Enterococcus hirae-related acute pyelonephritis and cholangitis with bacteremia: an unusual infection in humans

Abstract

Very few reports are available from the literature related to Enterococcus hirae infection in humans, which is more frequently seen in animals and birds. We report two patients with E hirae bacteremia caused by acute pyelonephritis and acute cholangitis. The clinical courses have been smooth on use of sensitive antibiotic therapy. In both cases, the primary sources and portals of entry are clearly identified.

Figure 1

(A) Polymerase chain reaction of the two Enterococcus hirae strains (EH‐1 and EH‐2) together with E faecium using the mur‐2 primers. Amplification products of 521 base pairs can only be seen for the E hirae DNA but not for the E faecium DNA. (B) Pulsed‐field gel electrophoresis of ApaI‐digested genomic DNA from EH‐1 and EH‐2 showed a close kinship between the two isolates. mur‐2  =  muramidase‐2; PFGE  =  pulsed‐field gel electrophoresis.

Figure 2

Polymerase chain reaction of EH‐1, EH2, and vancomycin‐resistant enterococcus (VRE). The products of 732 base pairs was visible only in VRE, corroborating with the antibiotic sensitivity test indicating that the isolated EH‐1 and EH‐2 are not intrinsically vancomycin resistant. The VRE used are E faecium carrying vanA only.