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Razi A, Ghiaei A, Dolatabadi FK, Haghighi R. Unraveling the association of bacteria and urinary stones in patients with urolithiasis: an update review article. Front Med (Lausanne) 2024; 11:1401808. [PMID: 39281813 PMCID: PMC11392849 DOI: 10.3389/fmed.2024.1401808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Accepted: 08/14/2024] [Indexed: 09/18/2024] Open
Abstract
Urinary stone disease (USD) is a prevalent urological condition, ranking as one of the most common urinary tract disorders globally. Various risk factors influence the formation of kidney stones, and recent research indicates a rising prevalence of urolithiasis worldwide, particularly in developing countries. While the morbidity associated with urinary stones has decreased in recent years, long-term complications such as stone recurrence, kidney failure, and uremia continue to burden patients. Understanding the etiologies of urolithiasis, including the role of bacteria, is crucial as they can contribute to stone recurrence. The incidence of urinary tract infection (UTI) stones can be attributed to specific infectious risk factors, socio-demographic factors, and comorbid metabolic disorders. This review article explores the emerging evidence suggesting the involvement of bacteria in USD. It discusses the potential role of microorganisms in non-infection stones and highlights the association between UTIs and urolithiasis. Furthermore, it surveys the relationship between kidney stones and recurrent UTIs and the formation of bacterial biofilms in UTIs. Considering various risk factors, including biochemical stone analysis and the presence of bacteria, is essential for treating patients with infectious stones optimally. This review aims to provide an updated understanding of the association between bacteria and urinary stones in patients with urolithiasis, shedding light on the pathophysiology of urinary stone formation, urinary stone characteristics, and the urinary microbiome in urinary stones.
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Affiliation(s)
- Abdolah Razi
- Department of Urology, Faculty of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Azita Ghiaei
- Department of Microbiology, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
| | - Fahimeh Kamali Dolatabadi
- Department of Cell and Molecular Biology, School of Biology, College of Science, University of Tehran, Tehran, Iran
| | - Ramin Haghighi
- Department of Urology, Faculty of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran
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Ockert LE, McLennan EA, Fox S, Belov K, Hogg CJ. Characterising the Tasmanian devil (Sarcophilus harrisii) pouch microbiome in lactating and non-lactating females. Sci Rep 2024; 14:15188. [PMID: 38956276 PMCID: PMC11220038 DOI: 10.1038/s41598-024-66097-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 06/27/2024] [Indexed: 07/04/2024] Open
Abstract
Wildlife harbour a diverse range of microorganisms that affect their health and development. Marsupials are born immunologically naïve and physiologically underdeveloped, with primary development occurring inside a pouch. Secretion of immunological compounds and antimicrobial peptides in the epithelial lining of the female's pouch, pouch young skin, and through the milk, are thought to boost the neonate's immune system and potentially alter the pouch skin microbiome. Here, using 16S rRNA amplicon sequencing, we characterised the Tasmanian devil pouch skin microbiome from 25 lactating and 30 non-lactating wild females to describe and compare across these reproductive stages. We found that the lactating pouch skin microbiome had significantly lower amplicon sequence variant richness and diversity than non-lactating pouches, however there was no overall dissimilarity in community structure between lactating and non-lactating pouches. The top five phyla were found to be consistent between both reproductive stages, with over 85% of the microbiome being comprised of Firmicutes, Proteobacteria, Fusobacteriota, Actinobacteriota, and Bacteroidota. The most abundant taxa remained consistent across all taxonomic ranks between lactating and non-lactating pouch types. This suggests that any potential immunological compounds or antimicrobial peptide secretions did not significantly influence the main community members. Of the more than 16,000 total identified amplicon sequence variants, 25 were recognised as differentially abundant between lactating and non-lactating pouches. It is proposed that the secretion of antimicrobial peptides in the pouch act to modulate these microbial communities. This study identifies candidate bacterial clades on which to test the activity of Tasmanian devil antimicrobial peptides and their role in pouch young protection, which in turn may lead to future therapeutic development for human diseases.
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Affiliation(s)
- Lucy E Ockert
- School of Life and Environmental Sciences, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Elspeth A McLennan
- School of Life and Environmental Sciences, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Samantha Fox
- Save the Tasmanian Devil Program, NRE Tasmania, Hobart, TAS, 7001, Australia
- Toledo Zoo, 2605 Broadway, Toledo, OH, 43609, USA
| | - Katherine Belov
- School of Life and Environmental Sciences, The University of Sydney, Sydney, NSW, 2006, Australia
- Australian Research Council Centre of Excellence for Innovations in Peptide and Protein Science, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Carolyn J Hogg
- School of Life and Environmental Sciences, The University of Sydney, Sydney, NSW, 2006, Australia.
- Australian Research Council Centre of Excellence for Innovations in Peptide and Protein Science, The University of Sydney, Sydney, NSW, 2006, Australia.
- San Diego Zoo Wildlife Alliance, PO BOX 120551, San Diego, CA, 92112, USA.
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Lavollay M, Buon C, Le Moigne V, Compain F, Guyonvarch A, Fonvielle M. Exploration of the role of the penicillin binding protein 2c (Pbp2c) in inducible β-lactam resistance in Corynebacteriaceae. Front Microbiol 2024; 15:1327723. [PMID: 38784795 PMCID: PMC11111852 DOI: 10.3389/fmicb.2024.1327723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 04/23/2024] [Indexed: 05/25/2024] Open
Abstract
Six genes encoding putative high molecular weight penicillin-binding proteins (Pbp) are present in the genome of the β-lactam-resistant strain Corynebacterium jeikeium K411. In this study, we show that pbp2c, one of these six genes, is present in resistant strains of Corynebacteriaceae but absent from sensitive strains. The molecular study of the pbp2c locus from C. jeikeium and its heterologous expression in Corynebacterium glutamicum allowed us to show that Pbp2c confers high levels of β-lactam resistance to the host and is under the control of a β-lactam-induced regulatory system encoded by two adjacent genes, jk0410 and jk0411. The detection of this inducible resistance may require up to 48 h of incubation, particularly in Corynebacterium amycolatum. Finally, the Pbp2c-expressing strains studied were resistant to all the β-lactam antibiotics tested, including carbapenems, ceftaroline, and ceftobiprole.
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Affiliation(s)
- Marie Lavollay
- INSERM, Université Paris Cité, Sorbonne Université, Centre de Recherche des Cordeliers, Paris, France
- Service de Microbiologie, Hôpital Européen Georges Pompidou, AP-HP Centre, Université Paris Cité, Paris, France
- Institut Mutualiste Montsouris (IMM), Service de Microbiology, Paris, France
| | - Céline Buon
- INSERM, Université Paris Cité, Sorbonne Université, Centre de Recherche des Cordeliers, Paris, France
| | - Vincent Le Moigne
- Université Paris-Saclay, UVSQ, Inserm, Infection et Inflammation, Montigny-le-Bretonneux, France
| | - Fabrice Compain
- Institut Mutualiste Montsouris (IMM), Service de Microbiology, Paris, France
| | - Armel Guyonvarch
- Institute for Integrative Biology of the Cell (I2BC), CEA, CNRS, Université Paris-Saclay, Gif-sur-Yvette, France
| | - Matthieu Fonvielle
- Institute for Integrative Biology of the Cell (I2BC), CEA, CNRS, Université Paris-Saclay, Gif-sur-Yvette, France
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Frickmann H, Schwinge K, Podbielski A, Warnke P. Preanalytical, Analytical and Postanalytical Analyses on Corynebacterium spp. and Actinomycetaceae in Urine Samples of Patients with Suspected Urinary Tract Infection-A Hypothesis-Forming Observational Study. Diagnostics (Basel) 2024; 14:746. [PMID: 38611658 PMCID: PMC11011480 DOI: 10.3390/diagnostics14070746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 03/24/2024] [Accepted: 03/28/2024] [Indexed: 04/14/2024] Open
Abstract
A hypothesis-forming exploratory cross-sectional assessment was conducted to assess the occurrence and relevance of Gram-positive rod-shaped bacteria like Corynebacterium spp. and Actinomycetaceae in human urine samples. In total, 1170 urine samples from 1031 inpatients with suspected urinary tract infection were assessed for culture-based growth of Gram-positive rod-shaped bacteria applying API Coryne assays, matrix-assisted laser desorption-ionization time-of-flight mass spectrometry (MALDI-TOF-MS), and in-house 16S rRNA gene sequencing. Overall, 502 different bacterial colonies from 346 urine samples taken from 324 inpatients were observed. The three quantitatively most abundant genera or genus clusters were Corynebacterium (254 isolates, 62%), Actinomyces/Winkia (79 isolates, 19%), and Actinotignum/Actinobaculum (29 isolates, 7%). Compared to sequencing, the diagnostic accuracy of all assessed competitor assays from the diagnostic routine was <80% for differentiation on the genus level and <30% for differentiation on the species level. Prolongated incubation for 4 days compared to 2 days resulted in additional detection of 15% of the totally recorded Gram-positive rod-shaped bacteria. An approximately 5-fold increased detection rate in mid-stream urine compared to urine acquired applying alternative sampling strategies was observed. In conclusion, in the rare event of the suspected clinical relevance of such findings, confirmatory testing with invasively sampled urine should be considered due to the high contamination rate observed in mid-stream urine. Confirmatory testing by DNA-sequencing methods should be considered if an exact identification of genus or species is regarded as relevant for the individual choice of the therapeutic strategy.
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Affiliation(s)
- Hagen Frickmann
- Institute for Medical Microbiology, Virology and Hygiene, University Medicine Rostock, 18057 Rostock, Germany; (K.S.); (A.P.)
- Department of Microbiology and Hygiene, Bundeswehr Hospital Hamburg, 20239 Hamburg, Germany
| | - Kerstin Schwinge
- Institute for Medical Microbiology, Virology and Hygiene, University Medicine Rostock, 18057 Rostock, Germany; (K.S.); (A.P.)
| | - Andreas Podbielski
- Institute for Medical Microbiology, Virology and Hygiene, University Medicine Rostock, 18057 Rostock, Germany; (K.S.); (A.P.)
| | - Philipp Warnke
- Institute for Medical Microbiology, Virology and Hygiene, University Medicine Rostock, 18057 Rostock, Germany; (K.S.); (A.P.)
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Ohishi T, Ootsuki K, Kanno S, Ishiyama C, Kashima S, Maruyama K, Fushimi R. Adenosine phosphate-based detection of worker exposure to contaminated water during bathroom cleaning. Am J Infect Control 2023; 51:884-889. [PMID: 36417952 DOI: 10.1016/j.ajic.2022.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 11/15/2022] [Accepted: 11/15/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND Workers who clean bathrooms at medical facilities may be regularly exposed to contaminated water harboring pathogenic microbes and should wear personal protective equipment (PPE) to prevent such exposure at medical facilities, which has not been quantitatively assessed. This study quantified the exposure risk from contaminated water when cleaning restrooms at medical facilities and clarified the importance of wearing PPE. METHODS Existing urinals, toilets, and handwashing sinks (16 each) in a hospital environment were coated with a simulated contaminant containing adenosine phosphate and cleaned with a brush or sponge by workers in PPE. Adenosine phosphate on the PPE, shelf near the toilet, and toilet paper cover was tested before and after cleaning to compare exposure status. RESULTS Adenosine phosphate on the worker's PPE, shelf near the toilet, and toilet paper cover was significantly higher after cleaning the urinal, toilet, and handwashing sink. More adenosine phosphate was disseminated from urinals and toilets when cleaning with a brush compared with a sponge. DISCUSSION Workers and the surrounding environment are exposed to contaminated water during bathroom cleaning. Wearing PPE while cleaning and wiping down the toilet environment after cleaning deserves further consideration.
