Emerging pathogens <i>Aerococcus urinae</i> and <i>Aerococcus sanguinicola</i> from a Canadian tertiary care hospital
Bibliographic record
Abstract
<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.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.127 | 0.003 |
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; both teacher heads agree on what is shown here.
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".