Infections due to Vagococcus spp. Microbiological and clinical aspects and literature review

Whole-genome analysis and antimicrobial resistance phenotype of Vagococcus fluvialis isolated from wild Niviventer

Vagococcus fluvialis (V. fluvialis), a Gram-positive bacterium belonging to the Enterococcaceae family, has been associated with human infections, including bacteremia and endocarditis. Its zoonotic potential raises concerns for public health, yet research on its antimicrobial resistance and pathogenicity is still limited. This study aimed to isolate and characterize V. fluvialis from wild Niviventer, analyze its genomic features (including antimicrobial resistance and virulence genes), and evaluate its antibiotic susceptibility profile to assess potential public health risks. We first isolated V. fluvialis (strain 25C42) from the rectum of wild Niviventer, confirmed through Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF MS) and 16S rRNA gene sequencing. Whole-genome sequencing (WGS) was performed using second-and third-generation technologies, with subsequent quality control and assembly. Six databases including KEGG, COG, CARD and VFDB were used for genome annotation. Antibiotic susceptibility was evaluated according to Clinical and Laboratory Standards Institute (CLSI) guidelines, determining the minimum inhibitory concentrations (MIC) for 16 antibiotics. Strain 25C42 was identified as V. fluvialis, confirmed by MALDI-TOF MS and 16S rRNA sequencing. WGS revealed a genome length of 2,720,341 bp, GC content of 32.57%. Functional genomic analysis identified 2,268 genes in the COG database and 2,023 genes in KEGG, highlighting key metabolic and cellular processes. Notably, 119 virulence genes and 65 antimicrobial resistance genes were found, indicating significant resistance potential. Phylogenetic analysis demonstrated a close relationship with other Vagococcus species, particularly V. fluvialis (ANI 98.57%, DDH 88.6%). Antibiotic susceptibility tests indicated strain 25C42 was resistant to clindamycin, tetracycline, rifampicin, cefoxitin and levofloxacin. Our findings reveal that the wild rodent-derived V. fluvialis strain 25C42 harbors clinically relevant antimicrobial resistance determinants and virulence-associated genes. The high genomic integrity and extensive functional gene annotation underscore its metabolic versatility. Notably, strain 25C42 exhibits significant antimicrobial resistance, necessitating ongoing surveillance and research to understand its implications for public health and environmental monitoring, as well as strategies for effective therapeutic intervention.

A Report of a Rare Case of Vagococcus fluvialis Isolated From Urine: Clinical Significance of Vagococcus Species With an Update of the Available Literature

Vagococcusspecies (spp.) are gram-positive cocci that are rarely reported in humans. These bacteria share physiological, cultural, and biochemical properties with Enterococcus spp. Recently, they have garnered attention as potential opportunistic pathogens capable of causing infections in individuals with predisposing factors and comorbidities. Human infections are sporadic, with only a few cases reported worldwide. A multidisciplinary microbiological approach is essential for the successful identification of these organisms. Antibiotic sensitivity is critical for effective treatment, especially considering that Vagococcus spp. not only were recently discovered but are also developing resistance to several antibiotics, as confirmed by the available literature, including the present case where the organism was found to be pan-drug resistant. Clinicians should be aware of these bacteria and consider them as emerging opportunistic pathogens. We report the case of a 56-year-old male with grade III hydronephrosis, urolithiasis, and a UTI, in whichVagococcus fluvialis was isolated from the patient's urine specimen.

First reported human case of isolation of Vagococcus fluvialis from the urine of a former zoo clerk in Japan: a case report

BACKGROUND

Vagococcal infections are extremely rare in humans. There are limited studies on the optimal methods for identification, antimicrobial susceptibility testing, and clinical manifestations of vagococcal infections. Herein, we report a patient with a urinary tract infection who had Vagococcus fluvialis in the urine.

CASE PRESENTATION

An 84-year-old man presented to our urology department with a fever that had persisted for several days. He previously worked as a zoo clerk. The patient underwent a left nephroureterectomy for ureteral cancer 5 years ago, and total cystectomy and right cutaneous ureterostomy for muscle-invasive bladder cancer 1 year prior. He was empirically treated with 500 mg of levofloxacin intravenously every 24 h for the urinary tract infection. V. fluvialis was detected in his urine samples and Pseudomonas aeruginosa was detected in his urine and blood samples. Two bacterial species were identified using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. He was administered intravenous levofloxacin for approximately 1 week, followed by oral levofloxacin for another week, after which the infections were eradicated.

CONCLUSIONS

To the best of our knowledge, this is the first report of V. fluvialis detected in human urine in Japan. Vagococcus spp. is commonly isolated from fish or animals, and based on the patient's work history, it is possible that the patient was a carrier because of transmission from animals.

A case of Vagococcus fluvialis isolated from the bile of a patient with calculous cholecystitis

BACKGROUND

Chronic cholecystitis, characterized by persistent inflammation of the gallbladder, predominantly stems from the prolonged presence of gallstones. Calculous cholecystitis has demonstrated a consistent escalation in its incidence over time.Gallbladder stones have been recognized as a predisposing factor for the development of biliary tract infections.Concomitantly, there have been substantial shifts in the distribution and resistance profiles of pathogenic microorganisms responsible for biliary tract infections. The timely acquisition of bile samples for pathogen analysis is of paramount importance, given its critical role in guiding judicious clinical pharmacotherapy and enhancing patient prognosis.

CASE PRESENTATION

We present a case involving a 66-year-old female patient who had previously undergone subtotal gastrectomy due to diffuse large B-cell lymphoma. The patient was admitted to our institution with complaints of abdominal pain. Subsequent diagnostic evaluation revealed concurrent choledocholithiasis and cholecystolithiasis. The patient underwent surgical cholecystectomy as the therapeutic approach. Histopathological examination of the excised gallbladder disclosed characteristic features indicative of chronic cholecystitis. Subsequent laboratory analysis of the patient's bile specimen yielded Gram-positive cocci, subsequently identified through biochemical assays, mass spectrometry, and 16 S rRNA analysis as Vagococcus fluvialis. Further in vitro antimicrobial susceptibility testing using disk diffusion and microfluidic dilution showed that this strain exhibited inhibition zone diameters ranging from 12.0 to 32.0 mm in response to 26 antibiotics, including ampicillin, cefazolin, cefuroxime, cefotaxime, ceftriaxone, cefepime, ampicillin/sulbactam, piperacillin, ciprofloxacin, cefoperazone/sulbactam, imipenem, meropenem, piperacillin/tazobarb, penicillin, erythromycin, chloramphenicol, vancomycin, methotrexate/sulfamethoxazole, teicoplanin, linezolid, tigecycline, cefoxitin, ceftazidime, levofloxacin, minocycline and tobramycin. However, the inhibition zone diameters were 6.0 mm for amikacin, oxacillin, clindamycin, and tetracycline. The patient received ceftazidime anti-infective therapy both preoperatively and within 24 h postoperatively and was discharged successfully one week after surgery.

CONCLUSION

In this study, we present the inaugural isolation and identification of Vagococcus fluvialis from bile specimens of patients afflicted with calculous cholecystitis. This novel finding lays a substantial experimental groundwork for guiding clinically rational antimicrobial therapy and advancing the exploration of relevant pathogenic mechanisms pertaining to Vagococcus fluvialis infections.