Case Series: Emerging Pathogens Aerococcus urinae and Aerococcus sanguinicola at a Canadian tertiary care hospital
Bibliographic record
Abstract
Abstract Introduction/Objective Background: Aerococcus urinae and sanguinicola are emerging opportunistic pathogen linked with urinary tract infections. Unmanaged Aerococcus infections have the propensity to precipitated into urosepsis. The ongoing gestalt of managing these infections needs standardization. We reviewed A. urinae and sanguinicola isolates from our clinical microbiology laboratory to better characterize its spectrum of clinical presentation, sources of infection, microbiological characteristics, and antimicrobial management. Methods/Case Report Methods: The electronic microbiology database was utilized to review the retrospective clinical data of patients that grew positive cultures for Aerococcus urinae and sanguinicola on matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF) in Saskatchewan from January to July 2023. Demographic variables, site of presentation, microbiological parameters surrounding culture and sensitivities, and antimicrobial management were recorded. The results were analyzed on SPSS 28 software. Results (if a Case Study enter NA) Results: This cohort (n=115) had a median age 82 years [Range: 7 to 103] with a female predilection (F:M = 78:37). A. urinae and sanguinicola were primarily involved in UTI (n=96), obstructive uropathy (n=9), and urosepsis (n=6). The hypothyroidism (26.9%, n = 31) rate in this population was 3-fold higher than the age-matched background rate for our province. Aerococcus infections were predominantly monomicrobial (73.9%, n= 85 out of 115) and showed sensitivity for ceftriaxone, penicillin G, and vancomycin. Antimicrobials were seldom used in the UTI cohort (31.2%, n=30 out of 96). Amoxicillin-clavulanate (29.8%, n=25 out 84) was the most popular choice at patient discharge in monomicrobial Aerococcus infections only. Conclusion Conclusion: Aerococcus urinae and sanguinicola are emerging uropathogen. Despite this, the clinical significance of these Aerococcus species remains undervalued. Our case series shows that untreated or recurrent A. urinae and A. sanguinicola infections can precipitate into urosepsis. Clinicians should utilize the antimicrobial susceptibility profiles for these Aerococcus species to provide appropriate antimicrobial coverage and manage these pathogens effectively. Further studies should explore the link between hypothyroidism and these aerococcal infections.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.003 |
| Science and technology studies | 0.006 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".