{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T05:04:28Z","timestamp":1780722268847,"version":"3.54.1"},"reference-count":30,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T00:00:00Z","timestamp":1780531200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>Facklamia species are Gram-positive, catalase-negative cocci within the family Aerococcaceae. Historically misidentified as streptococci or enterococci due to phenotypic similarity and conventional biochemical testing limitations, their clinical significance remains incompletely defined. This narrative review synthesizes the current literature on the microbiology, epidemiology, clinical manifestations, diagnostic challenges, and antimicrobial susceptibilities of Facklamia infections, with emphasis on urogynecologic relevance. A structured literature search identified peer-reviewed reports of microbiologically confirmed human infection published through December 2025. These reports indicate global distribution and a broad clinical spectrum. Invasive infections were reported most often in older adults and individuals with structural abnormalities, chronic comorbidities, or recent surgical interventions; however, cases in otherwise healthy patients are described. Emerging microbiome data suggest that F. hominis may be enriched in adult females with lower urinary tract symptoms, supporting the possibility that the female urogenital tract functions as a potential reservoir and site of pathogenic activity. Antimicrobial susceptibility patterns vary, with documented resistance to penicillin, macrolides, clindamycin, and tetracyclines, and susceptibility to cephalosporins, vancomycin, and linezolid. Overall, Facklamia species should be recognized as underdiagnosed opportunistic pathogens with both invasive and urogynecologic relevance. Increased awareness, improved diagnostic identification, and systematic susceptibility profiling are needed to clarify their pathogenic role and guide appropriate antimicrobial therapy.<\/jats:p>","DOI":"10.3390\/microorganisms14061269","type":"journal-article","created":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T17:11:04Z","timestamp":1780593064000},"page":"1269","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Review of Facklamia Species Involvement in Human Infection and Urological Disease"],"prefix":"10.3390","volume":"14","author":[{"given":"Malika","family":"Saxena","sequence":"first","affiliation":[{"name":"Department of Microbiology and Immunology, Stritch School of Medicine, Maywood, IL 60153, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5859-9050","authenticated-orcid":false,"given":"Brian I.","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, Stritch School of Medicine, Maywood, IL 60153, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4532-0545","authenticated-orcid":false,"given":"Alan J.","family":"Wolfe","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, Stritch School of Medicine, Maywood, IL 60153, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Peinado-Molina, R.A., Hern\u00e1ndez-Mart\u00ednez, A., Mart\u00ednez-V\u00e1zquez, S., Rodr\u00edguez-Almagro, J., and Mart\u00ednez-Galiano, J.M. (2023). Pelvic floor dysfunction: Prevalence and associated factors. BMC Public Health, 23.","DOI":"10.1186\/s12889-023-16901-3"},{"key":"ref_2","first-page":"40","article-title":"Urinary tract infection in women","volume":"20","author":"Czajkowski","year":"2021","journal-title":"Prz. Menopauzalny"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Whelan, S., Lucey, B., and Finn, K. (2023). Uropathogenic Escherichia coli (UPEC)-associated urinary tract infections: The molecular basis for challenges to effective treatment. Microorganisms, 11.","DOI":"10.3390\/microorganisms11092169"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.autneu.2015.06.002","article-title":"The unexplored relationship between urinary tract infections and the autonomic nervous system","volume":"200","author":"Hibbing","year":"2016","journal-title":"Auton. Neurosci."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e89","DOI":"10.1016\/j.amjmed.2024.01.029","article-title":"Aerococcus urinae: An emerging, gram-positive pathogen causing urinary tract infection","volume":"137","author":"Maezawa","year":"2024","journal-title":"Am. J. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1016\/j.jinf.2012.12.006","article-title":"Aerococci and aerococcal infections","volume":"66","author":"Rasmussen","year":"2013","journal-title":"J. Infect."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"ofv029","DOI":"10.1093\/ofid\/ofv029","article-title":"Facklamia Species and Streptococcus pneumoniae Meningitis: A Case Report and Review of the Literature","volume":"2","author":"Parvataneni","year":"2015","journal-title":"Open Forum Infect. Dis."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"ofw277","DOI":"10.1093\/ofid\/ofw277","article-title":"Globicatella sanguinis osteomyelitis and bacteremia: Review of an emerging human pathogen with an expanding spectrum of disease","volume":"4","author":"Miller","year":"2017","journal-title":"Open Forum Infect. Dis."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"R\u00eep\u0103, C.V., Cobzaru, R.G., Iancu, L.S., R\u00eep\u0103, M.R., Popescu, G., Ma\u0219taleru, A., Oancea, A., and Leon, M.M. (2025). Globicatella sanguinis\u2014A literature review of case reports. Medicina, 61.","DOI":"10.3390\/medicina61112048"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Moreland, R.B., Choi, B.I., Geaman, W., Gonzalez, C., Hochstedler-Kramer, B.R., John, J., Kaindl, J., Kesav, N., Lamichhane, J., and Lucio, L. (2023). Beyond the usual suspects: Emerging uropathogens in the microbiome age. Front. Urol., 3.","DOI":"10.3389\/fruro.2023.1212590"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"ofw272","DOI":"10.1093\/ofid\/ofw272","article-title":"Facklamia species as an underrecognized pathogen","volume":"4","author":"Rahmati","year":"2017","journal-title":"Open Forum Infect. Dis."