D G Hollis

Disease caused by a marine Vibrio. Clinical characteristics and epidemiology.

We studied the clinical characteristics and epidemiology of disease associated with a rare, unnamed halophilic lactose-fermenting Vibrio species in 39 persons from whom the organism had been isolated. Two distinct clinical presentations were seen. In the first, the illness began with septicemia, often within 24 hours after raw oysters had been eaten; 18 of 24 such patients had pre-existing hepatic disease, and 11 of the 24 died. In the second, there was a wound infection after exposure to seawater or an injury incurred during the handling of crabs; none of these persons had pre-existing hepatic disease, and one of 15 died. Most cases (85 per cent) occurred during relatively warm months (May to October) in men (90 per cent) 40 or more years of age (95 per cent). This Vibrio species is a pathogen and should be considered in the differential diagnosis of septicemia with secondary skin lesions and of wound infections after exposure to seawater.

Non-cholera vibrio infections in the United States. Clinical, epidemiologic, and laboratory features.

Non-cholera vibrios are organisms that are biochemically indistinguishable from Vibrio cholerae but do not agglutinate in vibrio 0 group 1 antiserum. Since 1972 there has been a dramatic increase in the number of these organisms referred to the Center for Disease Control for identification. Clinical, epidemiologic, and laboratory data were analyzed for 26 of 28 patients with isolates identified between January 1972 and March 1975. Thirteen (50%) of the isolates were obtained from feces of patients who had an acute diarrheal illness; no other pathogens were isolated from their feces, and all patients survived. Four (15%) patients had non-cholera vibrios isolated from other gastrointestinal or biliary tract sites; none of these patients had acute illness definitely attributable to non-cholera vibrios. Nine (35%) patients had non-cholera vibrios isolated from other tissues and body fluids; four deaths occurred in this group. Patients with acute diarrhea frequently had a history of recent shellfish ingestion or foreign travel, whereas some patients with systemic non-cholera vibrio infection had a history of recent occupational or recreational exposure to salt water.

Bartonella vinsonii subsp. berkhoffii subsp. nov., isolated from dogs ; Bartonella vinsonii subsp. vinsonii ; and emended description of Bartonella vinsonii

Two bacterial strains, one isolated from the blood of a dog with valvular endocarditis and one isolated from the blood of a healthy dog, were similar to Bartonella species, as determined by a number of phenotypic criteria, including growth characteristics, biochemical reactions, and cell wall fatty acid composition. The results of 16S rRNA gene sequence similarity studies confirmed that these strains are closely related and belong in the genus Bartonella and that Bartonella vinsonii is their closest relative (the 16S rRNA of isolate 93-C01T [T = type strain] was 99.37% identical to the 16S rRNA of the type strain of B. vinsonii, the 16S rRNA of isolate G7464 was 99.61% identical to the 16S rRNA of the type strain, and the 16S rRNAs of the dog isolates were 99.77% identical to each other). The 16S rRNAs of both strains contained a 12-base insertion that was not present in the 16S rRNA of the type strain of any Bartonella species. DNA relatedness tests revealed that these strains were related at the species level to the type strain of B. vinsonii. They were, however, significantly more closely related to each other than to B. vinsonii. On the basis of their unique 16S rRNA sequence insertion, their preferentially high level of relatedness, and their similar origins (dogs), we believe that strains 93-C01(T) and G7464 should be placed in a separate subspecies of B. vinsonii, for which we propose the name B. vinsonii subsp. berkhoffii subsp. nov. The type strain of B. vinsonii subsp. berkhoffii is strain 93-C01 (= ATCC 51672). The description of B. vinsonii is emended to accommodate the new subspecies, and B. vinsonii subsp. vinsonii is described.

Infection caused by Francisella philomiragia (formerly Yersinia philomiragia). A newly recognized human pathogen

We evaluated the clinical characteristics of patients with Francisella philomiragia (formerly Yersinia philomiragia) isolated from normally sterile sites. Isolates from 14 patients were received by the Centers for Disease Control between 1975 and 1987: 9 were from blood; 2 from lung biopsies; and 1 each from pleural, peritoneal, and cerebrospinal fluid. Underlying problems included chronic granulomatous disease in 5 patients, near-drowning in 5, and a myeloproliferative disease in 2. All 13 patients for whom records were available had a febrile syndrome compatible with bacterial infection. Pneumonia and fever-bacteremia were the commonest clinical syndromes reported. In 7 cases, F. philomiragia was the only sterile-site isolate, and the clinical syndrome did not resolve without appropriate antibiotics. Familiarity with this organism is important because of its ability to cause serious disease in chronic granulomatous disease and near-drowning patients. Further study may yield new insights into pathogenic and host defense mechanisms.

