Microbiological and Clinical Aspects of Actinomyces Infections

A special issue of Antibiotics (ISSN 2079-6382).

Deadline for manuscript submissions: closed (31 May 2022) | Viewed by 30497

Special Issue Editors


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Guest Editor
Department of Pharmacodynamics and Biopharmacy, Faculty of Pharmacy, University of Szeged, Pécs, Hungary
Interests: clinical microbiology; anaerobes; oral microbiology; epidemiology; Actinomyces spp.; Bacteroides spp.; Clostridium difficile; MALDI-TOF MS; molecular biology; medicine

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Co-Guest Editor
Department of Pharmacodynamics and Biopharmacy, Faculty of Pharmacy, University of Szeged, 6720 Szeged, Hungary
Interests: epidemiology; clinical microbiology; resistance trends; UTIs, antimicrobial stewardship; knowledge-attitude-practice (KAP); novel antimicrobials; drug design; anaerobes
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Special Issue Information

Dear Colleagues,

Actinomyces species are anaerobic, non-spore-forming Gram-positive rods that are important saprophytic constituents of the normal microbiota of humans, with highest numbers in the oropharynx (oral mucosa, gingival crevices, periodontal pockets, tonsillar crypts and dental plaques). Actinomyces species are considered as low-grade pathogens, without possessing ’classical’ virulence factors, therefore they can only cause disease if normal mucosal barriers have been disrupted or predisposing factors are present. Actinomyces infections (actinomycoses) are considered to be rare, however, due to the slow-growing and fastidious nature of these microorganisms, many Institutions do not have the capabilities or interest for their full diagnostic workup, therefore their true prevalence may be underestimated. Additonally, diagnosis of actinomycosis may be difficult as the clinical presentation of symptoms and signs can mimic other pathologies. Although antibiotic therapy is the mainstay of treating Actinomyces infections, surgical interventions as adjunctive therapy should also be considered. MALDI-TOF MS has allowed for the correct and precise identification of anaerobes in a clinically-relevant time frame, compared to conventional, biochemical methods.

The purpose of this Special Issue is to enrich the existing literature regarding this neglected pathogen, therefore manuscripts including but not limited to the following topics are welcome: vaulable case reports and novel results on the epidemiology, diagnostics, clinical features and therapy of actinomycoses, in addition to experimental findings on the virulence factors and resistace determinants of Actinomyces spp.

Prof. Dr. Edit Urbán
Dr. Márió Gajdács
Guest Editors

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Keywords

  • actinomyces spp.
  • actinomycosis
  • anaerobes
  • cervicofacial infections
  • thoracic infections
  • abdominal infections
  • pelvic infections
  • dentistry
  • surgery
  • antibiotic therapy
  • MALDI-TOF MS
  • clinical microbiology

Published Papers (7 papers)

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Editorial

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4 pages, 230 KiB  
Editorial
Microbiological and Clinical Aspects of Actinomyces Infections: What Have We Learned?
by Edit Urbán and Márió Gajdács
Antibiotics 2021, 10(2), 151; https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics10020151 - 03 Feb 2021
Cited by 5 | Viewed by 1538
Abstract
Obligate anaerobic bacteria are important members of the normal human microbiota, present in high numbers on mucosal surfaces (e [...] Full article
(This article belongs to the Special Issue Microbiological and Clinical Aspects of Actinomyces Infections)

