Management and treatment of Aerococcus bacteremia and endoca
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Researchers describe our multicenter experience on diagnosis and management of Aerococcus bacteremia including the susceptibility profile of Aerococcus species and a suggested algorithm for clinicians.

Retrospective study of all patients with positive blood cultures for Aerococcus species with clinical data and susceptibility profile was conducted. Data was collected from both electronic health record and clinical microbiology laboratory database.

-- There were 219 unique isolates with only the susceptibility profiles available, while 81 patients had clinical information available.

-- Forty-nine of those cases were deemed as true bloodstream infection and the rest were of unclear clinical significance.

-- Cases of endocarditis (n?=?7) were high-grade, monomicrobial bacteremia caused by Aerococcus urinae. Patients with endocarditis were younger (66 vs 80).

-- The risk for endocarditis was higher if duration of symptoms was longer than 7 days, or if there were septic emboli.

-- A DENOVA score cutoff of greater than 3 was 100% sensitive and 89% specific in detecting endocarditis.

-- The 30-day and 3-month all-cause mortality for bacteremia was 17% and 24%, respectively.

-- Six out of seven patients with endocarditis survived.

Conclusively, antibiotic regimen for aerococcal bloodstream infections and endocarditis should be guided by species identification and antimicrobial susceptibility testing. DENOVA scoring system’s performance in this study is more congruent to other studies.

Hence, it can be used as adjunctive tools in assessing the need for echocardiogram to rule out endocarditis. In our experience, two and four weeks of treatment for bloodstream infections and endocarditis, respectively, had good outcomes.