High interlaboratory reproducibility of matrix-assisted laser desorption ionization-time of flight mass spectrometry-based species identification of nonfermenting bacteria.

Matrix-assisted laser desorption ionization-time of flight mass spectrometry has emerged as a rapid, cost-effective alternative for bacterial species identification. Identifying 60 blind-coded nonfermenting bacteria samples, this international study (using eight laboratories) achieved 98.75% interlaboratory reproducibility. Only 6 of the 480 samples were misidentified due to interchanges (4 samples) or contamination (1 sample) or not identified because of insufficient signal intensity (1 sample).

[Kingella denitrificans endocarditis on an aortic valve prosthesis]. / Endocardite à Kingella denitrificans sur prothèse valvulaire aortique.

Kingella denitrificans is a Gram-negative bacillus which does not grow readily on the usual media. This organism, normally a commensal of the upper airways, may exceptionally be responsible for endocarditis. We report here the sixth case known in the literature. Cure was obtained with an intravenous combination of vancomycin and rifampicin.

[First confirmed case of laryngeal diphtheria in Djibouti]. / Premier cas confirmé d'angine diphtérique à Djibouti.

The first bacteriologically confirmed case of laryngeal diphtheria in Djibouti was reported in 1998. It involved a three-year-old native-born infant who had been vaccinated during the first year of life with three doses of a combined vaccine against diphtheria, tetanus, poliomyelitis, and pertussis. A rapid clinical improvement was observed under erythromycin treatment. Other cases of laryngeal diphtheria have been observed. It is important to reverse decreasing vaccinal coverage in Djibouti and to warn incoming travelers of the need to be adequate immunized against diphtheria. Enhanced epidemiologic surveillance of this disease is also needed.

[Interest of typing methods to study Corynebacterium diphtheriae strains.]. / Apport des méthodes de typage dans l'étude des souches de Corynebacterium diphtheriae.

Corynebacterium diphtheriae is the causative agent of Diphtheria. This bacteria circulates throughout the world. Recently, two outbreaks occurred in New independent states (Russia, Ukraine...) and Algeria. Routine technics permit to study the strains of Corynebacterium diphtheriae : biotype, antibiotype, toxin gene detection. However, molecular biological tests (ribotyping, and pulsed field gel electrophoresis) are necessary to characterize these strains in the space and the time. The studies with international laboratories exchanges are recents and have permitted first results concerning the molecular epidemiology of C. diphtheriae strains.

Microbacterium binotii sp. nov., isolated from human blood.

Two strains of non-spore-forming, rod-shaped, Gram-positive bacteria, CIP 101303(T) and CIP 102116, were isolated from human blood in 1976 and 1977, respectively. These strains had chemotaxonomic markers that were consistent with classification in the genus Microbacterium, i.e. MK-10, MK-11 and MK-12 as the major menaquinones, predominant iso- and anteiso-branched cellular fatty acids, galactose, mannose and rhamnose as the cell-wall sugars and ornithine as the diamino acid in the cell-wall peptidoglycan. The DNA G+C content was 70-72 mol%. Comparative 16S rRNA gene sequence studies revealed that strains CIP 101303(T) and CIP 102116 belonged to the genus Microbacterium and that they were related closely to Microbacterium halotolerans. The level of DNA-DNA relatedness showed that the two isolates represented a separate genomic species. Based on phenotypic and genotypic results, it is proposed that strains CIP 101303(T) and CIP 102116 be assigned to a novel species, Microbacterium binotii sp. nov. The type strain is CIP 101303(T) (=DSM 19164(T)).

In vitro susceptibility of Corynebacterium group D2 and Corynebacterium jeikeium to twelve antibiotics.

The in vitro susceptibility of 83 Corynebacterium group D2 strains and 44 Corynebacterium jeikeium strains to 12 antimicrobial agents was determined by an agar dilution technique using Mueller-Hinton agar supplemented with Tween 80 (0.025%). All strains of Corynebacterium group D2 were highly sensitive to fusidic acid, pristinamycin, teicoplanin and vancomycin (geometric mean MICs 0.047, 0.048, 0.338 and 0.396 mg/l respectively). Most of the strains were resistant to other antibiotics tested (ciprofloxacin, erythromycin, gentamicin, lincomycin, rifampin and tetracycline). However, a few strains were highly sensitive (MICs less than or equal to 0.2 mg/l). The overall pattern of susceptibility of 44 strains of Corynebacterium jeikeium was similar; the geometric mean MICs of fusidic acid, pristinamycin, vancomycin and teicoplanin were 0.234, 0.235, 0.557 and 0.652 mg/l respectively.

