Actinobaculum schaalii an emerging pediatric pathogen?

BMC Infectious Diseases

Nicole Ritz⁴  Philipp Agyeman²  Sebastian Grunt¹  Benjamin Liniger³  Livia Berlinger⁵  Petra Zimmermann² 

[1] Department of Neuropediatrics, Development and Rehabilitation, University Children’s Hospital, Berne, Switzerland;Department of Paediatrics, University Children’s Hospital, Berne, Switzerland;Department of Paediatric Surgery, University Children's Hospital, Berne, Switzerland;Infectious Diseases Unit, University Children’s Hospital Basel, Spitalstrasse 33, Basel, CH-4031, Switzerland;Bioanalytica AG, Lucerne, Switzerland

关键词: Antimicrobial susceptibility;    Gram-positive;    Urinary tract infection;    Emerging infection;    Children;    Actinobaculum schaalii;   

Others  :  1159707
DOI  :  10.1186/1471-2334-12-201

 received in 2012-04-28, accepted in 2012-08-15,  发布年份 2012

【 摘 要 】

Background

Actinobaculum schaalii was first described as a causative agent for human infection in 1997. Since then it has mainly been reported causing urinary tract infections (UTI) in elderly individuals with underlying urological diseases. Isolation and identification is challenging and often needs molecular techniques. A. schaalii is increasingly reported as a cause of infection in humans, however data in children is very limited.

Case presentation

We present the case of an 8-month-old Caucasian boy suffering from myelomeningocele and neurogenic bladder who presented with a UTI. An ultrasound of the urinary tract was unremarkable. Urinalysis and microscopy showed an elevated leukocyte esterase test, pyuria and a high number of bacteria. Empiric treatment with oral co-trimoxazole was started.

Growth of small colonies of Gram-positive rods was observed after 48 h. Sequencing of the 16S rRNA gene confirmed an A. schaalii infection 9 days later. Treatment was changed to oral amoxicillin for 14 days. On follow-up urinalysis was normal and urine cultures were negative.

Conclusions

A.schaalii is an emerging pathogen in adults and children. Colonization and subsequent infection seem to be influenced by the age of the patient. In young children with high suspicion of UTI who use diapers or in children who have known abnormalities of their urogenital tract, infection with A. schaalii should be considered and empiric antimicrobial therapy chosen accordingly.

【 授权许可】

   
2012 Zimmermann et al.; licensee BioMed Central Ltd.

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