Journal of Global Infectious Diseases

LETTER TO EDITOR
Year
: 2016  |  Volume : 8  |  Issue : 4  |  Page : 160-

Comment on: A case of Aerococcus urinae vertebral osteomyelitis


Erik Senneby 
 Department of Clinical Sciences, Division for Infection Medicine, Lund University, Lund, Sweden

Correspondence Address:
Erik Senneby
Department of Clinical Sciences, Division for Infection Medicine, Lund University, Lund
Sweden




How to cite this article:
Senneby E. Comment on: A case of Aerococcus urinae vertebral osteomyelitis.J Global Infect Dis 2016;8:160-160


How to cite this URL:
Senneby E. Comment on: A case of Aerococcus urinae vertebral osteomyelitis. J Global Infect Dis [serial online] 2016 [cited 2019 Oct 20 ];8:160-160
Available from: http://www.jgid.org/text.asp?2016/8/4/160/192964


Full Text

Sir,

I read with interest the report entitled "A case of Aerococcus urinae vertebral osteomyelitis" by Jerome et al.[1] published in Journal of Global Infectious Diseases, Volume 7, issue 2. The authors describe a 37-year-old male with back pain, who was diagnosed with spondylodiscitis. The bone specimen cultures grew, according to the authors, A. urinae. Case reports that describe rare but serious conditions caused by aerococci are important and add valuable information to the field.

Jerome et al. claim that their case is the first reported. Vertebral osteomyelitis, more commonly denoted spondylitis, caused by aerococci is a rare condition, but it has been described at least three times previously.[2],[3],[4] Aerococci have been hard to classify, and misidentification has occurred frequently.[4],[5] It is, therefor, important to use reliable identification methods to identify aerococci such as matrix-assisted laser desorption ionization - time of flight mass spectrometry or sequencing of 16S rRNA gene. The species identification method described in the case report by Jerome et al. is not sufficient to separate aerococcal species from each other. It is, therefor, not possible to securely claim A. urinae as the causative agent to this case of spondylodiscitis. Moreover, spondylodiscitis is potentially a complication to infective endocarditis, and it would be valuable to know if blood cultures were collected and if any additional work-up was performed.

If A. urinae is part of the normal human flora is not known. Jerome et al. claim that A. urinae is a commensal in the urinary tract, but there is no reference to support this statement. It would be of great interest to know where the authors have found this information. The patient in the case report received cefazolin, a first-generation cephalosporin, for 6 weeks. The authors do not comment on why the patient was switched from the initial empiric treatment with vancomycin and piperacillin-tazobactam to cefazolin when amoxicillin would be a more rational treatment option.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Jerome M, Slim J, Sison R, Marton R. A case of Aerococcus urinae vertebral osteomyelitis. J Glob Infect Dis 2015;7:85-6.
2Tekin A, Tekin G, Turunç T, Demiroglu Z, Kizilkiliç O. Infective endocarditis and spondylodiscitis in a patient due to Aerococcus urinae: First report. Int J Cardiol 2007;115:402-3.
3Astudillo L, Sailler L, Porte L, Lefevre JC, Massip P, Arlet-Suau E. Spondylodiscitis due to Aerococcus urinae: A first report. Scand J Infect Dis 2003;35:890-1.
4Senneby E, Petersson AC, Rasmussen M. Clinical and microbiological features of bacteraemia with Aerococcus urinae. Clin Microbiol Infect 2012;18:546-50.
5Cattoir V, Kobal A, Legrand P. Aerococcus urinae and Aerococcus sanguinicola, two frequently misidentified uropathogens. Scand J Infect Dis 2010;42:775-80.