Research

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10 pages, 297 KiB  
Article
Incidence and Clinical Characteristics of Anaerobic Bacteremia at a University Hospital in Hungary: A 5-Year Retrospective Observational Study
by Krisztina Kovács, Adrienn Nyul, Zsolt Lutz, Gyula Mestyán, Márió Gajdács, Edit Urbán and Ágnes Sonnevend
Antibiotics 2022, 11(10), 1326; https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics11101326 - 28 Sep 2022
Cited by 4 | Viewed by 1480
Abstract
Strict anaerobes have been reported to account for 0.5–13% of episodes of bacteremia in the adult population, with a growing awareness among clinicians regarding anaerobic bacteremia, especially in patients with specific predisposing factors. The aim of our present study was to assess the [...] Read more.
Strict anaerobes have been reported to account for 0.5–13% of episodes of bacteremia in the adult population, with a growing awareness among clinicians regarding anaerobic bacteremia, especially in patients with specific predisposing factors. The aim of our present study was to assess the incidence and clinical characteristics of anaerobic bacteremia during a 5-year period (2016–2020) at a tertiary care teaching hospital, and to compare our findings with other studies in Hungary. Overall, n = 160 strict anaerobes were detected, out of which, 44.4% (n = 71; 0.1% of positive blood cultures, 0.1/1000 hospitalizations, 3.3/100,000 patient days) were clinically significant, while Cutibacterium spp. accounted for 55.6% (n = 89) of isolates. Among relevant pathogens, the Bacteroides/Parabacteroides spp. group (32.4%; n = 23), Clostridium spp. (22.5%; n = 16) and Gram-positive anaerobic cocci (15.5%; n = 11) were the most common. The mean age of patients was 67.1 ± 14.1 years, with a male majority (59.2%; n = 42). A total of 38.0% of patients were affected by a malignancy or immunosuppression, while an abscess was identified in 15.5% of cases. A total of 74.7% (n = 53) of patients received antibiotics prior to blood culture sampling; in instances where antimicrobials were reported, anaerobic coverage of the drugs was appropriate in 52.1% (n = 37) of cases. The 30-day crude mortality rate was 39.4% (n = 28); age ≥ 75 years was a significant predictor of 30-day mortality (OR: 5.0; CI: 1.8–14.4; p = 0.003), while malignancy and immunosuppression, lack of anti-anaerobic coverage or female sex did not show a significant relationship with the mortality of these patients. Early recognition of the role played by anaerobes in sepsis and timely initiation of adequate, effective antimicrobial treatment have proven efficient in reducing the mortality of patients affected by anaerobic bacteremia. Full article
(This article belongs to the Special Issue Microbiological and Clinical Aspects of Actinomyces Infections)
8 pages, 1088 KiB  
Article
Actinomycosis of the Tongue: A Case Report and Review of Literature
by Fiorella D’Amore, Roberto Franchini, Laura Moneghini, Niccolò Lombardi, Giovanni Lodi, Andrea Sardella and Elena M. Varoni
Antibiotics 2020, 9(3), 124; https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics9030124 - 16 Mar 2020
Cited by 18 | Viewed by 4714
Abstract
Background: Actinomycosis of the tongue is an uncommon, suppurative infection of lingual mucosa, caused by actinomyces. The clinical diagnosis may present serious difficulties because of its ability to mimic other lesions, including both benign and malignant neoplasms. Methods: Here, we describe [...] Read more.
Background: Actinomycosis of the tongue is an uncommon, suppurative infection of lingual mucosa, caused by actinomyces. The clinical diagnosis may present serious difficulties because of its ability to mimic other lesions, including both benign and malignant neoplasms. Methods: Here, we describe the case of a 52-years-old patient affected by an asymptomatic, tumor-like tongue swelling, then diagnosed as actinomycosis. A review of tongue localization of actinomycosis is also reported, with emphasis on clinical findings and therapy. Results and Conclusion: Early diagnosis and treatment, with pus drainage and systemic antibiotic therapy, are pivotal to avoid severe and life-threatening complications. Full article
(This article belongs to the Special Issue Microbiological and Clinical Aspects of Actinomyces Infections)
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Review

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19 pages, 1953 KiB  
Review
The Pathogenic Role of Actinomyces spp. and Related Organisms in Genitourinary Infections: Discoveries in the New, Modern Diagnostic Era
by Márió Gajdács and Edit Urbán
Antibiotics 2020, 9(8), 524; https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics9080524 - 17 Aug 2020
Cited by 23 | Viewed by 8261
Abstract
Actinomycosis is a chronic, suppurative, granulomatous infectious disease, caused by different species of Actinomyces bacteria. To date, 26 validly published Actinomyces species have been described as part of a normal human microbiota or from human clinical specimens. Due to the rapid spread of [...] Read more.
Actinomycosis is a chronic, suppurative, granulomatous infectious disease, caused by different species of Actinomyces bacteria. To date, 26 validly published Actinomyces species have been described as part of a normal human microbiota or from human clinical specimens. Due to the rapid spread of new, modern diagnostic procedures, 13 of 26 of these species have been described in this century and the Actinomycetaceae family has undergone several taxonomic revisions, including the introduction of many novel species termed Actinomyces-like organisms (ALOs). There is scarce data available on the role of these novel bacterial species in various infectious processes in human medicine. The aim of this review is to provide a comprehensive overview of Actinomyces and closely related organisms involved in human diseases—with a special focus on newly described species—in particular their role in genitourinary tract infections in females and males. Full article
(This article belongs to the Special Issue Microbiological and Clinical Aspects of Actinomyces Infections)
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Other

