Aerococcus urinae– a rarely detected pathogen of infective endocarditis

Abstract number: 1134_03_65

Slany M., Pavlik P., Cerny J., Freiberger T.

Objectives:  

Aerococcus urinae is a rarely reported pathogen, possibly due to difficulties in the identification of the organism. A. urinae is a Gram-positive coccus that grows in pairs and clusters as alpha-hemolytic colonies on blood agar. Because of these characteristics A. urinae is often misidentified as a streptococcus, enterococcus, or staphylococcus. In addition, there were also reported several cases of blood culture negative infections due to A. urinae. Most infections are mild, but serious ones such as endocarditis and septicemia can occur. To our best knowledge, the total number of thirteen cases of infective endocarditis including eight fatal cases have been described in the world literature so far.

Methods:  

Silica based DNA isolation from aortic valve tissue sample and broad range 16S rRNA PCR followed by sequencing analysis was used.

Results:  

Here we report a case of blood culture negative and culture negative aortic valve endocarditis caused by A. urinae in 69-year-old male. Patient was successfully treated with surgical aortic valve replacement and ceftriaxon (4 g daily) applied for 12 weeks.

Discussion:  

Most patients infected with A. urinae are elderly males with predisposing conditions who present initially with urinary tract infections (UTI). However, our patient developed infective endocarditis in the absence of UTI symptoms.

Conclusion:  

Broad range 16S rRNA PCR is shown to be a power tool in detection of bacterial pathogens in culture negative cases of infective endocarditis.

This work was supported by grant of the MZ CR No. 209775.