Enterococcus hirae as a cause of bacteremic urinary tract infection: first case report from Turkey

  • Heval Can Bilek Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
  • Aydın Deveci Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
  • Sema Ünal Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
  • Yeliz Tanrıverdi Çaycı Department of Medical Microbiology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
  • Esra Tanyel Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
Keywords: bacteremia, Enterococcus hirae, Urinary tract infection, UTI

Abstract

Introduction: Enterococcus hirae (E. hirae) constitutes less than 1% of the enterococci strains in human clinical specimens. In this article, we report the first case of urinary tract infection-related bacteremia due to E. hirae from Turkey.

Case Presentation: A 74-year-old male patient with a history of coronary artery disease, hypertension, and chronic renal failure was admitted to the emergency department with abdominal pain, dysuria, and fever. The urine sample collected from the urinary catheter resulted as ampicillin-sensitive E. hirae. On the 4th day of hospitalization, E. hirae growth with the same sensitivity pattern was also reported in blood culture. Intravenous ampicillin 4×2 g/day treatment was initiated. There was no growth in subsequent blood and urine cultures. Fever resolved and general condition improved. The patient was discharged on the thirteenth day with clinical improvement after moxifloxacin treatment for four days and ampicillin treatment for nine days.

Discussion: The patient's medical history included risk factors for enterococcal bacteremia. There are a limited number of reports in the literature describing human infections caused by E. hirae. The reason for the rare isolation of E. hirae from clinical specimens may be the difficulty of identifying with standard diagnostic approaches.

Conclusions: For diagnostic purposes, as in our case, rapid and high sensitive diagnostic methods such as Matrix-assisted Laser Desorption/Ionization Time of Flight (MALDI-TOF) and molecular techniques may be useful to guide the selection of the least toxic and optimal duration of antibiotic treatment.

Published
2020-12-31
How to Cite
1.
Bilek HC, Deveci A, Ünal S, Tanrıverdi Çaycı Y, Tanyel E (2020) Enterococcus hirae as a cause of bacteremic urinary tract infection: first case report from Turkey. J Infect Dev Ctries 14:1780-1482. doi: 10.3855/jidc.12522
Section
Case Reports