Flavobacterium spiritivorum, a New Species Isolated from Human Clinical Specimens

A new species, Flavobacterium spiritivorum, is proposed. Each of the 13 strains placed in the new species was examined for 129 characteristics, including 58 enzyme reactions (API ZYM system). These bacteria were rod shaped, aerobic, gram negative, and nonmotile, and oxidized glucose in oxidation-fermentation medium. The mean guanine-plus-cytosine content of the deoxyribonucleic acids of six selected strains was 41.4 ± 0.4 mol%. A distinguishing feature of the new species is its ability to produce acid from various carbohydrates and alcohols. In particular, the ability of F. spiritivorum strains to produce acid from ethanol and mannitol distinguishes them from all other Flavobacterium species. Eleven strains of the new species were isolated from human clinical specimens, of which blood and urine were common sources. The type strain is E7288 (= NCTC 11386).

Assignment of CDC Weak Oxidizer Group 2 (WO-2) to the Genus Pandoraea and Characterization of Three New Pandoraea Genomospecies

ABSTRACT CDC weak oxidizer group 2 (WO-2) consists of nine phenotypically similar human clinical isolates received by the Centers for Disease Control and Prevention between 1989 and 1998. Four of the isolates were from blood, three were from sputum, and one each was from bronchial fluid and maxillary sinus. All are aerobic nonfermentative, motile gram-negative rods with one to eight polar flagella per cell. All grew at 25 and 35°C and were positive for catalase, urease (usually delayed 3 to 7 days), citrate, alkalinization of litmus milk, oxidization of glycerol (weakly), and growth on MacConkey agar and in nutrient broth without NaCl. All except one strain were oxidase positive with the Kovács method, and all except one isolate weakly oxidized d-glucose. All were negative for oxidation of d-xylose, d-mannitol, lactose, sucrose, maltose, and 20 other carbohydrates, esculin hydrolysis, indole production, arginine dihydrolase, and lysine and ornithine decarboxylase. Only two of nine isolates reduced nitrate. Broth microdilution susceptibilities were determined for all strains against 13 antimicrobial agents. Most of the strains were resistant to ampicillin, extended-spectrum cephalosporins, and aminoglycosides, including gentamicin, tobramycin, and amikacin, but they varied in their susceptibility to fluoroquinolones. High-performance liquid chromatographic and mass spectrometric analyses of the WO-2 group identified ubiquinone-8 as the major quinone component. The percent G+C of the WO-2 strains ranged from 65.2 to 70.7% (thermal denaturation method). All shared a common cellular fatty acid (CFA) profile, which was characterized by relatively large amounts (7 to 22%) of 16:1ω7c, 16:0, 17:0cyc, 18:1ω7c, and 19:0cyc11-12; small amounts (1 to 3%) of 12:0 and 14:0; and eight hydroxy acids, 2-OH-12:0 (4%), 2-OH-14:0 (trace), 3-OH-14:0 (12%), 2-OH-16:1 (1%), 2-OH-16:0 (3%), 3-OH-16:0 (4%), 2-OH-18:1 (2%), and 2-OH-19:0cyc (3%). This profile is similar to the CFA profile of Pandoraea, a recently described genus associated with respiratory infections in cystic fibrosis patients (T. Coenye et al., Int. J. Syst. Evol. Microbiol., 50:887–899, 2000). Sequencing of the 16S rRNA gene (1,300 bp) for all nine strains indicated a high level (≥98.8%) of homogeneity withPandoraea spp. type strains. DNA-DNA hybridization analysis (hydroxyapatite method; 70°C) confirmed the identity of WO-2 with the genus Pandoraea and assigned three strains toPandoraea apista and three to Pandoraea pnomenusa, and identified three additional new genomospecies containing one strain each (ATCC BAA-108, ATCC BAA-109, ATCC BAA-110). This study also shows that Pandoraea isolates may be encountered in blood cultures from patients without cystic fibrosis.

Paracoccus yeeii sp. nov. (Formerly CDC Group EO-2), a Novel Bacterial Species Associated with Human Infection

ABSTRACT CDC eugonic oxidizer group 2 (EO-2) is a group of unclassified gram-negative bacterial strains isolated from various human sources. As determined by biochemical tests and analyses of fatty acid compositions, these organisms form a homogeneous group that appears to be distinct from but related to other Paracoccus species. Molecular studies were performed on a set of 13 EO-2 strains from various clinical sources and geographic locations in the United States and Canada to determine their relationship to the Paracoccus genus. Control strains were Paracoccus denitrificans ATCC 17741T, P. versutus ATCC 25364T, P. aminophilus ATCC 49673T, P. solventivorans ATCC 700252T, and Psychrobacter immobilis ATCC 43116T, which are phenotypically similar to EO-2. Nearly complete (1,500-base) 16S rRNA gene sequencing of eight EO-2 strains showed a high level of sequence similarity (>99.3%) within the group, and a BLAST search of GenBank placed the EO-2 cluster in close proximity to Paracoccus species (95 to 97% similarity). DNA-DNA hybridization studies of 13 of the EO-2 strains showed all to be related at the species level, with >70% relatedness under stringent conditions and a divergence within the group of less than 2%. None of the Paracoccus control strains hybridized at >54% with any of the EO-2 strains. These results indicate that EO-2 represents a new Paracoccus species, the first isolated from human clinical specimens. A new species, Paracoccus yeeii, is proposed for the EO-2 strains. The type strain of P. yeeii is CDCG1212 (ATCC BAA-599 and CCUG 46822), isolated in Pennsylvania from dialysate of a 77-year-old male with peritonitis.

