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Actinotignum schaalii Infection: A Clandestine Cause of Sterile Pyuria?

Lucy E Horton1, Sanjay R Mehta1, Lejla Aganovic2

  • 1Department of Medicine, VA San Diego Healthcare System and University of California, San Diego, School of Medicine, San Diego, California.

Open Forum Infectious Diseases
|February 17, 2018
PubMed

Insights

Actinotignum schaalii frequently causes urinary tract infections (UTIs) in elderly patients, often leading to missed diagnoses and complications. This bacterium is naturally resistant to common UTI treatments, necessitating alternative therapeutic strategies.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Geriatrics

Background:

  • Urinary tract infections (UTIs) are common, particularly in older adults.
  • Actinotignum schaalii is an emerging pathogen in UTIs, often overlooked due to diagnostic challenges.
  • Intrinsic antibiotic resistance of A. schaalii complicates UTI management.

Purpose of the Study:

  • To highlight Actinotignum schaalii as an underappreciated cause of UTIs in the elderly.
  • To emphasize the diagnostic difficulties associated with A. schaalii.
  • To underscore the clinical implications of A. schaalii's antibiotic resistance.

Main Methods:

  • Case presentation of a patient with A. schaalii UTI.
  • Review of diagnostic methods for Actinotignum species.
  • Discussion of antimicrobial susceptibility patterns.

Main Results:

  • A. schaalii was identified as the causative agent of UTI.
  • The organism proved difficult to isolate and identify using standard laboratory procedures.
  • A. schaalii demonstrated intrinsic resistance to commonly prescribed UTI antibiotics.

Conclusions:

  • Actinotignum schaalii is a significant, yet underdiagnosed, cause of UTIs in older adults.
  • Diagnostic protocols may need refinement to improve A. schaalii detection.
  • Treatment strategies for A. schaalii UTIs require careful consideration of antibiotic resistance.
Keywords:
Actinotignum schaaliichronic prostatitisepididymitisorchitisurinary tract infection (UTI)

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