Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey.
Department of Medical Microbiology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey.
J Infect Dev Ctries. 2020 Dec 31;14(12):1780-1482. doi: 10.3855/jidc.12522.
Enterococcus hirae (E. hirae) constitutes less than 1% of the enterococci strains in human clinical specimens. In this article, we report the first case of urinary tract infection-related bacteremia due to E. hirae from Turkey.
A 74-year-old male patient with a history of coronary artery disease, hypertension, and chronic renal failure was admitted to the emergency department with abdominal pain, dysuria, and fever. The urine sample collected from the urinary catheter resulted as ampicillin-sensitive E. hirae. On the 4th day of hospitalization, E. hirae growth with the same sensitivity pattern was also reported in blood culture. Intravenous ampicillin 4×2 g/day treatment was initiated. There was no growth in subsequent blood and urine cultures. Fever resolved and general condition improved. The patient was discharged on the thirteenth day with clinical improvement after moxifloxacin treatment for four days and ampicillin treatment for nine days.
The patient's medical history included risk factors for enterococcal bacteremia. There are a limited number of reports in the literature describing human infections caused by E. hirae. The reason for the rare isolation of E. hirae from clinical specimens may be the difficulty of identifying with standard diagnostic approaches.
For diagnostic purposes, as in our case, rapid and high sensitive diagnostic methods such as Matrix-assisted Laser Desorption/Ionization Time of Flight (MALDI-TOF) and molecular techniques may be useful to guide the selection of the least toxic and optimal duration of antibiotic treatment.
海氏肠球菌（E. hirae）在人类临床标本中的肠球菌菌株中不到 1%。在本文中，我们报告了首例来自土耳其的与泌尿道感染相关的海氏肠球菌菌血症病例。
一名 74 岁男性患者，有冠心病、高血压和慢性肾衰竭病史，因腹痛、尿痛和发热而被收入急诊部。从导尿管采集的尿液样本显示为氨苄西林敏感的海氏肠球菌。住院第 4 天，血液培养也报告了具有相同敏感性模式的海氏肠球菌生长。开始给予静脉注射氨苄西林 4×2 g/天治疗。随后的血液和尿液培养均无生长。发热消退，一般情况改善。患者在临床改善后出院，在接受莫西沙星治疗 4 天和氨苄西林治疗 9 天后出院。
患者的病史包括肠球菌菌血症的危险因素。文献中有少量描述由海氏肠球菌引起的人类感染的报告。海氏肠球菌从临床标本中分离出来的情况很少见，原因可能是标准诊断方法难以识别。
出于诊断目的，如在我们的病例中，快速和高灵敏度的诊断方法，如基质辅助激光解吸/电离飞行时间（MALDI-TOF）和分子技术，可能有助于指导选择毒性最小和最佳抗生素治疗时间的抗生素。
