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Actinobaculum schaalii an emerging pediatric pathogen?

Petra Zimmermann¹, Livia Berlinger, Benjamin Liniger

¹Department of Paediatrics, University Children's Hospital, Berne, Switzerland.

BMC Infectious Diseases

|August 30, 2012

Summary

Actinobaculum schaalii, a bacterium causing urinary tract infections (UTIs), is increasingly seen in children. Early identification and appropriate antibiotic treatment are crucial for successful outcomes in pediatric patients.

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Area of Science:

Pediatric infectious diseases
Microbiology
Urology

Background:

Actinobaculum schaalii, identified in 1997, primarily causes urinary tract infections (UTIs) in elderly individuals with urological conditions.
Diagnosis of A. schaalii infections often requires specialized molecular techniques due to challenges in isolation and identification.
Limited data exists on A. schaalii infections in pediatric populations, highlighting a gap in current medical knowledge.

Observation:

A case study involved an 8-month-old boy with myelomeningocele and a neurogenic bladder presenting with a UTI.
Urinalysis revealed elevated leukocyte esterase, pyuria, and significant bacteriuria, despite a normal urinary tract ultrasound.
Initial empiric treatment with co-trimoxazole was administered, followed by amoxicillin after molecular confirmation of A. schaalii.

Findings:

Small colonies of Gram-positive rods were observed after 48 hours of incubation.
16S rRNA gene sequencing confirmed the presence of Actinobaculum schaalii, necessitating a change in antibiotic therapy.
The patient showed a positive response to amoxicillin, with normal urinalysis and negative urine cultures upon follow-up.

Implications:

Actinobaculum schaalii is recognized as an emerging pathogen affecting both adults and children.
Patient age appears to influence colonization and subsequent infection by A. schaalii.
Healthcare providers should consider A. schaalii in pediatric UTI cases, particularly in infants using diapers or those with congenital urogenital abnormalities, and select empiric antibiotics accordingly.