Chemical and phenotypic characteristics of Flavobacterium thalpophilum compared with those of other Flavobacterium and Sphingobacterium species

Seven strains of Flavobacterium thalpophilum which were isolated from clinical sources were compared with the type strains of Sphingobacterium mizutae and seven species of Flavobacterium. These 15 strains were examined for 11 biochemical characteristics; minor phenotypic variations were observed for the 7 strains of F. thalpophilum. All 15 strains were characterized by four major cellular fatty acids (13-methyltetradecanoate, 2-hydroxy-13-methyltetradecanoate, 3-hydroxy-15-methylhexadecanoate, and a monounsaturated 16-carbon straight-chain acid). Sphingophospholipid long-chain bases were detected in all strains of F. thalpophilum but were not detected in Flavobacterium balustinum, Flavobacterium breve, Flavobacterium indologenes, Flavobacterium meningosepticum, or Flavobacterium odoratum. F. thalpophilum, Flavobacterium multivorum, Flavobacterium spiritivorum, and S. mizuate contained major amounts of menaquinone 7 but no menaquinone 6, whereas F. balustinum, F. breve, F. indologenes, F. meningosepticum, and F. odoratum contained major amounts of menaquinone 6 but no menaquinone 7. The phenotypic and chemical characteristics of F. thalpophilum indicate a close taxonomic relationship with F. multivorum, F. spiritivorum, and S. mizutae.

Identification of “Haematobacter,” a New Genus of Aerobic Gram-Negative Rods Isolated from Clinical Specimens, and Reclassification of Rhodobacter massiliensis as “Haematobacter massiliensis comb. nov.”

ABSTRACT Twelve strains of gram-negative, nonfermenting rods recovered mainly from septicemic patients were studied using conventional and molecular methods. The phenotypic profiles of these strains most closely resembled Psychrobacter phenylpyruvicus. They produced catalase, oxidase, urease, and H2S (lead acetate paper) but did not produce indole, reduce nitrate or nitrite, or hydrolyze gelatin or esculin. No acid production was observed in a Kings oxidation-fermentation base containing d-glucose, d-xylose, d-mannitol, sucrose, lactose, or maltose. All strains were nonmotile and nonpigmented. Most strains produced green discoloration on blood agar. All strains grew at 25°C and 35°C and most grew on MacConkey agar. They shared a common cellular fatty acid (CFA) profile characterized by large amounts (56% to 90%) of 18:1ω7c and the presence of 3-OH-10:0, 16:1ω7c, 16:0, and 19:0cycω8c that overall was most similar to that of Rhodobacter species but was quite distinct from that of P. phenylpyruvicus. The MICs for most β-lactams, fluoroquinolones, aminoglycosides, and carbapenems were low. MICs for aztreonam and piperacillin were higher, with MICs for some strains of > 64 mg/liter and > 128 mg/liter, respectively. Polyphasic analysis of these strains, including morphological, biochemical, CFA composition, DNA-DNA hybridization, 16S rRNA gene sequencing, and percent guanine-plus-cytosine (G+C) content analysis, demonstrated that these strains and Rhodobacter massiliensis represent a new genus, “Haematobacter” (proposed name), with the species H. missouriensis (type strain H1892T = CCUG 52307T = CIP 109176T) and H. massiliensis comb. nov. (type strain FramboiseT = CCUG 47968T = CIP 107725T) and an unnamed genomospecies.

Flavobacterium thalpophilum, a New Species Recovered from Human Clinical Material

We propose a new species, Flavobacterium thalpophilum. Each of the seven strains placed in this new species was examined for 129 characteristics, including 58 enzyme reactions (API ZYM System). These bacteria are rodshaped, aerobic, gram negative, and nonmotile and oxidize glucose in oxidation-fermentation medium. The mean guanine-plus-cytosine content of the deoxyribonucleic acids of seven strains is 45.0 ± 0.8 mol%. The distinguishing features of the new species include an ability to reduce nitrate, an ability to grow at 42°C, and an ability to produce acid from various carbohydrates and alcohols. In particular, the ability of F. thalpophilum strains to produce acid from adonitol distinguishes them from all other Flavobacterium species. The seven strains of the new species were isolated from human clinical specimens. The type strain is strain K-1173 (= NCTC 11429).