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1016\/j.vetmic.2012.05.019","article-title":"Improved identification including MALDI-TOF mass spectrometry analysis of group D streptococci from bovine mastitis and subsequent molecular characterization of corresponding Enterococcus faecalis and Enterococcus faecium isolates","volume":"160","author":"Werner","year":"2012","journal-title":"Vet. Microbiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"16","DOI":"10.54660\/IJMBHR.2025.6.1.16-23","article-title":"Classification, importance, and pathogenicity of Facklamia species and related bacteria","volume":"6","author":"Mahmood","year":"2025","journal-title":"Int. J. Med. All Body Health Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2146","DOI":"10.1128\/JCM.36.7.2146-2148.1998","article-title":"Facklamia ignava sp. nov., isolated from human clinical specimens","volume":"36","author":"Collins","year":"1998","journal-title":"J. Clin. Microbiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2130","DOI":"10.1128\/AAC.44.8.2130-2132.2000","article-title":"Antimicrobial susceptibilities and clinical sources of Facklamia species","volume":"44","author":"LaClaire","year":"2000","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1016\/j.jinf.2004.05.013","article-title":"Facklamia hominis causing chorioamnionitis and puerperal bacteraemia","volume":"50","author":"Healy","year":"2005","journal-title":"J. Infect."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"bcr0620092023","DOI":"10.1136\/bcr.06.2009.2023","article-title":"Multi-territory ischaemic strokes and subacute bacterial endocarditis","volume":"2010","author":"Safavi","year":"2010","journal-title":"BMJ Case Rep."},{"key":"ref_18","first-page":"307852","article-title":"Infective endocarditis: A rare organism in an uncommon setting","volume":"2012","author":"Ananthakrishna","year":"2012","journal-title":"Case Rep. Infect. Dis."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1016\/j.diagmicrobio.2014.08.008","article-title":"Case report: First report of a prosthetic joint infection caused by Facklamia hominis","volume":"80","author":"Corona","year":"2014","journal-title":"Diagn. Microbiol. Infect. Dis."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1016\/j.nmni.2015.11.003","article-title":"Facklamia hominis scapula abscess, Marseille, France","volume":"9","author":"Abat","year":"2016","journal-title":"New Microbes New Infect."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1007\/s00101-017-0312-6","article-title":"Ungew\u00f6hnliche Komplikation nach Anlage eines Periduralkatheters","volume":"66","author":"Grieser","year":"2017","journal-title":"Anaesthesist"},{"key":"ref_22","first-page":"278","article-title":"Balanopostitis por Facklamia hominis en Pediatr\u00eda [Balanopostitis by Facklamia hominis in pediatrics]","volume":"32","year":"2019","journal-title":"Rev. Esp. Quimioter."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"50","DOI":"10.5145\/ACM.2019.22.2.50","article-title":"Facklamia hominis isolated from a wound: A case report and review of the literature","volume":"22","author":"Kim","year":"2019","journal-title":"Ann. Clin. Microbiol."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Gahl, M., St\u00f6ckli, T., and Fahrner, R. (2020). Facklamia hominis bacteremia after transurethral resection of the prostate: A case report. BMC Urol., 20.","DOI":"10.1186\/s12894-020-00762-8"},{"key":"ref_25","first-page":"138","article-title":"Identification of Facklamia hominis in a case of stercoral peritonitis: A case report and review of the literature","volume":"4","author":"Violette","year":"2020","journal-title":"Infect. Dis. Diagn. Treat."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1016\/j.jdcr.2021.03.017","article-title":"Facklamia hominis in hidradenitis suppurativa","volume":"11","author":"Basal","year":"2021","journal-title":"JAAD Case Rep."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/s12941-022-00497-4","article-title":"Facklamia hominis pyelonephritis in a pediatric patient: First case report and review of the literature","volume":"21","author":"Santos","year":"2022","journal-title":"Ann. Clin. Microbiol. Antimicrob."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"497","DOI":"10.18203\/2349-2902.isj20240584","article-title":"Facklamia hominis isolated from infected sebaceous cyst on the breast","volume":"11","author":"Agrawal","year":"2024","journal-title":"Int. Surg. J."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Dharmalingam, D., Semalaiyappan, J., Thirumal, S., and Kuttiatt, V.S. (2025). Unveiling Facklamia: Detection of an emerging microbe in the skin microbiome of patients with filarial lymphedema. Front. Cell. Infect. Microbiol., 15.","DOI":"10.3389\/fcimb.2025.1624288"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Joyce, C., Halverson, T., Gonzalez, C., Brubaker, L., and Wolfe, A.J. (2022). The urobiomes of adult women with various lower urinary tract symptoms status differ: A re-analysis. Front. Cell Infect. Microbiol., 12.","DOI":"10.3389\/fcimb.2022.860408"}],"container-title":["Microorganisms"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-2607\/14\/6\/1269\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T04:42:50Z","timestamp":1780720970000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-2607\/14\/6\/1269"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,4]]},"references-count":30,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["microorganisms14061269"],"URL":"https:\/\/doi.org\/10.3390\/microorganisms14061269","relation":{},"ISSN":["2076-2607"],"issn-type":[{"value":"2076-2607","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,4]]}}}