Escherichia coli spheroplasts in a Croatian patient misclassified by two urine sediment analysers as erythrocytes

It has already been reported that subinhibitory concentrations of β-lactam antibiotics can cause abnormal changes of bacterialforms, such as spheroplasts. Herein we report a case of Croatian male patient with Escherichia coli spheroplasts present in urine after treatment withtazobactam, on the tenth...

Full description

Permalink: http://skupni.nsk.hr/Record/nsk.NSK01001068949/Details
Matična publikacija: Biochemia medica (Online)
29 (2019), 3 ; str. 609-613
Glavni autori: Nikler, Ana (Author), Radišić Biljak, Vanja, Čičak, Helena, Marić, Nikolina, liječnica, Bejuk, Danijela, Tesser Poloni, Jose Antonio, Šimundić, Ana-Maria
Vrsta građe: e-članak
Jezik: eng
Predmet:
Online pristup: https://doi.org/10.11613/BM.2019.030801
Biochemia medica (Online)
Hrčak
LEADER 03424naa a22004334i 4500
001 NSK01001068949
003 HR-ZaNSK
005 20200909142106.0
006 m d
007 cr||||||||||||
008 200709s2019 ci ad |o |0|| ||eng
024 7 |2 doi  |a 10.11613/BM.2019.030801 
035 |a (HR-ZaNSK)001068949 
040 |a HR-ZaNSK  |b hrv  |c HR-ZaNSK  |e ppiak 
041 0 |a eng  |b eng 
042 |a croatica 
044 |a ci  |c hr 
080 1 |a 577  |2 2011 
080 1 |a 61  |2 2011 
100 1 |a Nikler, Ana  |4 aut 
245 1 0 |a Escherichia coli spheroplasts in a Croatian patient misclassified by two urine sediment analysers as erythrocytes  |h [Elektronička građa] :  |b case report /  |c Ana Nikler, Vanja Radišić Biljak, Helena Čičak, Nikolina Marić, Danijela Bejuk, Jose Antonio Tesser Poloni, Ana-Maria Simundic. 
300 |b Ilustr., graf. prikazi. 
504 |a Bibliografija: 13 jed. 
504 |a Summary. 
520 |a It has already been reported that subinhibitory concentrations of β-lactam antibiotics can cause abnormal changes of bacterialforms, such as spheroplasts. Herein we report a case of Croatian male patient with Escherichia coli spheroplasts present in urine after treatment withtazobactam, on the tenth day of hospitalization. The aim of this report is to emphasize the inability of imaging based automated urine analysers torecognize some relatively uncommon forms of bacterial presentation in urine sediment.Materials and methods: During routine urine analysis, unusual particles were observed in patient urine. Urine sediment was examined by twourine analysers: Atellica 1500 (Siemens, Germany) and Iris iQ200 (Beckman Coulter, USA). Additionally, urine was sent for culture testing to Microbiologydepartment.Results: Both urine analysers didn’t indicate presence of bacteria in urine sediment. Unusual particles observed on the tenth day were classified aserythrocytes by both instruments. Dipstick test showed blood trace and microscopic analysis revealed bacteria in urine. Urine culture was positivefor Escherichia coli. Careful examination of urine sediment has confirmed that shapes present in urine were abnormal bacterial forms called spheroplasts.Conclusions: Imaging based automated urine analysers are not able to recognize bacterial spheroplasts in urine sediment misclassifying it as erythrocytes.Microscopic examination remains the gold standard for urines with blood trace or negative blood, in which erythrocytes are reported byurine analyser in urine sediment. Failure to identify and follow up such cases may lead to inaccurate treatment decisions and puts patient safety at risk. 
653 0 |a Urin  |a Analiza urina  |a Escherichia coli  |a Sferoplasti  |a Bakterijski oblici  |a Pogrešna klasifikacija 
700 1 |a Radišić Biljak, Vanja  |4 aut 
700 1 |a Čičak, Helena  |4 aut 
700 1 |a Marić, Nikolina,  |c liječnica  |4 aut 
700 1 |a Bejuk, Danijela  |4 aut 
700 1 |a Tesser Poloni, Jose Antonio  |4 aut  |9 HR-ZaNSK 
700 1 |a Šimundić, Ana-Maria  |4 aut 
773 0 |t Biochemia medica (Online)  |x 1846-7482  |g 29 (2019), 3 ; str. 609-613  |w nsk.(HR-ZaNSK)000655372 
981 |b Be2019  |b B04/19 
998 |b dalo2009 
856 4 0 |u https://doi.org/10.11613/BM.2019.030801 
856 4 0 |u https://www.biochemia-medica.com/en/journal/29/3/10.11613/BM.2019.030801  |y Biochemia medica (Online) 
856 4 1 |y Digitalna.nsk.hr 
856 4 0 |u https://hrcak.srce.hr/226460  |y Hrčak