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Affiliation(s)
- Takayuki Ohishi
- Department of Infection Control and Prevention, Saiseikai Yokoyama Eastern Hospital, Yokohama, Kanagawa, Japan.
| | | | - Sayaka Kanno
- WATAKYU SEIMOA Corporation, Shimogyo-ku, Kyoto, Japan
| | | | | | | | - Ryo Fushimi
- WATAKYU SEIMOA Corporation, Shimogyo-ku, Kyoto, Japan
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Hong SY, Xia QD, Yang YY, Li C, Zhang JQ, Xu JZ, Qin BL, Xun Y, Wang SG. The role of microbiome: a novel insight into urolithiasis. Crit Rev Microbiol 2023; 49:177-196. [PMID: 35776498 DOI: 10.1080/1040841x.2022.2045899] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Urolithiasis, referred to as the formation of stones in the urinary tract, is a common disease with growing prevalence and high recurrence rate worldwide. Although researchers have endeavoured to explore the mechanism of urinary stone formation for novel effective therapeutic and preventative measures, the exact aetiology and pathogenesis remain unclear. Propelled by sequencing technologies and culturomics, great advances have been made in understanding the pivotal contribution of the human microbiome to urolithiasis. Indeed, there are diverse and abundant microbes interacting with the host in the urinary tract, overturning the dogma that urinary system, and urine are sterile. The urinary microbiome of stone formers was clearly distinct from healthy individuals. Besides, dysbiosis of the intestinal microbiome appears to be involved in stone formation through the gut-kidney axis. Thus, the human microbiome has potential significant implications for the aetiology of urolithiasis, providing a novel insight into diagnostic, therapeutic, and prognostic strategies. Herein, we review and summarize the landmark microbiome studies in urolithiasis and identify therapeutic implications, challenges, and future perspectives in this rapidly evolving field. To conclude, a new front has opened with the evidence for a microbial role in stone formation, offering potential applications in the prevention, and treatment of urolithiasis.
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Affiliation(s)
- Sen-Yuan Hong
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
| | - Qi-Dong Xia
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
| | - Yuan-Yuan Yang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
| | - Cong Li
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
| | - Jia-Qiao Zhang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
| | - Jin-Zhou Xu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
| | - Bao-Long Qin
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
| | - Yang Xun
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
| | - Shao-Gang Wang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
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Spectrum of Bacterial Pathogens from Urinary Infections Associated with Struvite and Metabolic Stones. Diagnostics (Basel) 2022; 13:diagnostics13010080. [PMID: 36611372 PMCID: PMC9818859 DOI: 10.3390/diagnostics13010080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 12/06/2022] [Accepted: 12/12/2022] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE The purposes of this multi-center study were to evaluate the rate of infection stones and to evaluate the urine cultures of patients with infection stones. MATERIALS Charts of adulpatients with urinary stones were reviewed and data on stone analyses and urine cultures were collected. RESULTS In total, 1204 renal stone formers (RSFs) from 10 countries were included (776 males, 428 females). Fifty-six patients (4.6%) had struvite stones. The highest frequency of struvite stones was observed in India (23%) and Pakistan (18%). Lower rates were reported in Canada (2%), China (3%), Argentina (3%), Iraq (3%), Italy (3.5%) and Poland (3%), and intermediate rates in Egypt (5.5%) and Bulgaria (5.4%). Urine cultures were retrieved from 508 patients. Patients with struvite stones had a positive culture in 64.3% of the samples and patients with other stones, in 26.7%. In struvite stones, the most common isolates were Escherichia coli (27.7%) and Proteus spp. (27.7%), followed by Klebsiella spp. (16.7%); in other types of stone, it was Escherichia coli (47.6%), followed by Gram-positive bacteria (14.0%) Conclusions: The struvite stone composition was associated with a urinary infection, although an infection was not demonstrable with a conventional midstream urine culture in about 30%.
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Liu YB, Xiao B, Hu WG, Zhang G, Fu M, Li JX. Endoscopic treatment of urothelial encrusted pyelo-ureteritis disease: A case series. World J Clin Cases 2022; 10:12980-12989. [PMID: 36569021 PMCID: PMC9782925 DOI: 10.12998/wjcc.v10.i35.12980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 09/11/2022] [Accepted: 11/22/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Urothelial encrusted pyelo-ureteritis disease is an infrequent condition and there is no unified surgical treatment and reference standard to consult. We have used a minimally invasive endoscopic method to treat three such cases, which yielded excellent results.
CASE SUMMARY The first case was a 45-year-old man who had unilateral ureteropelvic junction (UPJ) atresia and contralateral stenosis and was treated by double endoscopic surgery using an anterograde percutaneous nephroscope coupled with a rigid retrograde ureteroscope. The second case was a 12-year-old boy who received a percutaneous nephroscopy on one side and a percutaneous nephroscopy with a rigid ureteroscope on the other side due to the presence of bilateral UPJ stenosis. The third case was a 32-year-old woman with bilateral lower ureteral stricture treated using a rigid retrograde ureteroscope. Endoscopic surgeries were successfully performed on all the three patients. Varying degrees of encrustation and erosion of the urothelium were observed during the operation. The calcified layer composition analysis showed magnesium ammonium phosphate or carbonate apatite. Two patients achieved a good prognosis.
CONCLUSION Minimally invasive endoscopic treatment for urothelial encrusted pyelo-ureteritis disease can yield better results.
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Affiliation(s)
- Yu-Bao Liu
- Department of Urology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, China
| | - Bo Xiao
- Department of Urology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, China
| | - Wei-Guo Hu
- Department of Urology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, China
| | - Gang Zhang
- Department of Urology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, China
| | - Meng Fu
- Department of Urology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, China
| | - Jian-Xing Li
- Department of Urology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, China
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Du L, Zhang Y, Ji S, Wang L, Zhao X, Yan S, Xiao X, Li S. Mechanisms of Zhenwu decoction for the treatment of renal fibrosis at various stages: What is the role of Corynebacterium? Front Microbiol 2022; 13:913465. [PMID: 36147851 PMCID: PMC9485941 DOI: 10.3389/fmicb.2022.913465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 08/11/2022] [Indexed: 12/05/2022] Open
Abstract
Many studies demonstrated that Zhenwu decoction (ZWD) is effective in the treatment of kidney fibrosis, whereas the mechanism remains unclear. In this work, a microbiomics-based strategy was used to investigate the mechanism of protective effects of ZWD on kidney fibrosis. Unilateral ureteral obstruction was used to replicate a rat model of renal fibrosis, and rats were divided into prophylactic, early, and progression stages according to the timing of administration. Feces was collected to perform microbiota evaluation by high-throughput 16S DNA sequencing. The results indicated that Corynebacterium, Alistipes, Dorea, and Lactonifactor were highlighted as key targeted flora of ZWD in the treatment of renal fibrosis, and their biological functions were related to inflammation, immunity, and renal excretion. Especially, Corynebacterium presented a significant positive correlation with the concentration of Cys-C, Scr, and BUN. The studies on the changes in inflammatory cytokines (INF-γ, IL-1β, IL-4, and TNF-α) and immunoglobulin (IgA, IgM, and IgG) confirmed the beneficial effects of ZWD on kidney fibrosis. Therefore, this study confirmed the protective effect of ZWD against renal fibrosis at various disease stages, and its mechanism was associated with re-establishing dysbiosis of the intestinal microbiota, reducing inflammation, as well as regulating immune functions. In particular, Corynebacterium may be a key flora in the treatment of renal fibrosis.
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Affiliation(s)
- Lijing Du
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
- School of Pharmacy, Shanghai Jiao Tong University, Shanghai, China
| | - Yiping Zhang
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Shuai Ji
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
| | - Leqi Wang
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
- Institute of Traditional Chinese Medicine, Guangdong Pharmaceutical University, Guangzhou, China
| | - Xiaoshan Zhao
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
- State Key Laboratory of Dampness Syndrome of Chinese Medicine, Guangzhou, China
| | - Shikai Yan
- School of Pharmacy, Shanghai Jiao Tong University, Shanghai, China
- Institute of Traditional Chinese Medicine, Guangdong Pharmaceutical University, Guangzhou, China
| | - Xue Xiao
- Institute of Traditional Chinese Medicine, Guangdong Pharmaceutical University, Guangzhou, China
- *Correspondence: Xue Xiao,
| | - Shasha Li
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
- State Key Laboratory of Dampness Syndrome of Chinese Medicine, Guangzhou, China
- Shasha Li,
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Cheng PY, Huang YY, Jaw FS, Chung SD, Tsai CY. Diffused bladder wall calcification in a survivor with severe coronavirus disease 2019: A case report. Medicine (Baltimore) 2022; 101:e30314. [PMID: 36042663 PMCID: PMC9410584 DOI: 10.1097/md.0000000000030314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
RATIONALE Bladder calcification is a rare presentation that was first interpreted to be related to a urea-splitting bacterial infection. Aside from infection, other hypotheses such as schistosomiasis, tuberculosis, cancer, and cytokine-induced inflammatory processes have also been reported. Severe coronavirus disease 2019 (COVID-19) is known for its provoking cytokine storm and uninhibited systematic inflammation, and calcification over the coronary artery or lung has been reported as a long-term complication. PATIENT CONCERNS We presented a 68 years old man who had persistent lower urinary tract symptoms after recovery from severe COVID-19. No urea-splitting bacteria were identified from urine culture. DIAGNOSIS Cystoscopy examination revealed diffuse bladder mucosal and submucosa calcification. INTERVENTIONS Transurethral removal of the mucosal calcification with lithotripsy. OUTCOMES The patient's lower urinary tract symptoms improved, and stone analysis showed 98% calcium phosphate and 2% calcium oxalate. No newly formed calcifications were found at serial follow-up. CONCLUSION Diffuse bladder calcification may be a urinary tract sequela of COVID-19 infection. Patients with de novo lower urinary tract symptoms after severe COVID-19 should be further investigated.
