Actinotignum schaalii: Difference between revisions

Latest revision as of 00:37, 6 December 2020

Background

Microbiology

Small, non-motile, non-spore forming, facultatively anaerobic Gram-positive bacillus
Grows slowly on blood agar
Previously known as Actinobaculum schaalii
Classified within the family Actinomycetaceae, which also includes Arcanobacterium and Trueperella
Member of the genitourinary microflora

Epidemiology

Occurs most often in patients older than 60 years or in children
May be more common in patients with preexisting genitourinary conditions, including bladder cancer, urinary incontinence, urinary catheterization, BPH, neurogenic bladder, urethral stenosis, and prostate cancer, as well as in immunocompromised hosts

Clinical Manifestations

Rare, with only a few hundred cases described to date1
Mostly causes urinary tract infection (70% of cases published by 2016), which includes cystitis or prostatitis (40%), urosepsis or pyelonephritis (29%), epididymitis (0.5%), and bladder necrosis (0.5%)
Also causes bacteremia (19%), abscesses mostly in the groin but also elsewhere (7%), cellulitis (1.5%), discitis (1.5%), endocarditis (0.5%), and Fournier gangrene (0.5%)

Management

Susceptible to all β-lactams, as well as tetracyclines, vancomycin, linezolid, rifampin, and nitrofurantoin
May be susceptible to fosfomycin
Can have reduced susceptibility to gentamicin and can be resistant to macrolides, lincosamides, TMP-SMX, and ciprofloxacin (though may be susceptible to levofloxacin and moxifloxacin)

References

^ R. Lotte, L. Lotte, R. Ruimy. Actinotignum schaalii (formerly Actinobaculum schaalii ): a newly recognized pathogen—review of the literature. Clinical Microbiology and Infection. 2016;22(1):28-36. doi:10.1016/j.cmi.2015.10.038.

@@ Line 1: / Line 1: @@
-== Background ==
+==Background==
-=== Microbiology ===
+===Microbiology===
-* Small, non-motile, non-spore forming, facultatively anaerobic [[Stain::Gram-positive]] [[Shape::bacillus]]
+*Small, non-motile, non-spore forming, facultatively anaerobic [[Stain::Gram-positive]] [[Shape::bacillus]]
-* Grows slowly on blood agar
+*Grows slowly on blood agar
-* Previously known as ''Actinobaculum schaalii''
+*Previously known as ''Actinobaculum schaalii''
-* Classified within the family [[Actinomycetaceae]], which also includes [[Arcanobacterium]] and [[Trueperella]]
+*Classified within the family [[Actinomycetaceae]], which also includes [[Arcanobacterium]] and [[Trueperella]]
-* Member of the genitourinary microflora
+*Member of the genitourinary microflora
-=== Epidemiology ===
+===Epidemiology===
-* Occurs most often in patients older than 60 years or in children
+*Occurs most often in patients older than 60 years or in children
-* May be more common in patients with preexisting genitourinary conditions, including [[bladder cancer]], [[urinary incontinence]], [[urinary catheterization]], [[BPH]], [[neurogenic bladder]], [[urethral stenosis]], and [[prostate cancer]], as well as in immunocompromised hosts
+*May be more common in patients with preexisting genitourinary conditions, including [[bladder cancer]], [[urinary incontinence]], [[urinary catheterization]], [[BPH]], [[neurogenic bladder]], [[urethral stenosis]], and [[prostate cancer]], as well as in immunocompromised hosts
-== Clinical Manifestations ==
+==Clinical Manifestations==
-* Rare, with only 172 cases described to date[[CiteRef::lotte2016ac]]
+*Rare, with only a few hundred cases described to date[[CiteRef::lotte2016ac]]
-* Mostly causes [[urinary tract infection]] (70% of published cases), which includes [[cystitis]] or [[prostatitis]] (40%), [[urosepsis]] or [[pyelonephritis]] (29%), [[epididymitis]] (0.5%), and bladder necrosis (0.5%(
+*Mostly causes [[urinary tract infection]] (70% of cases published by 2016), which includes [[cystitis]] or [[prostatitis]] (40%), [[urosepsis]] or [[pyelonephritis]] (29%), [[epididymitis]] (0.5%), and bladder necrosis (0.5%)
-* Also causes [[bacteremia]] (19%), [[Abscess|abscesses]] mostly in the groin but also elsewhere (7%), [[cellulitis]] (1.5%), [[discitis]] (1.5%), [[endocarditis]] (0.5%), and [[Fournier gangrene]] (0.5%)
+*Also causes [[bacteremia]] (19%), [[Abscess|abscesses]] mostly in the groin but also elsewhere (7%), [[cellulitis]] (1.5%), [[discitis]] (1.5%), [[endocarditis]] (0.5%), and [[Fournier gangrene]] (0.5%)
-== Management ==
+==Management==
-* Susceptible to all [[β-lactams]], as well as [[tetracyclines]], [[vancomycin]], [[linezolid]], [[rifampin]], and [[nitrofurantoin]]
+*Susceptible to all [[β-lactams]], as well as [[tetracyclines]], [[vancomycin]], [[linezolid]], [[rifampin]], and [[nitrofurantoin]]
-* May be susceptible to [[fosfomycin]]
+*May be susceptible to [[fosfomycin]]
-* Can have reduced susceptibility to [[genatmicin]] and can be resistant to [[macrolides]], [[lincosamides]], [[TMP-SMX]], and [[fluoroquinolones]] (though may be susceptible to [[levofloxacin]] and [[moxifloxacin]])
+*Can have reduced susceptibility to [[gentamicin]] and can be resistant to [[macrolides]], [[lincosamides]], [[TMP-SMX]], and [[ciprofloxacin]] (though may be susceptible to [[levofloxacin]] and [[moxifloxacin]])
-== Further Reading ==
+==Further Reading==
-* ''Actinotignum schaalii'' (formerly ''Actinobaculum schaalii''): a newly recognized pathogen—review of the literature. ''Clin Microbiol Infect''. 2016;22(1):28-36. doi: [https://doi.org/10.1016/j.cmi.2015.10.038 10.1016/j.cmi.2015.10.038]
+*''Actinotignum schaalii'' (formerly ''Actinobaculum schaalii''): a newly recognized pathogen—review of the literature. ''Clin Microbiol Infect''. 2016;22(1):28-36. doi: [https://doi.org/10.1016/j.cmi.2015.10.038 10.1016/j.cmi.2015.10.038]
+*Clinical and microbiological features of ''Actinotignum'' bacteremia: a retrospective observational study of 57 cases. ''Eur J Clin Microbiol Infect Dis''. 2017;36(5):791–796. doi: [https://doi.org/10.1007/s10096-016-2862-y 10.1007/s10096-016-2862-y]
 {{DISPLAYTITLE:''Actinotignum schaalii''}}