Yasukawa Kosuke, Afzal Zeeshan, Mbang Pamela, Stager Charles E, Musher Daniel M
From the Section of Infectious Diseases, Department of Medicine, and the Department of Pathology & Immunology, Baylor College of Medicine, Houston, and the Infectious Disease Section, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas.
South Med J. 2014 Oct;107(10):642-7. doi: 10.14423/SMJ.0000000000000158.
The aim of the present study was to determine clinical features of Aerococcus infections and the significance of the Aerococcus species isolated from any clinical samples.
Electronic records of all cultures yielding Aerococcus species from 2002 to 2012 were obtained from three tertiary care hospitals. We performed an in-depth review of medical records.
Aerococcus was isolated from ≥ 1 site in 93 patients. Blood cultures were positive in 64 patients; 15 with definite bacteremia, including 3 with endocarditis, 7 with urinary tract infections, 13 with probable bacteremia, and 36 in which Aerococcus was judged to be a possible contaminant. Of 19 urine isolates, 10 were from patients with symptomatic urinary tract infections and 7 were from patients with asymptomatic bacteriuria; in 2 cases, urine isolates were regarded as possible contaminants. Most patients with urinary isolates had underlying urological abnormalities. Other sources for Aerococcus included synovial fluid, bile, bone, intraabdominal abscess, and ovarian abscess. All of the isolates tested with ampicillin, cefazolin, clindamycin, and vancomycin were susceptible. A total of two patients with definite Aerococcus infection died, but all of the others responded to antibiotic therapy.
Aerococcus often is considered a contaminant; however, in our case series, 35% of cases in which Aerococcus was isolated from any site indicated a definite infection. In patients with positive blood cultures for Aerococcus, at least 23% were associated with infection. Appropriate attention needs to be directed to Aerococcus when it is isolated from a normally sterile site.
本研究旨在确定气球菌感染的临床特征以及从任何临床样本中分离出的气球菌属的意义。
从三家三级医疗机构获取2002年至2012年所有培养出气球菌属的电子记录。我们对病历进行了深入审查。
93例患者的≥1个部位分离出气球菌。64例患者血培养阳性；15例确诊为菌血症，包括3例心内膜炎、7例尿路感染、13例可能菌血症，36例中气球菌被判定为可能污染物。19例尿液分离株中，10例来自有症状尿路感染患者，7例来自无症状菌尿患者；2例中尿液分离株被视为可能污染物。大多数尿液分离株患者有潜在泌尿系统异常。气球菌的其他来源包括滑液、胆汁、骨骼、腹腔脓肿和卵巢脓肿。所有用氨苄西林、头孢唑林、克林霉素和万古霉素检测的分离株均敏感。共有2例确诊为气球菌感染的患者死亡，但其他所有患者对抗生素治疗均有反应。
气球菌常被视为污染物；然而，在我们的病例系列中，从任何部位分离出气球菌的病例中有35%表明存在确诊感染。血培养气球菌阳性的患者中，至少23%与感染有关。当从正常无菌部位分离出气球菌时，需要给予适当关注。