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Affiliation(s)
- Pai-Yu Cheng
- Department of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taiwan
- Divisions of Urology, Department of Surgery, Far Eastern Memorial Hospital, Taiwan
- *Correspondence: Pai-Yu Cheng, Divisions of Urology, Department of Surgery, Far Eastern Memorial Hospital, Taiwan, No. 21, Sec. 2, Nanya S. Rd., Banciao Dist., New Taipei City 220, Taiwan (e-mail: )
| | - Yi-You Huang
- Department of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taiwan
| | - Fu-Shan Jaw
- Department of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taiwan
| | - Shiu-Dong Chung
- Divisions of Urology, Department of Surgery, Far Eastern Memorial Hospital, Taiwan
- Department of Nursing, College of Healthcare & Management, Asia Eastern University of Science and Technology, Taiwan
- General Education Center, Eastern University of Science and Technology, Taiwan
| | - Chung-You Tsai
- Divisions of Urology, Department of Surgery, Far Eastern Memorial Hospital, Taiwan
- Department of Electrical Engineering, Yuan Ze University, Taiwan
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Sun W, Ma L, Li Y, Xu Y, Wei J, Sa L, Chen X, Su J. In vitro Studies of Non-Diphtheriae Corynebacterium Isolates on Antimicrobial Susceptibilities, Drug Resistance Mechanisms, and Biofilm Formation Capabilities. Infect Drug Resist 2022; 15:4347-4359. [PMID: 35971555 PMCID: PMC9375566 DOI: 10.2147/idr.s376328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 07/29/2022] [Indexed: 11/30/2022] Open
Abstract
Objective This study aimed to investigate the antimicrobial susceptibilities, drug resistance mechanisms, and biofilm formation capacities of non-diphtheriae Corynebacterium strains isolated from sterile midstream urine of hospitalized patients with clinical urinary tract infections (UTIs). Methods A total of 45 non-diphtheriae Corynebacterium isolates were recovered from sterile midstream urine. The available data of 45 patients were collected. Minimum inhibitory concentrations (MICs) of 10 commonly used antibiotics were determined. Meanwhile, the molecular resistance mechanisms of each agent were performed through PCR with specific primers. Moreover, the biofilm formation capability of each isolate on abiotic surfaces was detected with the MTT method. Results In this study, the most prevalent three species were C. striatum (15/45, 33.3%), C. glucuronolyticum (9/45, 20.0%) and C. urealyticum (8/45, 17.8%). These three species also accounted for most renal and ureteral calculi cases. Male patients older than 50 years, especially those with underlying diseases, were more susceptible to non-diphtheriae Corynebacterium infection. All the 45 isolates were 100% susceptible to vancomycin and linezolid, but highly resistant to macrolide–lincosamide–streptogramin B (MLSB), fluoroquinolones, tetracyclines and β-lactams with corresponding mechanisms. The detection rate of multidrug–resistant (MDR) non-diphtheriae Corynebacterium is 91.1%. All isolates are able to form biofilm on abiotic surfaces, except those of C. urealyticum, C. tuberculostearicum and C. jeikeium. Isolates of C. glucuronolyticum and C. Striatum possessed the strongest biofilm formation capacity. C. amycolatum could form biofilm, but varied greatly among different isolates. Conclusion C. striatum, C. glucuronolyticum and C. urealyticum were the most prevalent species relevant to UTIs. The high occurrence of MDR isolates and high diversities in resistance profiles, and the distinctive abilities of biofilm formation highlighted the urgency for identification to species level. We should pay more attention to the drug resistance profiles of non-diphtheriae Corynebacterium, which would help improve empirical antibiotic therapy and reduce drug resistance transmission.
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Affiliation(s)
- Wei Sun
- Department of Clinical Laboratory, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People's Republic of China
| | - Liyan Ma
- Department of Clinical Laboratory, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People's Republic of China
| | - Yana Li
- Department of Clinical Laboratory, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People's Republic of China
| | - Ying Xu
- Department of Clinical Laboratory, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People's Republic of China
| | - Jingjuan Wei
- Department of Clinical Laboratory, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People's Republic of China
| | - Lei Sa
- Department of Clinical Laboratory, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People's Republic of China
| | - Xinxin Chen
- Department of Clinical Laboratory, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People's Republic of China
| | - Jianrong Su
- Department of Clinical Laboratory, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People's Republic of China
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Famularo G, Galluzzo M. Encrusted cystitis. Intern Emerg Med 2021; 16:2297-2298. [PMID: 33890207 DOI: 10.1007/s11739-021-02721-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 11/29/2018] [Indexed: 11/25/2022]
Affiliation(s)
- Giuseppe Famularo
- Internal Medicine, San Camillo Hospital, Circonvallazione Gianicolense, 00152, Rome, Italy.
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13
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Peiffer RF, Iulo C, LeCuyer T, Bolton T. Vasovagal reaction secondary to bladder overdistension in a dog undergoing a unique timeline of medical and surgical treatment for Corynebacterium urealyticum encrusting cystitis: a case report. BMC Vet Res 2021; 17:317. [PMID: 34583703 PMCID: PMC8479914 DOI: 10.1186/s12917-021-03028-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 09/16/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Corynebacterium urealyticum urinary tract infections can result in a rarely reported condition called encrusting cystitis whereby plaque lesions form on and within the urinary bladder mucosa. Chronic lower urinary tract signs manifest subsequent to the infection-induced cystitis and plaque-induced decreased bladder wall distensibility. Because of the organism's multidrug resistance and plaque forming capability, infection eradication can be difficult. While systemic antimicrobial therapy is the mainstay of treatment, adjunctive surgical debridement of plaques has been used with relative paucity in such cases, thereby limiting our understanding of this modality's indications and success rate. Consequently, this report describes the successful eradication of Corynebacterium urealyticum encrusting cystitis utilizing a unique timeline of medical and surgical treatments. Additionally, this represents the first reported veterinary case of a vasovagal reaction due to bladder overdistension. CASE PRESENTATION A 6-year-old female spayed Miniature Schnauzer was evaluated for lower urinary tract clinical signs and diagnosed with Corynebacterium urealyticum encrusting cystitis. The infection was persistent despite prolonged courses of numerous oral antimicrobials and urinary acidification. A unique treatment timeline of intravenous vancomycin, intravesical gentamicin, and mid-course surgical debridement ultimately resulted in infection resolution. During surgery, while the urinary bladder was copiously flushed and distended with saline, the dog experienced an acute vasovagal reaction from which it fully recovered. CONCLUSIONS Surgical debridement of bladder wall plaques should be considered a viable adjunctive therapy for Corynebacterium urealyticum encrusting cystitis cases failing to respond to systemic antibiotic therapy. The timing in which surgery was employed in this case, relative to concurrent treatment modalities, may be applicable in future cases of this disease as dictated on a case-by-case basis. If surgery is ultimately pursued, overdistension of the urinary bladder should be avoided, or at least minimized as much as possible, so as to prevent the possibility of a vasovagal reaction.
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Affiliation(s)
- Ryan F Peiffer
- BluePearl Specialty and Emergency Pet Hospital, Sandy Springs, GA, USA
| | - Carly Iulo
- Upstate Vet Emergency and Specialty Care, Greenville, SC, USA
| | - Tessa LeCuyer
- Department of Biomedical Science and Pathobiology, Virginia-Maryland Regional College of Veterinary Medicine, Virginia Tech University, Blacksburg, VA, USA
| | - Timothy Bolton
- Department of Small Animal Clinical Sciences, Virginia-Maryland Regional College of Veterinary Medicine, Virginia Tech University, Blacksburg, VA, USA.
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Hashimoto S, Tamura Y, Kodera R, Tachibana A, Toyoshima K, Oba K, Toyoshima K, Nishina Y, Chiba Y, Araki A. [A case of hyperammonemia caused by urinary tract infection due to urease-producing bacteria in dementia with Lewy bodies]. Nihon Ronen Igakkai Zasshi 2021; 58:297-302. [PMID: 34039807 DOI: 10.3143/geriatrics.58.297] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
An 87-year-old woman diagnosed with dementia with Lewy bodies (DLB) 2 years earlier was referred to our institution because of difficulty walking. She was diagnosed with urinary tract infection and admitted to our hospital. During hospitalisation, she became delirious, which prompted the administration of haloperidol. Afterwards, an altered level of consciousness was noted, measuring 300 on the Japan coma scale. A blood test revealed hyperammonaemia without liver damage. Urine culture detected the presence of Corynebacterium urealyticum. Therefore, we diagnosed this case as one of hyperammonaemia due to urinary tract infection caused by urease-producing bacteria. Soon after the insertion of a urethral catheter, the ammonia level decreased, and the consciousness level improved. In this case, the patient took medication to preserve her bladder function, which is frequently associated with DLB. We suspected that the drug caused urinary retention, resulting in hyperammonaemia. Hyperammonaemia due to these bacteria should be considered in DLB patients with an impaired consciousness, especially in those using regulators of the urinary bladder function.
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Affiliation(s)
- Seiji Hashimoto
- Department of Diabetes, Metabolism and Endocrinology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology
| | - Yoshiaki Tamura
- Department of Diabetes, Metabolism and Endocrinology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology
| | - Remi Kodera
- Department of Diabetes, Metabolism and Endocrinology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology
| | - Aya Tachibana
- Department of Diabetes, Metabolism and Endocrinology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology
| | - Koichi Toyoshima
- Department of Diabetes, Metabolism and Endocrinology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology
| | - Kazuhito Oba
- Department of Diabetes, Metabolism and Endocrinology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology
| | - Kenji Toyoshima
- Department of Diabetes, Metabolism and Endocrinology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology
| | - Yasushi Nishina
- Department of Neurology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology
| | - Yuko Chiba
- Department of Diabetes, Metabolism and Endocrinology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology
| | - Atsushi Araki
- Department of Diabetes, Metabolism and Endocrinology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology
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Van de Perre E, Reichman G, De Geyter D, Geers C, Wissing KM, Letavernier E. Encrusted Uropathy: A Comprehensive Overview-To the Bottom of the Crust. Front Med (Lausanne) 2021; 7:609024. [PMID: 33553205 PMCID: PMC7858656 DOI: 10.3389/fmed.2020.609024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 12/14/2020] [Indexed: 12/14/2022] Open
Abstract
Encrusted uropathy is a rare subacute to chronic inflammatory disorder caused by infection with urease-producing bacteria, mainly Corynebacterium urealyticum. The disorder is characterized by urothelial deposition of struvite and carbonated apatite, resulting in encrustations and ulceronecrotic inflammation of the urothelium and surrounding tissues. Most commonly, encrusted uropathy is encountered in patients with predisposing conditions. The disease remains underdiagnosed. High urinary pH and negative conventional urine cultures should raise suspicion of the diagnosis. Prognosis is dependent on timely diagnosis and treatment installment, which consists of urological removal of encrustations in combination with urinary acidification and long-term antibiotic therapy.
