Aerococcus urinae and Aerococcus sanguinicola: Susceptibility Testing of 120 Isolates to Six Antimicrobial Agents Using Disk Diffusion (EUCAST), Etest, and Broth Microdilution Techniques

Derya Carkaci1, 2, 3, Xiaohui C. Nielsen1, Kurt Fuursted2, Robert Skov2, Ole Skovgaard3, Emilio P. Trallero4, Reto Lienhard5, Jenny Åhman6, Erika Matuschek6, Gunnar Kahlmeter6, Jens J. Christensen1, 7, *
1 Department of Clinical Microbiology, Slagelse Hospital, Slagelse, Denmark
2 Department of Microbiology and Infection Control, Reference Laboratory Statens Serum Institut, Copenhagen, Denmark
3 Department of Science and Environment, Roskilde University, Roskilde, Denmark
4 Department of Microbiology, Hospital Universitario Donostia, San Sebastián, Spain
5 ADMED Microbiologie, La Chaux-de-Fonds, Switzerland
6 EUCAST Development Laboratory, Clinical Microbiology, Central Hospital, Växjö, Sweden
7 Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark

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Creative Commons License
© 2017 Carkaci et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Clinical Microbiology, Slagelse Hospital, Ingemannsvej 46, DK-4200 Slagelse, Denmark; Tel: (+45)58559404; Fax: (+45)58559410; E-mail: jejc@regionsjaelland.dk



Aerococcus urinae and Aerococcus sanguinicola are relatively newcomers and emerging organisms in clinical and microbiological practice. Both species have worldwide been associated with urinary tract infections. More rarely cases of bacteremia/septicemia and infective endocarditis have been reported. Treatment options are therefore important. Just recently, European recommendations on susceptibility testing and interpretive criteria have been released.


In this investigation 120 A. urinae and A. sanguinicola isolates were tested for susceptibility to six antimicrobial agents: Penicillin, cefotaxime, meropenem, vancomycin, linezolid, and rifampicin.


Three susceptibility testing methods were used; disk diffusion according to The European Committee on Antimicrobial Susceptibility Testing (EUCAST) standardized disk diffusion methodology and MIC determination with Etest and broth microdilution (BMD). All testing was performed with EUCAST media for fastidious organisms.


Data obtained in this study were part of the background data for establishing EUCAST breakpoints. MIC values obtained by Etest and BMD were well correlated with disk diffusion results.


All isolates were found susceptible to all six antimicrobial agents: penicillin, cefotaxime, meropenem, vancomycin, linezolid, and rifampicin.

Keywords: Aerococcus urinae, Aerococcus sanguinicola, Antimicrobial susceptibility testing, Urinary tract infections, Disk diffusion, Etest, Broth microdilution.