7 pages, 1777 KiB  
Brief Report
Disseminated Pelvic Actinomycosis Caused by Actinomyces Naeslundii
by Olga Džupová, Jana Kulichová and Jiří Beneš
Antibiotics 2020, 9(11), 748; https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics9110748 - 29 Oct 2020
Cited by 2 | Viewed by 2170
Abstract
Actinomycosis is a chronic bacterial infection characterized by continuous local spread, irrespective of anatomical barriers, and granulomatous suppurative inflammation. Due to its expansive local growth, it can simulate a malignant tumour. Subsequent hematogenous dissemination to distant organs can mimic metastases and further increase [...] Read more.
Actinomycosis is a chronic bacterial infection characterized by continuous local spread, irrespective of anatomical barriers, and granulomatous suppurative inflammation. Due to its expansive local growth, it can simulate a malignant tumour. Subsequent hematogenous dissemination to distant organs can mimic metastases and further increase suspicion for malignancy. A case of severe disseminated pelvic actinomycosis associated with intrauterine device is described here. The patient presented with a pelvic mass mimicking a tumour, bilateral ureteral obstruction, ascites, multinodular involvement of the liver, lungs and spleen, inferior vena cava thrombosis and extreme cachexia. Actinomycosis was diagnosed by liver biopsy and confirmed by culture of Actinomyces naeslundii from extracted intrauterine contraceptive device (IUD). Prolonged treatment with aminopenicillin and surgery resulted in recovery with moderate sequelae. Full article
(This article belongs to the Special Issue Microbiological and Clinical Aspects of Actinomyces Infections)
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6 pages, 1160 KiB  
Case Report
Pulmonary Sequestration Associated with Actinomycosis: A Case Report
by Juan José Chaves, Fernando Polo Nieto, María Gómez-Gómez, Diana Fierro Rodríguez, Daniel García-Concha and Rafael Parra-Medina
Antibiotics 2020, 9(10), 687; https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics9100687 - 09 Oct 2020
Cited by 3 | Viewed by 2524
Abstract
Background: Bronchopulmonary sequestration is a rare congenital malformation of the lower respiratory tract; it consists of a nonfunctioning mass of lung tissue that is irrigated by an anomalous systemic artery. The association with Actinomyces superinfection has not been well established. Methods: We present [...] Read more.
Background: Bronchopulmonary sequestration is a rare congenital malformation of the lower respiratory tract; it consists of a nonfunctioning mass of lung tissue that is irrigated by an anomalous systemic artery. The association with Actinomyces superinfection has not been well established. Methods: We present the case of a 35-year-old woman with a history of recurrent episodes of pneumonia. Based on radiological and histopathological examination, she was diagnosed with intralobar bronchopulmonary sequestration associated with Actinomyces infection. Promoting clinical suspicion is essential to diagnose pulmonary actinomycosis in patients with recurrent pneumonia, to improve early recognition and timely management. Full article
(This article belongs to the Special Issue Microbiological and Clinical Aspects of Actinomyces Infections)
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10 pages, 1082 KiB  
Case Report
Diagnosis and Management of Cervicofacial Actinomycosis: Lessons from Two Distinct Clinical Cases
by Anette Stájer, Barrak Ibrahim, Márió Gajdács, Edit Urbán and Zoltán Baráth
Antibiotics 2020, 9(4), 139; https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics9040139 - 25 Mar 2020
Cited by 21 | Viewed by 8160
Abstract
Members of the Actinomyces genus are non-spore-forming, anaerobic, and aerotolerant Gram-positive bacteria that are abundantly found in the oropharynx. They are the causative agents of actinomycosis, a slowly progressing (indolent) infection with non-specific symptoms in its initial phase, and a clinical course of [...] Read more.
Members of the Actinomyces genus are non-spore-forming, anaerobic, and aerotolerant Gram-positive bacteria that are abundantly found in the oropharynx. They are the causative agents of actinomycosis, a slowly progressing (indolent) infection with non-specific symptoms in its initial phase, and a clinical course of extensive tissue destruction if left untreated. Actinomycoses are considered to be rare; however, reliable epidemiological data on their prevalence is lacking. Herein, we describe two representative and contrasting cases of cervicofacial actinomycosis, where the affected patients had distinctively different backgrounds and medical histories. Identification of the relevant isolates was carried out using matrix-assisted laser desorption/ionization mass spectrometry; antimicrobial susceptibility was performed using E-tests. Cervicofacial actinomycoses are the most frequent form of the disease; isolation and identification of these microorganisms from relevant clinical samples (with or without histological examination) is the gold standard for diagnosis. The therapy of these infections includes surgical debridement and antibiotic therapy, mainly with a penicillin-derivative or clindamycin. Full article
(This article belongs to the Special Issue Microbiological and Clinical Aspects of Actinomyces Infections)
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