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Affiliation(s)
- Els Van de Perre
- Nephrology Department, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Gina Reichman
- Urology Department, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Deborah De Geyter
- Microbiology Department, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Caroline Geers
- Pathology Department, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Karl M Wissing
- Nephrology Department, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Emmanuel Letavernier
- Service des Explorations Fonctionnelles Multidisciplinaires, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Sorbonne Universités, Université Pierre et Marie Curie, Paris, France.,Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche S 1155, Paris, France
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16
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Sakhi H, Join-Lambert O, Goujon A, Culty T, Loubet P, Dang J, Drouot S, de Bayser H, Michaud C, Ghislain L, Stehlé T, Legendre C, Joly D, Meria P, Zaidan M. Encrusted Urinary Tract Infections Due to Corynebacteria Species. Kidney Int Rep 2020; 6:179-186. [PMID: 33426397 PMCID: PMC7783559 DOI: 10.1016/j.ekir.2020.10.034] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 10/21/2020] [Accepted: 10/27/2020] [Indexed: 12/14/2022] Open
Abstract
Introduction Encrusted pyelitis and cystitis are peculiar disorders characterized by the calcification of the vesical, the pyelic, and/or the ureteral walls. These calcifications are composed of struvite and calcium carbonate‒apatite due to the presence of Corynebacterium urealyticum. Methods We have identified the clinical features and outcomes of 17 patients with encrusted pyelitis (n = 15) or encrusted cystitis (n = 2). Diagnosis was based on computed tomography scan and sonography including thickening and calcified lesions of the urinary tract. Results The main clinical presentation was suggestive of subacute urinary tract infection with fever and urologic symptoms, mostly gross hematuria. Biologic features were characterized by the presence of struvite crystals and alkaline urine. Acute kidney injury was reported in 70.6% of cases. Predisposing factors were mostly due to urologic background (82.4%) with a history of urologic procedure (71%) and prior exposure to antibiotics (59%). All patients received appropriate antibiotherapy and 15 were treated with topical urinary acidification. A significant reduction of encrusted calcifications was observed in 88% of cases. Renal function improved in 71% of the patients. Nevertheless, poor tolerance of the treatment and side effects were common, affecting 71% of patients, with Gram-negative bacilli urinary tract infections (53%) being the most frequent. At last follow-up, 4 patients (23.5%) progressed to end-stage renal disease and only 1 had a clinical relapse. Conclusions Encrusted urinary tract infections are rare, characterized by a severe renal and overall prognosis in the absence of appropriate treatment. Topical urinary acidification and appropriate antibiotherapy are efficient but may be burdened by significant adverse events.
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Affiliation(s)
- Hamza Sakhi
- Department of Nephrology‒Transplantation, Hôpital Necker, APHP, Paris, France
| | | | - Anna Goujon
- Department of Urology, CHU Angers, Angers, France
| | | | - Paul Loubet
- Department of Infectiology, CHU Nîmes, Nîmes, France
| | - Julien Dang
- Department of Nephrology‒Transplantation, Hôpital Bicêtre, APHP, Le Kremlin‒Bicêtre, France
| | - Sylvain Drouot
- Clinical Pharmacy Department, Hôpital Bicêtre, APHP, Paris, France
| | - Hubert de Bayser
- Department of Urology, Hôpital Edouard Herriot, HCL, Lyon, France
| | | | - Louise Ghislain
- Department of Nephrology and Dialysis, Hôpital Tenon, APHP, Paris, France
| | - Thomas Stehlé
- Department of Nephrology‒Transplantation, Hôpital Henri-Mondor, APHP, Créteil, France
| | - Christophe Legendre
- Department of Nephrology‒Transplantation, Hôpital Necker, APHP, Paris, France
| | - Dominique Joly
- Department of Nephrology‒Transplantation, Hôpital Necker, APHP, Paris, France
| | - Paul Meria
- Department of Urology, Hôpital Saint-Louis, APHP, Paris, France
| | - Mohamad Zaidan
- Department of Nephrology‒Transplantation, Hôpital Bicêtre, APHP, Le Kremlin‒Bicêtre, France.,Paris-Saclay, Le Kremlin‒Bicêtre, France
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Fu JG, Xie KJ. Successful treatment of encrusted cystitis: A case report and review of literature. World J Clin Cases 2020; 8:4234-4244. [PMID: 33024784 PMCID: PMC7520765 DOI: 10.12998/wjcc.v8.i18.4234] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 08/03/2020] [Accepted: 08/21/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Encrusted cystitis (EC) is a chronic inflammation of the bladder associated with mucosal encrustations. Early diagnosis and optimal treatment are not well established. Here, we report a case of EC successfully treated with com-bination therapy.
CASE SUMMARY A 27-year-old man presented with frequency, urgency, dysuria, gross hematuria and suprapubic pain for 2 mo. He was diagnosed with EC based on characteristic calcifications of the bladder wall (most of them were struvite), cystoscopy and histopathological examination. He was cured after combined therapy of elimination of encrustations, bladder instillation of hyaluronic acid and injection of botulinum-A neurotoxin into bladder submucosal tissue.
CONCLUSION Bladder instillation of hyaluronic acid and injection of botulinum-A neurotoxin into the bladder submucosal tissue can be used for treatment of EC.
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Affiliation(s)
- Jin-Gao Fu
- Department of Urology, Jiangmen Central Hospital, Affiliated Jiangmen Hospital of Sun Yat-Sen University, Jiangmen 529000, Guangdong Province, China
| | - Ke-Ji Xie
- Department of Urology, Guangzhou First People’s Hospital, Guangzhou 510180, Guangdong Province, China
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Antimicrobial Susceptibility and Characterization of Resistance Mechanisms of Corynebacterium urealyticum Clinical Isolates. Antibiotics (Basel) 2020; 9:antibiotics9070404. [PMID: 32668585 PMCID: PMC7400432 DOI: 10.3390/antibiotics9070404] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 07/03/2020] [Accepted: 07/10/2020] [Indexed: 01/18/2023] Open
Abstract
Corynebacterium urealyticum is a non-diphtherial urease-producing clinically relevant corynebacterial, most frequently involved in urinary tract infections. Most of the C. urealyticum clinical isolates are frequently resistant to several antibiotics. We investigated the susceptibility of 40 C. urealyticum isolated in our institution during the period 2005–2017 to eight compounds representative of the main clinically relevant classes of antimicrobial agents. Antimicrobial susceptibility was determined by the Epsilometer test. Resistance genes were searched by PCR. All strains were susceptible to vancomycin whereas linezolid and rifampicin also showed good activity (MICs90 = 1 and 0.4 mg/L, respectively). Almost all isolates (39/40, 97.5%) were multidrug resistant. The highest resistance rate was observed for ampicillin (100%), followed by erythromycin (95%) and levofloxacin (95%). Ampicillin resistance was associated with the presence of the blaA gene, encoding a class A β-lactamase. The two rifampicin-resistant strains showed point mutations driving amino acid replacements in conserved residues of RNA polymerase subunit β (RpoB). Tetracycline resistance was due to an efflux-mediated mechanism. Thirty-nine PFGE patterns were identified among the 40 C. urealyticum, indicating that they were not clonally related, but producing sporadic infections. These findings raise the need of maintaining surveillance strategies among this multidrug resistant pathogen.
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Ito K, Takahashi T, Kanno T, Okada T, Higashi Y, Yamada H. Renal failure due to encrusted cystitis and pyelitis. IJU Case Rep 2020; 3:112-115. [PMID: 32743486 PMCID: PMC7292115 DOI: 10.1002/iju5.12158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 03/23/2020] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION Encrusted cystitis and pyelitis are a rare urinary tract infection characterized by mold-like calcification of collecting system. Here, we show a case of encrusted cystitis proceeding to pyelitis during a 1-month delay in diagnosis. CASE PRESENTATION A 73-year-old man developed hematuria and pain during micturition while he was being treated for granulomatosis with polyangiitis and lung abscess. Cystoscopy revealed calcification of the bladder wall, and an initial diagnosis of a bladder stone was made. While awaiting surgery, the bladder wall calcification extended to the renal pelvis on both sides, with renal failure. He underwent bilateral nephrostomy replacement and bladder irrigation with Solita T1 and was administered intravenous vancomycin. Calcification almost regressed after 4 weeks of treatment. CONCLUSION Encrusted cystitis and pyelitis should be suspected if the patient shows alkaline urine and urothelial mucosa calcification. Appropriate treatment includes antibiotics, urine drainage, and chemolysis by bladder irrigation.
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Affiliation(s)
- Katsuhiro Ito
- Department of UrologyIjinkai Takeda General HospitalKyotoJapan
| | | | - Toru Kanno
- Department of UrologyIjinkai Takeda General HospitalKyotoJapan
| | - Takashi Okada
- Department of UrologyIjinkai Takeda General HospitalKyotoJapan
| | | | - Hitoshi Yamada
- Department of UrologyIjinkai Takeda General HospitalKyotoJapan
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20
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Nicolosi D, Genovese C, Cutuli MA, D’Angeli F, Pietrangelo L, Davinelli S, Petronio Petronio G, Di Marco R. Preliminary in Vitro Studies on Corynebacterium urealyticum Pathogenetic Mechanisms, a Possible Candidate for Chronic Idiopathic Prostatitis? Microorganisms 2020; 8:E463. [PMID: 32218312 PMCID: PMC7232468 DOI: 10.3390/microorganisms8040463] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 03/16/2020] [Accepted: 03/23/2020] [Indexed: 01/01/2023] Open
Abstract
Corynebacterium urealyticum is a well-known opportunistic uropathogen that can occur with cystitis, pyelonephritis, and urinary sepsis. Although a wide variety of coryneform bacteria have been found from the male genital tract of prostatitis patients, only one clinical case of prostatitis caused by C. urealyticum has been reported. The aim of this study was to evaluate the in vitro tropism of C. urealyticum towards LNCaP (lymph node carcinoma of the prostate) human cells line and the influence of acetohydroxamic acid as an irreversible urease inhibitor on different aspects of its pathogenicity by means of several in vitro tests, such as the determination and analysis of growth curves, MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay, the production of biofilms, and adhesion to LNCaP and HeLa cell lines. Results have brought new pieces of evidence on the in vitro tropism of C. urealyticum for the human prostate cell line LNCaP and the therapeutic use of the irreversible urease inhibitors such as acetohydroxamic acid (AHA), not only as enzyme blockers to facilitate the removal of encrustations but also as modulators of some pathogenic mechanisms. These interesting preliminary data allow us to assert that there is a real possibility that C. urealyticum is a new candidate for chronic idiopathic prostatitis.
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Affiliation(s)
- Daria Nicolosi
- Department of Biomedical and Biotechnological Sciences—Microbiology Section, Università degli Studi di Catania, 95100 Catania, Italy; (D.N.); (C.G.); (F.D.)
| | - Carlo Genovese
- Department of Biomedical and Biotechnological Sciences—Microbiology Section, Università degli Studi di Catania, 95100 Catania, Italy; (D.N.); (C.G.); (F.D.)
| | - Marco Alfio Cutuli
- Department of Medicine and Health Sciences “Vincenzo Tiberio”, Università degli Studi del Molise—III Ed Polifunzionale, 86100 Campobasso, Italy; (M.A.C.); (L.P.); (S.D.); (R.D.M.)
| | - Floriana D’Angeli
- Department of Biomedical and Biotechnological Sciences—Microbiology Section, Università degli Studi di Catania, 95100 Catania, Italy; (D.N.); (C.G.); (F.D.)
| | - Laura Pietrangelo
- Department of Medicine and Health Sciences “Vincenzo Tiberio”, Università degli Studi del Molise—III Ed Polifunzionale, 86100 Campobasso, Italy; (M.A.C.); (L.P.); (S.D.); (R.D.M.)
| | - Sergio Davinelli
- Department of Medicine and Health Sciences “Vincenzo Tiberio”, Università degli Studi del Molise—III Ed Polifunzionale, 86100 Campobasso, Italy; (M.A.C.); (L.P.); (S.D.); (R.D.M.)
| | - Giulio Petronio Petronio
- Department of Medicine and Health Sciences “Vincenzo Tiberio”, Università degli Studi del Molise—III Ed Polifunzionale, 86100 Campobasso, Italy; (M.A.C.); (L.P.); (S.D.); (R.D.M.)
| | - Roberto Di Marco
- Department of Medicine and Health Sciences “Vincenzo Tiberio”, Università degli Studi del Molise—III Ed Polifunzionale, 86100 Campobasso, Italy; (M.A.C.); (L.P.); (S.D.); (R.D.M.)
