Camille
Publisher: name: Taylor & Francis
Year: 2024
Subjects: subject: Medicine
subject: Microbiology
subject: FOS: Biological sciences
subject: Pharmacology
subject: Biotechnology
subject: Ecology
subject: Science Policy
subject: Immunology
subject: FOS: Clinical medicine
subject: Cancer
subject: Infectious Diseases
subject: FOS: Health sciences
subject: Virology
subject: Computational Biology

description: <b>Background:</b><i>Aerococcus urinae</i> and <i>Aerococcus sanguinicola</i> are emerging pathogens linked with urinary tract infections. We present a case series of <i>A. urinae</i> and <i>A. sanguinicola</i> isolates characterizing the spectrum of clinical presentation, microbiological characteristics and antimicrobial sensitivities. <b>Methods:</b> Retrospective chart review was performed on patients who grew positive cultures for <i>A. urinae</i> and <i>A. sanguinicola</i> identified on MALDI-TOF in Saskatchewan from January to June 2023. Demographic and clinical variables, antimicrobial susceptibility and prescription were documented. <b>Results:</b> This cohort (n = 115) had a median age 82 years. <i>A. urinae</i> and <i>A. sanguinicola</i> infections spanned from urinary tract infection (n = 96) to urosepsis (n = 6). These infections were predominantly monomicrobial (73.9%) and were susceptible to ceftriaxone, penicillin G and vancomycin. Antimicrobials were seldom prescribed within the urinary tract infection cohort (31.2%). <b>Conclusion:</b> Untreated <i>A. urinae</i> and <i>A. sanguinicola</i> infections can precipitate into urosepsis. The reported antimicrobial susceptibility for these <i>Aerococcus</i> isolates should be utilized to provide appropriate antimicrobial coverage. <i>Aerococcus urinae</i> and <i>Aerococcus sanguinicola</i> are bacteria that can cause urine infections. They are often overlooked and thought to be unable to cause serious blood infections, such as sepsis. We collected data on 87 cases of <i>A. urinae</i> and 28 cases of <i>A. sanguinicola</i> to show that these bacteria can cause urine and blood infections in elderly patients. We also looked at other studies and summarized that patients with serious blood infections from these bacteria often had a previous urine infection from these same bacteria. These bacteria can be resistant to a common antibiotic used to treat urine infections. It is important to test and report if these bacteria are resistant to this common antibiotic and doctors must be aware that they can cause serious blood infections if not treated with the correct antibiotics. The clinical importance of <i>Aerococcus urinae</i> and <i>Aerococcus sanguinicola</i> infections remains underscored in clinical practice. In cases of <i>Aerococcus</i> with polymicrobial growth, clinicians often target their antimicrobial choice against the other organisms. We present a single center case series highlighting the clinical presentation, microbiological findings and antibiotic management in patients with these <i>Aerococcus</i> infections. The patient profile of <i>A. urinae</i> or <i>A. sanguinicola</i> infections at our institution was an elderly patient from long-term care facilities, background medical history notable for hypothyroidism and hypertension and clinical presentation ranging from asymptomatic bacteriuria to sepsis. <i>A. urinae</i> or <i>A. sanguinicola</i> isolates were susceptible to penicillin, ceftriaxone and vancomycin. Our literature review indicated that 20% of <i>A. sanguinicola</i> and 10% of <i>A. urinae</i> isolates show fluoroquinolone resistance. Therefore, microbiology labs must report fluoroquinolone susceptibilities in these isolates. Our literature review also showed that 84% (n = 165 out of 197) of <i>A. urinae</i> or <i>A. sanguinicola</i> systemic infections had an antecedent urinary tract infection within 30 days. Therefore, untreated or recurrent urinary tract infections with <i>A. urinae</i> or <i>A. sanguinicola</i> have the propensity to develop systemic infections.