Cedecea davisae로 잘못 동정된 Enterobacter hormaechei 감염 2예
Two Cases of Enterobacter hormaechei Infection Misidentified as Cedecea davisae Infection
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Enterobacteriaceae는 조건무산소성 그람음성막대균으로 다양한 균종으로 이루어져 있으며, 그중 Cedecea는 임상 검체에서 매우 드물게 분리되는 것으로 알려져 있다. 생화학적 성상을 이용하는 자동화 장비를 통하여 비교적 정확하게 균종 동정이 가능하다고 알려져 있지만, 다양한 생화학적 성상을 나타내는 일부 균속은 자동화 장비에서 정확한 균종 동정에 한계가 있을 수 있다. 저자들은 급성 담낭염 환자와 심부정맥 혈전증 환자에서 분리되어 VITEK II system에서 C. davisae로 동정된 두 그람음성막대균에 대하여 gyrB 유전자 염기서열분석을 시행하였고 그 결과 두 균 모두 C. davisae가 아닌 E. hormaechei임을 확인하였다. 그뿐만 아니라 이들 균에 대하여 시행한 MALDI-TOF MS와 16S rRNA 염기서열 분석 결과에서도 정확하지 않은 동정 결과를 보여 gyrB와 같은 다른 유전자 부위에 대한 직접 염기서열 분석이 Enterobacteriaceae의 정확한 균종 동정에 유용하게 사용될 것으로 생각된다.
Abstract
Enterobacteriaceae is a family of gram-negative, rod-shaped bacteria that consists of various species. Among these, members of the genus Cedecea has been reported as relatively rare causative pathogens of human infections. Commercially available automated identification systems that use biochemical reactions are known to accurately identify Enterobacteriaceae species. However, the accurate identification of some organisms with diverse biochemical profiles by these automated identification systems may be problematic. In this study, we report two cases of isolate misidentification, from patients with acute cholecystitis and deep vein thrombosis, as Cedecea davisae with VITEK II system. Both the isolates were correctly identified as Enterobacter hormaechei using gyrB gene sequence analysis. We also performed 16S rRNA sequence analyses and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry analyses; however, indeterminate results were obtained from both the assays. Therefore, the sequence analysis of alternative genes, like gyrB, might be useful for accurate identification of species that belong to the family of Enterobacteriaceae.
참고문헌 (14)
- Sanders WE Jr, "Enterobacter spp.: pathogens poised to flourish at the turn of the century", Clin Microbiol Rev, 10, pp.220~241 (1997)
- Ling TK, "Evaluation of the VITEK 2 system for rapid direct identification and susceptibility testing of gram-negative bacilli from positive blood cultures", J Clin Microbiol, 41, pp.4705~4707 (2003)
- Delmas J, "Rapid identification of Enterobacteriaceae by sequencing DNA gyrase subunit B encoding gene", Diagn Microbiol Infect Dis, 55, pp.263~268 (2006)
- O’Hara CM, "Enterobacter hormaechei, a new species of the family Enterobacteriaceae formerly known as enteric group 75", J Clin Microbiol, 27, pp.2046~2049 (1989)
- Wenger PN, "An outbreak of Enterobacter hormaechei infection and colonization in an intensive care nursery", Clin Infect Dis, 24, pp.1243~1244 (1997)
- Campos LC, "Outbreak of Enterobacter hormaechei septicaemia in newborns caused by contaminated parenteral nutrition in Brazil", J Hosp Infect, 66, pp.95~97 (2007)
- Bae BH, "Cedecea davisae isolated from scrotal abscess", J Urol, 130, pp.148~149 (1983)
- Perkins SR, "Cedecea davisae bacteremia", J Clin Microbiol, 24, pp.675~676 (1986)
- Abate G, "Cedecea davisae bacteremia in a neutropenic patient with acute myeloid leukemia", J Infect, 63, pp.83~85 (2011)
- Townsend SM, "Characterization of an extended-spectrum beta-lactamase Enterobacter hormaechei nosocomial outbreak, and other Enterobacter hormaechei misidentified as Cronobacter (Enterobacter) sakazakii", Microbiology, 154, pp.3659~3667 (2008)
- Mollet C, "rpoB sequence analysis as a novel basis for bacterial identification", Mol Microbiol, 26, pp.1005~1011 (1997)
- van Baar BL, "Characterisation of bacteria by matrix-assisted laser desorption", ionisation and electrospray mass spectrometry, 2000, pp.24, 193~219
- Pavlovic M, "A dual approach employing MALDI-TOF MS and real-time PCR for fast species identification within the Enterobacter cloacae complex", FEMS Microbiol Lett, 328, pp.46~53 (2012)
- Ohad S, "Rapid identification of Enterobacter hormaechei and Enterobacter cloacae genetic cluster III", J Appl Microbiol, 116, pp.1315~1321 (2014)