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Antibiotic resistance genes in the Actinobacteria phylum. Eur J Clin Microbiol Infect Dis 2019; 38:1599-1624. [PMID: 31250336 DOI: 10.1007/s10096-019-03580-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 05/01/2019] [Indexed: 02/07/2023]
Abstract
The Actinobacteria phylum is one of the oldest bacterial phyla that have a significant role in medicine and biotechnology. There are a lot of genera in this phylum that are causing various types of infections in humans, animals, and plants. As well as antimicrobial agents that are used in medicine for infections treatment or prevention of infections, they have been discovered of various genera in this phylum. To date, resistance to antibiotics is rising in different regions of the world and this is a global health threat. The main purpose of this review is the molecular evolution of antibiotic resistance in the Actinobacteria phylum.
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The Risk of Nosocomial Infection with Multidrug-Resistant Corynebacterium urealyticum After Prostate Cancer Surgery. ARCHIVES OF CLINICAL INFECTIOUS DISEASES 2019. [DOI: 10.5812/archcid.65327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Kispal ZF, Vajda P, Kardos D, Klymiuk I, Moissl-Eichinger C, Castellani C, Singer G, Till H. The local microbiome after pediatric bladder augmentation: intestinal segments and the native urinary bladder host similar mucosal microbiota. J Pediatr Urol 2019; 15:30.e1-30.e7. [PMID: 30206025 DOI: 10.1016/j.jpurol.2018.07.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 07/26/2018] [Indexed: 01/26/2023]
Abstract
INTRODUCTION Next-generation sequencing (NGS) techniques have provided novel insights into the microbiome of the urinary bladder (UB). In children after bladder augmentation using either ileum (ileocystoplasty, ICP) or colon (colocystoplasty, CCP), the fate of the mucosal microbiome introduced into the urinary tract remains unknown. OBJECTIVE The aim was to compare the mucosal microbiome of the native UB vs the augmented intestinal segment (IS) using NGS. STUDY DESIGN Twelve children after bladder augmentation (ICP n = 6, CCP n = 6) were included. Biopsies were taken during routine postoperative cystoscopy from the native UB and the IS. Specimens underwent whole-genome DNA extraction, 16S rRNA gene amplification, NGS, and Quantitative Insights Into Microbial Ecology (QIIME) data analysis. Downstream statistical data analyses were performed in Calypso. RESULTS Patients' median age at the time of surgery was 11 years (6-17 years), and the median interval between augmentation and sampling was 7 years (4-13 years). α-Diversity (Shannon diversity index) was not significantly different between IS vs UB, ICP vs CCP, and male vs female. No general differences in the overall bacterial pattern (β-diversity) were found between IS, UB, ICP, and CCP groups. The groups overlapped in principal coordinate analysis (PCoA) and non-metric multidimensional scaling (NMDS) analysis (Figure). Age at sampling had a statistically significant influence on β-diversity at the genus level. Corynebacterium, Pseudoxanthomonas, Lactobacillus, Flavobacterium, and Micrococcus were the most dominating taxa detected over all samples. There was an obvious dominance of the genus Corynebacterium in the samples taken from the UB and IS in both ICP and CCP patients. Limitations of this study include the relatively small number of patients. CONCLUSION After bladder augmentation, the native UB and augmented ISs (ICP and CCP) host similar microbiota despite their distinct differences of originating mucosal anatomy.
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Affiliation(s)
- Z F Kispal
- Department of Pediatric and Adolescent Surgery, Medical University of Graz, Auenbruggerplatz 34, 8036 Graz, Austria
| | - P Vajda
- Department of Pediatrics, Surgical Division, University of Pecs, József A Str 7, 7623 Pecs, Hungary
| | - D Kardos
- Department of Pediatrics, Surgical Division, University of Pecs, József A Str 7, 7623 Pecs, Hungary
| | - I Klymiuk
- Center for Medical Research, Core Facility Molecular Biology, Medical University of Graz, Stiftingtalstraße 24, 8036 Graz, Austria
| | - C Moissl-Eichinger
- Department of Internal Medicine, Joint Facilities, Medical University of Graz, Stiftingtalstraße 24, 8036 Graz, Austria; BioTechMed, Mozartgasse 12/II, 8010 Graz, Austria
| | - C Castellani
- Department of Pediatric and Adolescent Surgery, Medical University of Graz, Auenbruggerplatz 34, 8036 Graz, Austria
| | - G Singer
- Department of Pediatric and Adolescent Surgery, Medical University of Graz, Auenbruggerplatz 34, 8036 Graz, Austria.
| | - H Till
- Department of Pediatric and Adolescent Surgery, Medical University of Graz, Auenbruggerplatz 34, 8036 Graz, Austria
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Maurey C, Boulouis HJ, Canonne-Guibert M, Benchekroun G. Clinical description of Corynebacterium urealyticum urinary tract infections in 11 dogs and 10 cats. J Small Anim Pract 2019; 60:239-246. [PMID: 30653665 DOI: 10.1111/jsap.12973] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 11/01/2018] [Accepted: 11/14/2018] [Indexed: 01/03/2023]
Abstract
OBJECTIVES To examine the clinical signs, laboratory findings, possible predisposing factors, antimicrobial sensitivity and outcomes of dogs and cats diagnosed with urinary tract infection caused by Corynebacterium urealyticum. MATERIALS AND METHODS Retrospective, observational study of dogs and cats that were diagnosed with urinary tract infection caused by C. urealyticum. RESULTS This report concerns a total of 11 dogs and 10 cats. All cats had a history of urethral catheterisation, and six cats had undergone urological surgery before diagnosis of this specific infection. Dogs had history of neurogenic urinary incontinence (n=5), urethral catheterisation (n=4), urological surgery (n=4), lower urinary tract disease (n=2) or prostatic disease (n=1). In seven animals, previous urine culture was negative. Median urine pH was 8.6 (interquartile range 7.5 to 9), and 19 animals had pyuria and struvite crystalluria. Encrusted cystitis was diagnosed by abdominal ultrasound in nine animals. All but one isolate were resistant to at least three antimicrobial classes. Thirteen isolates were sensitive to tetracyclines. There was bacterial and clinical resolution of the infection in nine dogs and seven cats. Two animals died from sepsis and two cats were euthanased because of clinical deterioration. CLINICAL SIGNIFICANCE Urinary tract infection caused by C. urealyticum should be suspected in animals with pre-existing urinary disorders, especially if urine is alkaline and there is struvite crystalluria, negative routine urine culture and encrusted cystitis.
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Affiliation(s)
- C Maurey
- Ecole Nationale Vétérinaire d'Alfort, Unité de Médecine Interne, 94700 Maisons Alfort, France
| | - H-J Boulouis
- Ecole Nationale Vétérinaire d'Alfort, BioPôle Alfort, 94700 Maisons Alfort, France
| | - M Canonne-Guibert
- Ecole Nationale Vétérinaire d'Alfort, Unité de Médecine Interne, 94700 Maisons Alfort, France
| | - G Benchekroun
- Ecole Nationale Vétérinaire d'Alfort, Unité de Médecine Interne, 94700 Maisons Alfort, France
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Affiliation(s)
- Paul A Devine
- Regional Nephrology and Transplant Unit, Belfast City Hospital, Belfast, UK
| | - Aisling E Courtney
- Regional Nephrology and Transplant Unit, Belfast City Hospital, Belfast, UK
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Hemenway AN, Christensen A, Schriever C. Treatment considerations for potential uropathogens detected by precision microbiological testing. Am J Health Syst Pharm 2018; 75:1775-1782. [PMID: 30404894 DOI: 10.2146/ajhp180208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The clinical and microbiological data for urinary tract infections (UTIs) for 6 organisms detected by matrix-assisted laser desorption ionization time-of-flight (MALDI-TOF) at community health systems were examined. SUMMARY The use of precision microbiological diagnostic testing such as MALDI-TOF and real-time quantitative polymerase chain reaction has increased the ability to detect a wider spectrum of organisms. This has raised questions of the clinical relevance of infrequently encountered organisms, especially when cultured from urine. This article reviews clinical and microbiological data for UTIs for 6 organisms detected by MALDI-TOF at community health systems (Actinotignum schaalii, Chryseobacterium indologenes, Aerococcus urinae, Aerococcus sanguinicola, Corynebacterium riegelii, and Corynebacterium urealyticum). Since little information currently exists, most of the data associating the aforementioned organisms with UTIs were derived from case reports. Although these organisms are more readily identified using precision microbiological diagnostic testing methods, infection should not be assumed based on culture results alone since asymptomatic bacteriuria has been reported. Similar to more common urinary pathogens, clinical correlation is essential. To facilitate treatment, we provide a table of empirical options likely to achieve clinical success based on in vivo and in vitro data. If available, pathogen-specific susceptibility data should be used to direct therapy. CONCLUSION Clinical and microbiological data and potential treatment options were presented for 6 traditionally underrecognized organisms that are increasingly being found from urinary specimens. The treatment recommendations should be interpreted cautiously as they were devised through the use of very limited data.
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Affiliation(s)
- Alice N Hemenway
- Department of Pharmacy Practice, University of Illinois at Chicago College of Pharmacy, Rockford, IL
| | - Alyssa Christensen
- Department of Pharmacy Practice, University of Illinois at Chicago College of Pharmacy, Rockford, IL
| | - Christopher Schriever
- Department of Pharmacy Practice, University of Illinois at Chicago College of Pharmacy, Rockford, IL
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Identification and characterization of smallest pore-forming protein in the cell wall of pathogenic Corynebacterium urealyticum DSM 7109. BMC BIOCHEMISTRY 2018; 19:3. [PMID: 29743008 PMCID: PMC5944148 DOI: 10.1186/s12858-018-0093-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 04/30/2018] [Indexed: 11/30/2022]
Abstract
Background Corynebacterium urealyticum, a pathogenic, multidrug resistant member of the mycolata, is known as causative agent of urinary tract infections although it is a bacterium of the skin flora. This pathogenic bacterium shares with the mycolata the property of having an unusual cell envelope composition and architecture, typical for the genus Corynebacterium. The cell wall of members of the mycolata contains channel-forming proteins for the uptake of solutes. Results In this study, we provide novel information on the identification and characterization of a pore-forming protein in the cell wall of C. urealyticum DSM 7109. Detergent extracts of whole C. urealyticum cultures formed in lipid bilayer membranes slightly cation-selective pores with a single-channel conductance of 1.75 nS in 1 M KCl. Experiments with different salts and non-electrolytes suggested that the cell wall pore of C. urealyticum is wide and water-filled and has a diameter of about 1.8 nm. Molecular modelling and dynamics has been performed to obtain a model of the pore. For the search of the gene coding for the cell wall pore of C. urealyticum we looked in the known genome of C. urealyticum for a similar chromosomal localization of the porin gene to known porH and porA genes of other Corynebacterium strains. Three genes are located between the genes coding for GroEL2 and polyphosphate kinase (PKK2). Two of the genes (cur_1714 and cur_1715) were expressed in different constructs in C. glutamicum ΔporAΔporH and in porin-deficient BL21 DE3 Omp8 E. coli strains. The results suggested that the gene cur_1714 codes alone for the cell wall channel. The cell wall porin of C. urealyticum termed PorACur was purified to homogeneity using different biochemical methods and had an apparent molecular mass of about 4 kDa on tricine-containing sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE). Conclusions Biophysical characterization of the purified protein (PorACur) suggested indeed that cur_1714 is the gene coding for the pore-forming protein in C. urealyticum because the protein formed in lipid bilayer experiments the same pores as the detergent extract of whole cells. The study is the first report of a cell wall channel in the pathogenic C. urealyticum.
