Slany Michal, Freiberger Tomas, Pavlik Petr, Cerny Jan
Centrefor Cardiovascular Surgery and Transplantation, Brno, Czech Republic.
J Heart Valve Dis. 2007 Mar;16(2):203-5.
Aerococcus urinae is a rarely reported pathogen that often causes mild urinary tract infection (UTI), although serious complications such as endocarditis and septicemia have also been described. The organism may easily be missed or misidentified when using commercial detection systems. A. urinae is resistant to sulfonamides and, therefore, a typical treatment for UTI may be inappropriate. To date, 14 cases of A. urinae infective endocarditis (IE) have been reported, most of which were elderly males with predisposing conditions to UTI. Of these patients, eight died and 50% of survivors had severe neurological problems. The case is reported of blood culture-negative IE in a 69-year-old male. The patient recovered fully after undergoing aortic valve replacement and receiving a nine-day course of intravenous ceftriaxone, followed by peroral cefuroxime for the next 11 weeks. The causative agent was identified from the excised valve by bacterial broad-range PCR and direct sequencing of the 16S rRNA gene.
尿液气球菌是一种报道较少的病原体，常引起轻度尿路感染（UTI），不过也有诸如心内膜炎和败血症等严重并发症的相关描述。使用商业检测系统时，该病原体可能很容易被漏检或误识别。尿液气球菌对磺胺类药物耐药，因此，UTI的典型治疗方法可能并不合适。迄今为止，已报道了14例尿液气球菌感染性心内膜炎（IE）病例，其中大多数是患有UTI易感因素的老年男性。在这些患者中，有8人死亡，50%的幸存者有严重的神经问题。本文报道了一名69岁男性血培养阴性的IE病例。该患者在接受主动脉瓣置换术并接受为期九天的静脉注射头孢曲松治疗，随后在接下来的11周口服头孢呋辛后完全康复。通过细菌广谱PCR和16S rRNA基因直接测序从切除的瓣膜中鉴定出病原体。
