Bacteremia with Aerococcus sanguinicola: Case Series with Characterization of Virulence Properties.

"Potential conflicts of interest.  All authors: No reported conflicts. Potential conflicts of interest."

"Financial support.  This work was financed by the Swedish Government Funds for Clinical Research (ALF), the Royal Physiographic Society in Lund, the Scandinavian Society for Antimicrobial Chemotherapy, and the foundations of Österlund and Groschinsky. Financial support."

"Isolates were identified by searching the databases of the 2 clinical microbiology laboratories belonging to University and Regional Laboratories of Skåne, Sweden. These laboratories are located in Malmö and Lund and serve all hospitals in a region with ∼1.2 million inhabitants. Searches were performed among all isolates from blood cultures drawn between March 2006 and November 2012. Both laboratories used the BacT/Alert blood culture system (bioMérieux, Marcy l’Etoile, France), and Gram stains were used to provide preliminary identification. Growth of catalase-negative bacteria, with colony appearance resembling α-hemolytic streptococci, in more than 1 bottle resulted routinely in species identification by sequencing of the 16S rRNA gene in Lund (2006–2011) or by Vitek2 (bioMérieux) in Malmö (2006–2011). Matrix-assisted laser desorption ionization time-of-flight mass spectrometry was introduced in both laboratories in 2011 and was the primary method of species identification during 2011–2012. Bacterial isolates were stored at −80oC. All isolates of A sanguinicola were subjected to sequencing of the 16S rRNA gene [] to confirm species identity. Reclassification of older isolates from the same time period (2006–2012) was carried out with MALDI-TOF MS, as described in Senneby et al []. Reclassification was performed if growth was identified in more than 1 bottle and the isolates had been identified as A viridans by Vitek 2, or isolates that had been identified as α-hemolytic streptococci or Gram-positive coccus, although preliminary Gram stain had been interpreted as Gram-positive cocci in clusters. The local research ethical committee approved this study (registration number 2010/681)."