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In Vitro Antibiotic Susceptibility Pattern of Non-diphtheriae Corynebacterium Isolates in Ontario, Canada, from 2011 to 2016. Antimicrob Agents Chemother 2018; 62:AAC.01776-17. [PMID: 29339389 DOI: 10.1128/aac.01776-17] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 01/04/2018] [Indexed: 12/15/2022] Open
Abstract
Non-diphtheriae Corynebacterium-associated disease has been increasingly observed and often presents a conundrum to the treating physician. Analysis of antibiotic susceptibility testing data for 1,970 clinical Corynebacterium isolates received between 2011 and 2016 revealed that empirical drug treatment options are limited to vancomycin and linezolid. Corynebacterium striatum was the most frequently observed species during this study period, along with C. amycolatum and C. pseudodiphtheriticum/C. propinquum Low levels of susceptibility to penicillin (14.5%), erythromycin (15.1%), and clindamycin (8.7%) were observed for non-diphtheriae Corynebacterium species, while 3.0% of isolates were not susceptible to daptomycin. Similarly, 26.9% and 38.1% of Corynebacterium isolates were susceptible to ciprofloxacin and trimethoprim-sulfamethoxazole, respectively. Our data show much lower susceptibility to penicillin than previously reported in the literature and an increasing number of isolates resistant to daptomycin, highlighting the need for continued antibiotic surveillance studies for appropriate patient management and treatment success.
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29
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Hollyer I, Ison MG. The challenge of urinary tract infections in renal transplant recipients. Transpl Infect Dis 2018; 20:e12828. [PMID: 29272071 DOI: 10.1111/tid.12828] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 12/13/2017] [Accepted: 12/15/2017] [Indexed: 12/11/2022]
Abstract
Urinary tract infections (UTI) are an important cause of morbidity and mortality in renal transplant patients. These infections are quite common, and the goal of care is to identify and reduce risk factors while providing effective prophylaxis and treatment. Better understanding of long-term outcomes from these infections has led to the distinctions among UTI, recurrent UTI, and asymptomatic bacteriuria (ASB), and that each requires a different therapeutic approach. Specifically, new research has supported the perspective that asymptomatic bacteriuria should not be treated. Symptomatic UTI, on the other hand, requires intervention and remains an ongoing challenge for infectious disease clinicians. Many bacteria species are responsible for UTI in renal transplant patients, and in recent years there has been a global rise in infection caused by bacteria with newly acquired antibacterial resistance genes. Many renal transplant patients who experience UTI will also have multiple recurring episodes, which likely has a distinct pathophysiological mechanism leading to chronic colonization of the urinary tract. In these cases, long-term management includes bacterial suppression, which aims to reduce rather than eliminate bacteria to levels below the threshold for symptomatic infection. This review will address the current understanding of UTI epidemiology, pathogenesis, and risk factors in the renal transplant community, and also focus on current prevention and treatment strategies for patients who face an environment of increasingly antibiotic-resistant bacteria.
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Affiliation(s)
- Ian Hollyer
- Divisions of Infectious Diseases and Organ Transplantation, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Michael G Ison
- Divisions of Infectious Diseases and Organ Transplantation, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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30
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Meštrović T, Bedenić B, Wilson J, Ljubin-Sternak S, Sviben M, Neuberg M, Ribić R, Kozina G, Profozić Z. The impact of Corynebacterium glucuronolyticum on semen parameters: a prospective pre-post-treatment study. Andrology 2017; 6:223-229. [PMID: 29216684 DOI: 10.1111/andr.12453] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 10/22/2017] [Accepted: 11/07/2017] [Indexed: 11/28/2022]
Abstract
Corynebacterium glucuronolyticum (C. glucuronolyticum) is a rare isolate that is only recently being acknowledged as a potential urogenital pathogen. The bibliographical references on this bacterial species are scarce, and its influence on all semen parameters was hitherto unknown - therefore, the aim of this study was to evaluate its effects on a range of sperm quality parameters. A prospective approach to compare semen parameters before and after treatment was used in this study. C. glucuronolyticum in semen specimens was identified using analytical profile index biotyping system (API Coryne) and additionally confirmed by matrix-assisted laser desorption/ionization time-of-flight mass-spectrometry (MALDI-TOF MS), with the determination of antimicrobial susceptibility by Kirby-Bauer method. Semen analysis was performed according to the criteria from the World Health Organization (with the use of Tygerberg method of sperm morphology categorization). Very strict inclusion criteria for participants also included detailed medical history and urological evaluation. From a total of 2169 screened semen specimens, the inclusion rate for participants with C. glucuronolyticum that satisfied all the criteria was 1.01%. Antibiogram-guided treatment of the infection with ensuing microbiological clearance has shown that the resolution of the infection correlates with statistically significant improvement in the vitality of spermatozoa, but also with a lower number of neck and mid-piece defects. Parameters such as sperm count, motility and normal morphology were not affected. In addition, susceptibility testing revealed a trend towards ciprofloxacin resistance, which is something that should be considered when selecting an optimal treatment approach. Albeit it is rarely encountered as a monoisolate in significant quantities, C. glucuronolyticum may negatively influence certain sperm parameters; therefore, it has to be taken into account in the microbiological analysis of urogenital samples.
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Affiliation(s)
- T Meštrović
- Clinical Microbiology and Parasitology Unit, Polyclinic 'Dr. Zora Profozić', Zagreb, Croatia.,Department of Biomedical Sciences, University Centre Varaždin, University North, Varaždin, Croatia
| | - B Bedenić
- Medical Microbiology Department, School of Medicine, University of Zagreb, Zagreb, Croatia.,Department of Clinical and Molecular Microbiology, University Hospital Centre Zagreb, Zagreb, Croatia
| | - J Wilson
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - S Ljubin-Sternak
- Medical Microbiology Department, School of Medicine, University of Zagreb, Zagreb, Croatia.,Clinical Microbiology Department, Teaching Institute of Public Health 'Dr Andrija Štampar', Zagreb, Croatia
| | - M Sviben
- Medical Microbiology Department, School of Medicine, University of Zagreb, Zagreb, Croatia.,Microbiology Service, Croatian National Institute of Public Health, Zagreb, Croatia
| | - M Neuberg
- Department of Biomedical Sciences, University Centre Varaždin, University North, Varaždin, Croatia
| | - R Ribić
- Research and Development Sector, TESLA d.o.o., Ivanec, Croatia
| | - G Kozina
- Department of Biomedical Sciences, University Centre Varaždin, University North, Varaždin, Croatia
| | - Z Profozić
- Clinical Microbiology and Parasitology Unit, Polyclinic 'Dr. Zora Profozić', Zagreb, Croatia
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Liu F, Ling Z, Xiao Y, Yang Q, Zheng L, Jiang P, Li L, Wang W. Characterization of the urinary microbiota of elderly women and the effects of type 2 diabetes and urinary tract infections on the microbiota. Oncotarget 2017; 8:100678-100690. [PMID: 29246012 PMCID: PMC5725054 DOI: 10.18632/oncotarget.21126] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Accepted: 09/05/2017] [Indexed: 12/21/2022] Open
Abstract
Evidence shows that urine has complex bacterial profiles with considerable variation between individuals. Aging and age-related conditions can lead to the changes to the composition of urine, which means that the available nutrition for bacteria in the bladder changes with age. We explored the characteristics of the urinary microbiota of elderly women and whether these are associated with age-related conditions such as diabetes and urinary tract infections. An elderly and a non-elderly cohort of women were included. Magnetic beads were used to isolate bacterial genomic DNA, which was analyzed based on the V3-V4 hypervariable region of the 16S rRNA gene. There were significant differences between the elderly and non-elderly regarding thirteen genera of bacteria. For example, the relative abundance of Lactobacillus was dramatically reduced in the elderly compared with the non-elderly; it also decreased with age in the elderly cohort and it was not correlated with urine pH. The relative abundance of Peptococcus increased with age in the elderly while the abundance of Bifidobacteria decreased with age. The abundance of Escherichia coli was the same in the two cohorts, and it increased with water intake and was not associated with urinary tract infection events. Higher levels of Lactobacillus (including Lactobacillus iners) in the elderly were associated with diabetes, and lower levels of Peptoniphilus and Dialister were correlated with asymptomatic bacteriuria. The urinary microbiota of women is affected by ageing, type 2 diabetes mellitus and asymtomatic bacteriuria.
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Affiliation(s)
- Fengping Liu
- Department of Urology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310003, China
- Nursing Department, Jiangsu Vocational College of Medicine, Yancheng, Jiangsu, 224005, China
| | - Zongxin Ling
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310003, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310003, China
| | - Yonghong Xiao
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310003, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310003, China
| | - Qing Yang
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310003, China
| | - Li Zheng
- Department of Urology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310003, China
| | - Ping Jiang
- Department of Urology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310003, China
| | - Lanjuan Li
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310003, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310003, China
| | - Wei Wang
- Department of Urology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310003, China
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Bazzi AM, Al-Tawfiq JA, Rabaan AA. Misinterpretation of Gram Stain from the Stationary Growth Phase of Positive Blood Cultures for Brucella and Acinetobacter Species. Open Microbiol J 2017; 11:126-131. [PMID: 28839492 PMCID: PMC5543624 DOI: 10.2174/1874285801711010126] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2017] [Revised: 04/21/2017] [Accepted: 04/22/2017] [Indexed: 01/12/2023] Open
Abstract
Introduction: Acinetobacter baumannii and Brucella species are Gram-negative organisms that are vulnerable to misinterpretation as Gram-positive or Gram-variable in blood cultures. Objective: We assess the random errors in gram stain interpretation to reduce the likelihood of such errors and therefore patient harm. Methodology: Aerobic and anaerobic blood cultures from two patients in an acute care facility in Saudi Arabia were subjected to preliminary Gram-staining. In case 1, VITEK-2 Anaerobe Identification, repeat Gram staining from a blood agar plate, Remel BactiDrop™ Oxidase test, Urea Agar urease test and real-time PCR were used to confirm presence of Brucella and absence of Coryneform species. In case 2, repeat Gram- staining from the plate and the vials, VITEK-2 Gram-Negative Identification, real-time PCR and subculture on to Columbia agar, blood agar, and MacConkey agar were carried out to identify A. baumannii. Results: In case 1, initially pleomorphic Gram-positive bacteria were identified. Coryneform species were suspected. Tiny growth was observed after 24 h on blood agar plates, and good growth by 48 h. Presence of Brucella species was ultimately confirmed. In case 2, preliminary Gram-stain results suggested giant Gram-positive oval cocci. Further testing over 18-24 h identified A. baumannii. Conclusions: Oxidase test from the plate and urease test from the culture vial is recommended after apparent identification of pleomorphic Gram-positive bacilli from blood culture, once tiny growth is observed, to distinguish Brucella from Corynebacterium species. If giant Gram-positive oval cocci are indicated by preliminary Gram-staining, it is recommended that the Gram stain be repeated from the plate after 4-6 h, or culture should be tested in Triple Sugar Iron (TSI) medium and the Gram stain repeated after 2-4 h incubation.
