Lenherr Nina, Berndt Anita, Ritz Nicole, Rudin Christoph
Nephrology Unit, University Children's Hospital Basel, Spitalstrasse 33, CH-4056, Basel, Switzerland,
Eur J Pediatr. 2014 Aug;173(8):1115-7. doi: 10.1007/s00431-014-2348-9. Epub 2014 Jun 10.
Recently, Aerococcus urinae, primarily recognized as a common pathogen in elderly women, has been reported to cause an extremely unpleasant odour of the urine in paediatric patients similar to trimethylaminuria (fish odour syndrome). Herein, we present a case of A. urinae urinary tract colonization in a 12-year-old otherwise healthy boy, who finally refused micturition outside from his home environment as a result of the unpleasant odour. Within the last year, three cases (including our own) of A. urinae colonization causing foul-smelling urine in healthy children have been published, suggesting that this condition might be as frequent as trimethylaminuria. In case of polymicrobial growth in a urine specimen, A. urinae as the leading pathogen will usually be missed by routine bacteriological investigation. Novel bacteriological techniques such as MALDI-TOF MS provide a rapid tool to recognize this pathogen in urine.
As treatment of A. urinae infection is simple, we recommend that in healthy children with malodorous urine, this pathogen is excluded before the initiation of costly metabolic investigations.
最近，尿液气球菌主要被认为是老年女性的常见病原体，据报道它会在儿科患者中导致尿液产生极其难闻的气味，类似于三甲胺尿症（鱼腥味综合征）。在此，我们报告一例12岁健康男孩尿液气球菌尿路定植的病例，该男孩最终因气味难闻而拒绝在家庭环境之外排尿。在过去一年中，已发表了三例（包括我们自己的病例）健康儿童尿液气球菌定植导致尿液恶臭的病例，表明这种情况可能与三甲胺尿症一样常见。如果尿液标本中存在多种微生物生长，常规细菌学检查通常会遗漏尿液气球菌作为主要病原体。诸如基质辅助激光解吸电离飞行时间质谱（MALDI-TOF MS）等新型细菌学技术提供了一种在尿液中识别这种病原体的快速工具。
由于尿液气球菌感染的治疗很简单，我们建议对于尿液有异味的健康儿童，在开始进行昂贵的代谢检查之前先排除这种病原体。
