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Reviewing the Emergence of Lactococcus garvieae: A Case of Catheter Associated Urinary Tract Infection Caused by Lactococcus garvieae and Escherichia coli Coinfection.

ABSTRACT: Lactococcus garvieae is considered a low virulence organism which is rarely associated with human infections. Most of the reported cases have been associated with bacteremia with or without endocarditis. We report a rare case of catheter associated urinary tract infection (CAUTI) caused by Lactococcus garvieae and Escherichia coli coinfection without any bacteremia in a patient with indwelling urinary catheter placed for benign prostatic hyperplasia (BPH). The patient also had a history of gastroesophageal reflux disease (GERD) with long standing famotidine treatment. In our case, Lactococcus garvieae was initially misidentified as Enterococcus species but was later detected by automated microbial identification system VITEK-2 (BioMerieux, Marcy-l'Étoile, France) and was confirmed with API 32 Strep system (BioMerieux, Marcy-l'Étoile, France). The patient responded well to a two-week course of cephalosporin. Interestingly, apart from the acid suppressive treatment, no other risk factors were identified.

SUBMITTER: Choksi TT

PROVIDER: S-EPMC5546070 | biostudies-other | 2017

REPOSITORIES: biostudies-other

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Project description:Escherichia coli is the leading cause of urinary tract infections (UTIs) in children and adults. The gastrointestinal tract is the primary reservoir of uropathogenic E. coli, which can be acquired from a variety of environmental exposures, including retail meat. In the current study, we used a novel statistical-genomic approach to estimate the proportion of pediatric UTIs caused by foodborne zoonotic E. coli strains. E. coli urine isolates were collected from DC residents aged 2 months to 17 years from the Children's National Medical Center Laboratory, 2013-2014. During the same period, E. coli isolates were collected from retail poultry products purchased from 15 sites throughout DC. A total of 52 urine and 56 poultry isolates underwent whole-genome sequencing, core genome phylogenetic analysis, and host-origin prediction by a Bayesian latent class model that incorporated data on the presence of mobile genetic elements (MGEs) among E. coli isolates from multiple vertebrate hosts. A total of 56 multilocus sequence types were identified among the isolates. Five sequence types-ST10, ST38, ST69, ST117, and ST131-were observed among both urine and poultry isolates. Using the Bayesian latent class model, we estimated that 19% (10/52) of the clinical E. coli isolates in our population were foodborne zoonotic strains. These data suggest that a substantial portion of pediatric UTIs in the Washington DC region may be caused by E. coli strains originating in food animals and likely transmitted via contaminated poultry meat.IMPORTANCEEscherichia coli UTIs are a heavy public health burden and can have long-term negative health consequences for pediatric patients. E. coli has an extremely broad host range, including humans, chickens, turkeys, pigs, and cattle. E. coli derived from food animals is a frequent contaminant of retail meat products, but little is known about the risk these strains pose to pediatric populations. Quantifying the proportion of pediatric UTIs caused by food-animal-derived E. coli, characterizing the highest-risk strains, and identifying their primary reservoir species could inform novel intervention strategies to reduce UTI burden in this vulnerable population. Our results suggest that retail poultry meat may be an important vehicle for pediatric exposure to zoonotic E. coli strains capable of causing UTIs. Vaccinating poultry against the highest-risk strains could potentially reduce poultry colonization, poultry meat contamination, and downstream pediatric infections.

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Reviewing the Emergence of Lactococcus garvieae: A Case of Catheter Associated Urinary Tract Infection Caused by Lactococcus garvieae and Escherichia coli Coinfection.

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