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Affiliation(s)
- Ali M Bazzi
- Microbiology Lab, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
| | - Jaffar A Al-Tawfiq
- Specialty Internal Medicine, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia.,Department of Medicine Indiana University School of Medicine, Indianapolis, IN, USA
| | - Ali A Rabaan
- Molecular Diagnostic Lab, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
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Gram-Positive Uropathogens, Polymicrobial Urinary Tract Infection, and the Emerging Microbiota of the Urinary Tract. Microbiol Spectr 2017; 4. [PMID: 27227294 DOI: 10.1128/microbiolspec.uti-0012-2012] [Citation(s) in RCA: 200] [Impact Index Per Article: 28.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Gram-positive bacteria are a common cause of urinary-tract infection (UTI), particularly among individuals who are elderly, pregnant, or who have other risk factors for UTI. Here we review the epidemiology, virulence mechanisms, and host response to the most frequently isolated Gram-positive uropathogens: Staphylococcus saprophyticus, Enterococcus faecalis, and Streptococcus agalactiae. We also review several emerging, rare, misclassified, and otherwise underreported Gram-positive pathogens of the urinary tract including Aerococcus, Corynebacterium, Actinobaculum, and Gardnerella. The literature strongly suggests that urologic diseases involving Gram-positive bacteria may be easily overlooked due to limited culture-based assays typically utilized for urine in hospital microbiology laboratories. Some UTIs are polymicrobial in nature, often involving one or more Gram-positive bacteria. We herein review the risk factors and recent evidence for mechanisms of bacterial synergy in experimental models of polymicrobial UTI. Recent experimental data has demonstrated that, despite being cleared quickly from the bladder, some Gram-positive bacteria can impact pathogenic outcomes of co-infecting organisms. When taken together, the available evidence argues that Gram-positive bacteria are important uropathogens in their own right, but that some can be easily overlooked because they are missed by routine diagnostic methods. Finally, a growing body of evidence demonstrates that a surprising variety of fastidious Gram-positive bacteria may either reside in or be regularly exposed to the urinary tract and further suggests that their presence is widespread among women, as well as men. Experimental studies in this area are needed; however, there is a growing appreciation that the composition of bacteria found in the bladder could be a potentially important determinant in urologic disease, including susceptibility to UTI.
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The successful management of a case of extensive alkaline-encrusted pyelitis in native kidneys. JOURNAL OF CLINICAL UROLOGY 2017. [DOI: 10.1177/2051415814539325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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35
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[Encrusted cystitis by Corynebacterium urealyticum]. Med Mal Infect 2016; 47:167-170. [PMID: 27955880 DOI: 10.1016/j.medmal.2016.11.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 11/14/2016] [Indexed: 02/06/2023]
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Abstract
OBJECTIVE To evaluate the vaginal and cervical microbiota in women with spinal cord injury compared with mobile women. METHODS Fifty-two women with spinal cord injury (study group) and 57 mobile women (control group) were evaluated in a case-control study. All answered a structured questionnaire and were submitted to the following microbiological tests: microscopic examination of vaginal secretions for Trichomonas vaginalis and yeasts, Nugent score by Gram stain, bacterial culture, yeast culture, and endocervical sampling for Chlamydia trachomatis, Neisseria gonorrhoeae, and Mycoplasma species. RESULTS Candida species detected by direct microscopic examination of vaginal fluid was more common in women with spinal cord injuries than in control women: 17.3% (9/52) compared with 3.5% (2/57), respectively (P=.017). However, the frequency of yeast-positive cultures was similar in both groups (21.2% [10/52] compared with 15.8% [14/57]). Women with spinal cord injury were more likely to have positive vaginal cultures for Escherichia coli (15.4% [8/52] compared with 0% [0/57], P=.002) and Corynebacterium species (25.0% [13/52] compared with 8.8% [5/57], P=.037) and less likely for Lactobacillus species (63.5% [33/52] compared with 94.7% [54/57], P<.001). Women with spinal cord injury were more likely to have intermediate flora by Gram stain (Nugent score 4-6) than did the women in the control group (13.5% [7/52] compared with 1.8% [1/57], P=.033). The frequency of Mycoplasma species detection was similar in both groups (36.9% [18/52] compared with 34.6% [21/57]). No woman in either group was positive for T vaginalis, C trachomatis, or N gonorrhoeae. CONCLUSION Women with spinal cord injury have an alteration in their vaginal microbiota away from a Lactobacillus species-dominated flora and a higher concentration of vaginal Candida species than do mobile women.
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Saljoghi R, Lipsker A, Caillet K, Malaterre J, Le Roux F, Pignot G, Saint F. Encrusted Uretero-pyelitis: Case Report. Urol Case Rep 2016; 7:58-60. [PMID: 27335796 PMCID: PMC4909632 DOI: 10.1016/j.eucr.2016.04.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2016] [Accepted: 04/21/2016] [Indexed: 12/14/2022] Open
Abstract
Encrusted uretero-pyelitis is a rare and serious disease, related to the presence of calcifications in the pelvicalyceal system and ureter, associated with chronic urinary tract infection. In most cases, the causal agent of this infection lithiasis is corynebacterium urealyticum. The specific aspect of calcifications on CT scan can help to suggest diagnosis. To avoid a delay in diagnosis (which is frequent), an accurate exploration by the bacteriologist is crucial. The combination of a glycopeptides antibiotherapy and urine acidification has proved its effectiveness, as described in the medical literature. We report the case of a 77-year-old male patient, successfully treated for a bilateral encrusted uretero-pyelitis by local acidification (Thomas's solution) followed by oral acidification (ammonium chloride).
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Affiliation(s)
- Romain Saljoghi
- Urology & Transplantation Department, Amiens University Hospital, University of Picardie Jules Verne, CHU d'Amiens, Avenue R.-Laennec, 80054 Amiens cedex 1, France
| | - Allan Lipsker
- Urology & Transplantation Department, Amiens University Hospital, University of Picardie Jules Verne, CHU d'Amiens, Avenue R.-Laennec, 80054 Amiens cedex 1, France
| | - Kévin Caillet
- Urology & Transplantation Department, Amiens University Hospital, University of Picardie Jules Verne, CHU d'Amiens, Avenue R.-Laennec, 80054 Amiens cedex 1, France
| | - Josselin Malaterre
- Urology & Transplantation Department, Amiens University Hospital, University of Picardie Jules Verne, CHU d'Amiens, Avenue R.-Laennec, 80054 Amiens cedex 1, France
| | - Fabien Le Roux
- Digestive & Metabolic Surgery Department, Amiens University Hospital, CHU d'Amiens, Avenue R.-Laennec, 80054 Amiens cedex 1, France
| | - Géraldine Pignot
- Urology Department, Institut Paoli Calmettes, 232 Boulevard de Sainte-Marguerite, 13009 Marseille, France
| | - Fabien Saint
- Urology & Transplantation Department, Amiens University Hospital, University of Picardie Jules Verne, CHU d'Amiens, Avenue R.-Laennec, 80054 Amiens cedex 1, France
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Tauch A, Fernández-Natal I, Soriano F. A microbiological and clinical review on Corynebacterium kroppenstedtii. Int J Infect Dis 2016; 48:33-9. [PMID: 27155209 DOI: 10.1016/j.ijid.2016.04.023] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Revised: 04/27/2016] [Accepted: 04/28/2016] [Indexed: 11/18/2022] Open
Abstract
The genus Corynebacterium represents a taxon of Gram-positive bacteria with a high G+C content in the genomic DNA. Corynebacterium kroppenstedtii is an unusual member of this taxon as it lacks the characteristic mycolic acids in the cell envelope. Genome sequence analysis of the C. kroppenstedtii type strain has revealed a lipophilic (lipid-requiring) lifestyle and a remarkable repertoire of carbohydrate uptake and utilization systems. Clinical isolates of C. kroppenstedtii have been obtained almost exclusively from female patients and mainly from breast abscesses and cases of granulomatous mastitis. However, the role of C. kroppenstedtii in breast pathologies remains unclear. This review provides a comprehensive overview of the taxonomy, microbiology, and microbiological identification of C. kroppenstedtii, including polyphasic phenotypic approaches, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry, and the use of 16S rRNA gene sequencing. A clinical review presents reported cases, various antimicrobial treatments, antibiotic susceptibility assays, and antibiotic resistance genes detected during genome sequencing. C. kroppenstedtii must be considered a potential opportunistic human pathogen and should be identified accurately in clinical laboratories.
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Affiliation(s)
- Andreas Tauch
- Centrum für Biotechnologie (CeBiTec), Universität Bielefeld, Bielefeld, Germany
| | - Isabel Fernández-Natal
- Department of Clinical Microbiology, Complejo Asistencial Universitario de León, calle Altos de Nava, s/n, 24080 León, Spain; Institute of Biomedicine (IBIOMED), León, Spain.
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Sánchez-Martín F, López-Martínez J, Kanashiro-Azabache A, Moncada E, Angerri-Feu O, Millán-Rodríguez F, Villavicencio-Mavrich H. Corinebacterium urealyticum: increased incidence of infection and encrusted uropathy. Actas Urol Esp 2016; 40:102-7. [PMID: 26585531 DOI: 10.1016/j.acuro.2015.09.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Revised: 09/17/2015] [Accepted: 09/18/2015] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Corynebacterium urealyticum (CU) affects patients who are immunosuppressed, chronically ill or have undergone numerous operations. Obstructive uropathy (OU) is a complication of infection. STUDY OBJECTIVE To demonstrate the growing increase in cases of infection by CU and OU in the past 5 years. MATERIAL AND METHODS A descriptive study was conducted of urological patients with CU-positive urine cultures (January 2009-December 2014). We calculated the annual distribution and clinical characteristics of infection by CU and OU. Minimum follow-up: 6 months. We obtained the statistical means and ranges of clinical parameters pre/post-therapy. RESULTS The total number of patients with CU was 115 (men, 87; women, 28). The mean age was 67.9 years (range, 6-95 years), and the annual distribution of cases for 2009, 2010, 2011, 2012, 2013 and 2014 was 9 (7.8%), 13 (11.3%), 9 (7.8%), 20 (17.4%), 31 (27%) and 33 (28.7%), respectively. The increase in cases for 2009-2014 was 300%. Multiple urological surgeries were performed in 89 cases (77.3%), with surgical complications in 77 cases (66.9%). Eighteen (15.6%) patients had OU (men, 13; women, 5), 12 had pyelitis (66.7%), 3 had cystopathy (16.6%), 2 had prostatic capsule disease (11.2%) and 1 had mesh calcification (5.5%). The analysis of the 18 cases with OU showed pre/postantibiotic therapy urine pHs of 8 (r, 6-9) vs. 6 (r, 5-7). All postantibiotic cultures were negative. Acidifying solution was applied in 5 cases, and surgery was performed in 13 cases (72.2%). The results from before/after the multimodal therapy showed renal impairment in 12 (66.6%) vs. 9 cases (50%) and glomerular filtration rates (GFR) of 45.8 (r, 6->90) vs. 52.7 (r, 13->90). The improvement in GFR was 6.94 points (T Wilcoxon; P=.102). The radiology results (incrustations) showed improvement in 13 patients (72.2%) and no change in 5 (27.8%). There was no specific mortality for CU. CONCLUSIONS The prevalence of infection by CU and OU is increasing. Antibiotic treatment is highly effective. Acidifying solutions are an acceptable option for reducing calcifications.
