ABSTRACT
An unusual staphylococcal isolate was recovered from blood cultures in a patient with chronic hepatitis B virus infection, who presented with low grade fever accompanied by increased upper abdominal pain, nausea and weakness. The isolate was identified as Staphylococcus gallinarum based on biochemical characteristics and 16S rRNA gene sequence analyses.
Subject(s)
Hepatitis B virus/isolation & purification , Hepatitis B, Chronic/complications , Staphylococcal Infections/microbiology , Staphylococcus/isolation & purification , Female , Hepatitis B virus/genetics , Humans , Middle Aged , Phylogeny , Polymerase Chain Reaction , RNA, Ribosomal, 16S/genetics , Staphylococcal Infections/genetics , Staphylococcus/classification , Staphylococcus/geneticsABSTRACT
Twelve coagulase-negative staphylococcal isolates recovered from blood cultures with positive pyrrolidonyl arylamidase and ornithine decarboxylase reactions were identified as Staphylococcus lugdunensis by the clinical microbiology laboratory. However, none of these 12 isolates were recognized by a S. lugdunensis translation elongation factor Tu (tuf) gene-specific probe. Under the API STAPH V4.0 identification system (bioMérieux, Durham, NC), 8 of these 12 isolates could not be identified with low discrimination scores, and 4 were identified as Kocuria varians/rosea with identification probabilities that ranged from 95.5% to 99.6%. All 12 isolates possessed identical partial 16S rRNA gene sequences, and the full 16S rRNA gene sequences of the prototype strain B006 were closely related to a tentatively assigned "Staphylococcus pettenkoferi". All 12 isolates had identical partial tuf gene sequences corresponding to 666 to 858 nucleotide positions, and the 1188-base pair full tuf sequences of B006 strain were mostly related to 2 Staphylococcus epidermidis isolates with a 93.02% similarity. Two isolates, which were recovered from the same patient over a 16-day interval, were considered to be a pathogen causing an intravenous line-associated infection; the remaining 10 isolates were considered to be skin contaminants. Biochemical tests currently used in the clinical microbiology laboratory to identify S. lugdunensis appear to lack specificity in identifying these isolates. On the basis of the close biochemical reactions with S. lugdunensis and phylogenetic evidence, these isolates are proposed the designation Staphylococcus pseudolugdunensis sp. nov.
Subject(s)
Aminopeptidases/metabolism , Bacteremia/microbiology , Blood/microbiology , Ornithine Decarboxylase/metabolism , Staphylococcus/classification , Staphylococcus/isolation & purification , Adult , Aged , Aged, 80 and over , Bacterial Typing Techniques , Coagulase/metabolism , DNA, Bacterial/chemistry , DNA, Bacterial/genetics , DNA, Ribosomal/chemistry , DNA, Ribosomal/genetics , Electrophoresis, Gel, Pulsed-Field , Female , Humans , Male , Microbial Sensitivity Tests , Middle Aged , Molecular Sequence Data , Peptide Elongation Factor Tu/genetics , Phylogeny , RNA, Bacterial/genetics , RNA, Ribosomal, 16S/genetics , Sequence Analysis, DNA , Sequence Homology, Amino Acid , Sequence Homology, Nucleic Acid , Staphylococcal Skin Infections/microbiology , Staphylococcus/metabolismABSTRACT
Clinical presentations for viral respiratory tract infections are often nonspecific, and a rapid, high-throughput laboratory technique that can detect a panel of common viral pathogens is clinically desirable. We evaluated two multiplex reverse transcription-PCR (RT-PCR) products coupled with microarray-based systems for simultaneous detection of common respiratory tract viral pathogens. The NGEN respiratory virus analyte-specific assay (Nanogen, San Diego, CA) detects influenza A virus (Flu-A) and Flu-B, parainfluenza virus 1 (PIV-1), PIV-2, and PIV-3, and respiratory syncytial virus (RSV), while the ResPlex II assay (Genaco Biomedical Products, Inc., Huntsville, AL) detects Flu-A, Flu-B, PIV-1, PIV-2, PIV-3, PIV-4, RSV, human metapneumovirus (hMPV), rhinoviruses (RhVs), enteroviruses (EnVs), and severe acute respiratory syndrome (SARS) coronavirus (CoV). A total of 360 frozen respiratory specimens collected for a full year were tested, and results were compared to those obtained with a combined reference standard of cell culture and monoplex real-time TaqMan RT-PCR assays. NGEN and ResPlex II gave comparable sensitivities for Flu-A (82.8 to 86.2%), Flu-B (90.0 to 100.0%), PIV-1 (87.5 to 93.8%), PIV-3 (66.7 to 72.2%), and RSV (63.3 to 73.3%); both assays achieved excellent specificities (99.1 to 100.0%) for these five common viruses. The ResPlex II assay detected hMPV in 13 (3.6%) specimens, with a sensitivity of 80.0% and specificity of 99.7%. The ResPlex II assay also differentiated RSV-A and RSV-B and gave positive results for RhV and EnV in 31 (8.6%) and 19 (5.3%) specimens, respectively. PIV-2, PIV-4, and SARS CoV were not detected in the specimens tested. The two systems can process 80 (NGEN) and 96 (ResPlex II) tests per run, with a hands-on time of approximately 60 min and test turnaround times of 6 h (ResPlex II) and 9 h (NGEN). Multiple-panel testing detected an additional unsuspected 9 (3.4%) PIV-1 and 10 (3.7%) PIV-3 infections. While test sensitivities for RSV and PIV-3 need improvement, both the NGEN and ResPlex II assays provide user-friendly and high-throughput tools for simultaneous detection and identification of a panel of common respiratory viral pathogens in a single test format. The multiplex approach enhances diagnosis through detection of respiratory viral etiologic agents in cases in which the presence of the agent was not suspected and a test was not ordered by the clinicians.
