Table 1.
Characteristic of patients with positive blood cultures for Actinobaculum speciesa
| Patient | Age (yr)/gender | Diagnosis | Comorbidity(-ies) | No. of urine leukocytes/HPF | Urine Gram stain result | Urine culture result | Blood culture (no. of positive sets)b | Clinical significance (assessed by treating physicians) | Treatment (duration in days) |
|---|---|---|---|---|---|---|---|---|---|
| 1 | 70/Male | UTI | BPH, prostate CA | 100 | GPB | − | A. schaalii (2) | Yes | Ciprofloxacin (3), pip-taz (2), amoxicillin-clavulanate (7) |
| 2 | 89/Male | Urosepsis and pneumonia | Dementia, BPH | 10 | GPB, GPC | Aerococcus urinae | Aerococcus urinae (3), A. schaalii (2) | Yes | Pip-taz (14), amoxicillin-clavulanate (14) |
| 3 | 70/Male | Urosepsis | BPH, CKD, diabetes | 41–50 | Not done | − | A. urinale (1) | No | Vancomycin plus cefepime (2), levofloxacin (7) |
| 4 | 91/Male | Acute cholecystitis | Dementia | 0 | − | − | A. schaalii (1) | No | No antibiotics |
| 5 | 90/Male | Complicated UTI and prostatitis | Dementia, BPH | 51–100 | GPC, GPB | Yeast | A. schaalii (2), Candida glabrata (1) | Yes | Penicillin G (5), cefpodoxime (42) |
| 6 | 84/Male | Pneumonia and UTI | Dementia, recurrent hematuria | 51–100 | − | − | A. schaalii (1) | No | Levofloxacin plus metronidazole (14) |
| 7 | 77/Male | Urosepsis | Dementia, Parkinson disease, urinary retention | 51–100 | GNB, GPB | Escherichia coli, Enterococcus sp. | A. massiliense (1), Escherichia coli (2) | No | Ciprofloxacin (4), TMP-SMX (17) |
| 8 | 65/Female | Urosepsis s/p ureteral stents | Neurogenic bladder with cystectomy/ileal conduit/ureter stent | 51–100 | Not done | − | A. schaalii (2) | Yes | Ciprofloxacin (2), pip-taz (4), amoxicillin-clavulanate (14) |
| 9 | 67/Female | UTI | Urethral stricture, rheumatoid arthritis | Not done | GPB | − | A. schaalii (1) | No | Ciprofloxacin (7) |
| 10 | 81/Female | UTI | Lung CA | 4–10 | GPB | Mixed | CNS (1), Actinobaculum sp. (1) | No | Ceftriaxone (4), cephalexin (2) |
| 11 | 77/Male | Perineal necrotizing cellulitis | Prostate CA, cystoprostatectomy, and artificial urethral sphincter | 4–10 | GPB | − | A. schaalii (2) | Yes | Vancomycin plus metronidazole (21) |
| 12 | 94/Female | UTI | CKD, Evan syndrome, resection of bladder CA | 41–50 | GPB, GNB | − | A. schaalii (1) | No | Ciprofloxacin (7) |
a
Abbreviations: HPF, high-power field; UTI, urinary tract infection; BPH, benign prostatic hyperplasia; CKD, chronic kidney disease; CA, cancer; pip-taz, piperacillin-tazobactam; −, no growth; GPB, Gram-positive bacilli; GNB, Gram-negative bacilli; GPC, Gram-positive cocci; CNS, coagulase-negative Staphylococcus species; TMP-SMX, trimethoprim-sulfamethoxazole.
b
A blood culture set consisted of two aerobic bottles and an anaerobic bottle.