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Guimarães L, Soares S, Trost E, Blom J, Ramos R, Silva A, Barh D, Azevedo V. Genome informatics and vaccine targets in Corynebacterium urealyticum using two whole genomes, comparative genomics, and reverse vaccinology. BMC Genomics 2015; 16 Suppl 5:S7. [PMID: 26041051 PMCID: PMC4460590 DOI: 10.1186/1471-2164-16-s5-s7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Corynebacterium urealyticum is an opportunistic pathogen that normally lives on skin and mucous membranes in humans. This high Gram-positive bacteria can cause acute or encrusted cystitis, encrusted pyelitis, and pyelonephritis in immunocompromised patients. The bacteria is multi-drug resistant, and knowledge about the genes that contribute to its virulence is very limited. Two complete genome sequences were used in this comparative genomic study: C. urealyticum DSM 7109 and C. urealyticum DSM 7111. RESULTS We used comparative genomics strategies to compare the two strains, DSM 7109 and DSM 7111, and to analyze their metabolic pathways, genome plasticity, and to predict putative antigenic targets. The genomes of these two strains together encode 2,115 non-redundant coding sequences, 1,823 of which are common to both genomes. We identified 188 strain-specific genes in DSM 7109 and 104 strain-specific genes in DSM 7111. The high number of strain-specific genes may be a result of horizontal gene transfer triggered by the large number of transposons in the genomes of these two strains. Screening for virulence factors revealed the presence of the spaDEF operon that encodes pili forming proteins. Therefore, spaDEF may play a pivotal role in facilitating the adhesion of the pathogen to the host tissue. Application of the reverse vaccinology method revealed 19 putative antigenic proteins that may be used in future studies as candidate drug or vaccine targets. CONCLUSIONS The genome features and the presence of virulence factors in genomic islands in the two strains of C. urealyticum provide insights in the lifestyle of this opportunistic pathogen and may be useful in developing future therapeutic strategies.
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Salem N, Salem L, Saber S, Ismail G, Bluth MH. Corynebacterium urealyticum: a comprehensive review of an understated organism. Infect Drug Resist 2015; 8:129-45. [PMID: 26056481 PMCID: PMC4445954 DOI: 10.2147/idr.s74795] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Corynebacterium urealyticum is a Gram positive, slow-growing, lipophilic, multi-drug resistant, urease positive micro-organism with diphtheroid morphology. It has been reported as an opportunistic nosocomial pathogen and as the cause of a variety of diseases including but not limited to cystitis, pyelonephritis, and bacteremia among others. This review serves to describe C. urealyticum with respect to its history, identification, laboratory investigation, relationship to disease and treatment in order to allow increased familiarity with this organism in clinical disease.
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Affiliation(s)
- Nagla Salem
- Department of Pathology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Lamyaa Salem
- Department of Clinical and Chemical Pathology, Ain Shams University, Cairo, Egypt
| | - Sally Saber
- Department of Clinical and Chemical Pathology, Ain Shams University, Cairo, Egypt
| | - Ghada Ismail
- Department of Clinical and Chemical Pathology, Ain Shams University, Cairo, Egypt
| | - Martin H Bluth
- Department of Pathology, Wayne State University School of Medicine, Detroit, MI, USA
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Whiteside SA, Razvi H, Dave S, Reid G, Burton JP. The microbiome of the urinary tract--a role beyond infection. Nat Rev Urol 2015; 12:81-90. [PMID: 25600098 DOI: 10.1038/nrurol.2014.361] [Citation(s) in RCA: 374] [Impact Index Per Article: 41.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Urologists rarely need to consider bacteria beyond their role in infectious disease. However, emerging evidence shows that the microorganisms inhabiting many sites of the body, including the urinary tract--which has long been assumed sterile in healthy individuals--might have a role in maintaining urinary health. Studies of the urinary microbiota have identified remarkable differences between healthy populations and those with urologic diseases. Microorganisms at sites distal to the kidney, bladder and urethra are likely to have a profound effect on urologic health, both positive and negative, owing to their metabolic output and other contributions. Connections between the gut microbiota and renal stone formation have already been discovered. In addition, bacteria are also used in the prevention of bladder cancer recurrence. In the future, urologists will need to consider possible influences of the microbiome in diagnosis and treatment of certain urological conditions. New insights might provide an opportunity to predict the risk of developing certain urological diseases and could enable the development of innovative therapeutic strategies.
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Affiliation(s)
- Samantha A Whiteside
- Department of Microbiology and Immunology, The University of Western Ontario, 1151 Richmond Street, London, ON N6A 3K7, Canada
| | - Hassan Razvi
- Division of Urology, Department of Surgery, The University of Western Ontario, 1151 Richmond Street, London, ON N6A 3K7, Canada
| | - Sumit Dave
- Division of Urology, Department of Surgery, The University of Western Ontario, 1151 Richmond Street, London, ON N6A 3K7, Canada
| | - Gregor Reid
- Canadian Centre for Human Microbiome and Probiotic Research, Lawson Health Research Institute, 268 Grosvenor Street, London, ON N6A 4V2, Canada
| | - Jeremy P Burton
- Division of Urology, Department of Surgery, The University of Western Ontario, 1151 Richmond Street, London, ON N6A 3K7, Canada
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Curry CR, Saluja K, Das S, Thakral B, Dangle P, Keeler TC, Watkin WG. Encrusted Cystitis Secondary to Corynebacterium glucuronolyticum in a 57-Year-Old Man Without Predisposing Factors. Lab Med 2015; 46:136-9. [PMID: 25918192 DOI: 10.1309/lmxqp557einxbxif] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Encrusted cystitis is a rare condition characterized by encrustation of the bladder mucosa with associated chronic inflammation induced by urea-splitting bacterial infection--most commonly, Corynebacterium urealyticum. Moreover, it usually occurs in immunocompromised patients, especially recipients of renal transplants or patients with a history of previous urological procedures. Due to the rarity of the entity and the slow growth of Corynebacterium species, appropriate treatment is often delayed due to difficulties in diagnosis and resistance to numerous antibiotics. We report a case of encrusted cystitis caused by Corynebacterium glucuronolyticum, another urea-splitting microbe, in a 57-year-old previously healthy Caucasian man with no known predisposing factors. The timely diagnosis and management in this otherwise healthy patient was facilitated by characteristic imaging, cystoscopy, and histologic findings confirmed by results of prolonged urine cultures and 16S ribosomal RNA (rRNA) gene sequencing of the microbe.
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Affiliation(s)
- Chelsea R Curry
- Department of Pathology and Laboratory Medicine, University of Chicago Pritzker School of Medicine, Chicago, Illinois and NorthShore University HealthSystem, Evanston, Illinois
| | - Karan Saluja
- Department of Pathology and Laboratory Medicine, University of Chicago Pritzker School of Medicine, Chicago, Illinois and NorthShore University HealthSystem, Evanston, Illinois
| | - Sanchita Das
- Department of Pathology and Laboratory Medicine, University of Chicago Pritzker School of Medicine, Chicago, Illinois and NorthShore University HealthSystem, Evanston, Illinois
| | - Beenu Thakral
- Department of Pathology and Laboratory Medicine, University of Chicago Pritzker School of Medicine, Chicago, Illinois and NorthShore University HealthSystem, Evanston, Illinois
| | - Pankaj Dangle
- Division of Urology, University of Chicago Pritzker School of Medicine, Chicago, Illinois and NorthShore University HealthSystem, Evanston, Illinois
| | - Thomas C Keeler
- Division of Urology, University of Chicago Pritzker School of Medicine, Chicago, Illinois and NorthShore University HealthSystem, Evanston, Illinois
| | - William G Watkin
- Department of Pathology and Laboratory Medicine, University of Chicago Pritzker School of Medicine, Chicago, Illinois and NorthShore University HealthSystem, Evanston, Illinois
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Milse J, Petri K, Rückert C, Kalinowski J. Transcriptional response of Corynebacterium glutamicum ATCC 13032 to hydrogen peroxide stress and characterization of the OxyR regulon. J Biotechnol 2014; 190:40-54. [DOI: 10.1016/j.jbiotec.2014.07.452] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Revised: 07/22/2014] [Accepted: 07/29/2014] [Indexed: 11/26/2022]
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Complete Genome Assembly of Corynebacterium sp. Strain ATCC 6931. GENOME ANNOUNCEMENTS 2014; 2:2/5/e01074-14. [PMID: 25342684 PMCID: PMC4208328 DOI: 10.1128/genomea.01074-14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The genus Corynebacterium is best known for the pathogen C. diphtheriae; however, it contains mostly commensal and nonpathogenic, as well as several opportunistic, pathogens. Here, we present the 2.47-Mb scaffolded assembly of the type strain, Corynebacterium sp. ATCC 6931 (NCTC 1914), as deposited into GenBank under accession number CP008913.
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Nephrolithiasis by Corynebacterium urealyticum infection: literature review and case report. J Nephrol 2014; 27:117-25. [DOI: 10.1007/s40620-014-0064-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2013] [Accepted: 03/26/2013] [Indexed: 10/25/2022]
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Affiliation(s)
- N Anagnostou
- Department of Microbiology and Infectious Diseases, Flinders University, Adelaide, South Australia, Australia
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Complete Genome Sequence of Corynebacterium urealyticum Strain DSM 7111, Isolated from a 9-Year-Old Patient with Alkaline-Encrusted Cystitis. GENOME ANNOUNCEMENTS 2013; 1:1/3/e00264-13. [PMID: 23704183 PMCID: PMC3662823 DOI: 10.1128/genomea.00264-13] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Corynebacterium urealyticum is a common skin colonizer with potent urease activity. It is clinically recognized as an opportunistic pathogen causing urinary tract infections. The annotated genome sequence of strain DSM 7111, isolated from the urine of a young boy with an ectopic kidney, provides new insights into the pathomechanisms of this bacterium.
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Biegen VR, Slusser PG, Fischetti AJ, Geist MR. Successful treatment of encrusted cystitis associated withStaphylococcus pseudintermediusinfection in the urinary bladder of a dog. J Am Vet Med Assoc 2013; 242:798-802. [DOI: 10.2460/javma.242.6.798] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Johnson MH, Strope SA. Encrusted cystitis. Urology 2012; 79:e31-2. [PMID: 22386439 DOI: 10.1016/j.urology.2011.12.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2011] [Revised: 12/08/2011] [Accepted: 12/12/2011] [Indexed: 12/20/2022]
Abstract
We report a case of a patient who developed encrusted cystitis after transurethral resection of the prostate. This rare urological condition is characterized by intramucosal calcifications and is commonly preceded by urological instrumentation. Urea-splitting bacteria, most commonly Corynebacterium urealyticum, are the causative pathogen. Treatment is a combination of antibiotics, urine acidification, and endoscopic removal of encrustations.
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Affiliation(s)
- Michael H Johnson
- Division of Urologic Surgery, Barnes-Jewish Hospital/Washington University School of Medicine, St. Louis, MO 63110, USA
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