Comparative chemotaxonomic studies of mycolic acid-free coryneform bacteria of human origin.

Forty-two clinical isolates were classified as Corynebacterium minutissimum, Corynebacterium striatum, and Corynebacterium CDC group I by the API Coryne system. The chemotaxonomic characteristics of the isolates were determined by thin-layer chromatographic analysis. Twenty-six isolates were found to have a type IV cell wall (meso-di-aminopimelic acid arabinose, galactose) but did not contain mycolic acids. These 26 isolates shared chemotaxonomic characteristics with those of mycolic acid-free reference strains (including the Corynebacterium amycolatum NCFB 2768 type strain, "Corynebacterium asperum," and coryneform CDC groups I2 and F2). The total protein profiles of the isolates determined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis were similar to each other and to that of the C. amycolatum type strain. The profiles of the reference strains "Corynebacterium asperum" (CIP 100836, CIP 80.54, CIP 79.37, CIP 52.13), coryneform bacteria CDC groups I2 and F2 (CDC F5771, F5890, G723, G1970), and C. amycolatum were closely related. Thus, the mycolic acid-negative strains with a chemotype IV wall may belong to a single taxon. DNA hybridization studies could confirm this hypothesis. The present study shows the importance of chemotaxonomic analysis for verifying strain identifications and completing results from biochemical tests, particularly for coryneform bacteria.

Polymerase chain reaction assay for diagnosis of potentially toxinogenic Corynebacterium diphtheriae strains: correlation with ADP-ribosylation activity assay.

We have developed a polymerase chain reaction assay for the clinical diagnosis of potentially toxinogenic strains of Corynebacterium diphtheriae, the causative agent of diphtheria. A 910-bp amplification product, overlapping a DNA portion encoding both fragments of the diphtheria toxin, has been found in 28 among the 36 strains tested. In addition, effective toxin production, as evidenced by the ability of bacterial culture supernatants to ADP ribosylate eukaryotic elongation factor 2, was determined. In every case, the presence of an amplification product correlated with an ADP-ribosylation activity, thus confirming the diagnosis. The polymerase chain reaction assay herein described is very rapid (2 h) compared with the Elek immunodiffusion test or the guinea pig lethality test. It can provide a convenient and reliable method for laboratories involved in the identification of toxinogenic corynebacteria.

Corynebacterium seminale sp. nov., a new species associated with genital infections in male patients.

We studied 12 coryneform isolates having similar biochemical profiles which did not permit their assignment to any recognized taxa. Human semen was the source for seven of these strains, whereas the other strains were isolated from urethra, urine, and blood specimens of adult male patients. These bacteria were found in significant quantities (10(4) to 10(5) CFU/ml) in semen specimens from infertile male patients with the diagnosis of prostatitis. These strains had characteristics of the genus Corynebacterium, such as 60 mol% G + C in the DNA and corynemycolic acids, meso-diaminopimelic acid, arabinose, and galactose in the cell wall. Quantitative DNA-DNA hybridizations (S1 nuclease procedure) and phylogenies based on comparisons of almost-complete small-subunit ribosomal DNA sequences confirmed that these strains constitute a single new species within the genus Corynebacterium. All 12 strains showed similar phenotypic features, i.e., good growth on sheep blood agar in contrast with poor growth on the same medium supplemented with 1% Tween 80, a positive CAMP test in the presence of Staphylococcus aureus, glucose and sucrose fermentation, and the presence of beta-glucuronidase. Some strains reduced nitrate and hydrolyzed urea or esculin. These features allowed us to distinguish these strains from members of any other coryneform taxon, and the proposed name is Corynebacterium seminale with strain IBS B12915 (CIP 104297) as the type strain. The description and delineation of these strains as a new species should be useful for further studies, including evaluations of their prevalence among the normal flora and their clinical implications.

Corynebacterium argentoratense sp. nov., from the human throat.

A new Corynebacterium species, Corynebacterium argentoratense was isolated from the throats of four human patients. It is characterized by the presence of chemotype IV, a cell wall, corynomycolic acids, and a G+C content ranging from 60 to 61 mol%. Strains belonging to this species exhibit high levels of DNA relatedness as determined by DNA-DNA hybridization experiments (S1 nuclease procedure) but no close DNA relatedness with related Corynebacterium species. Phylogenies based on comparative analyses of nearly complete small-subunit rDNA sequences confirmed the inclusion of this new species within the genus Corynebacterium and grouped it in a cluster with C. diphtheriae, C. ulcerans, C. pseudotuberculosis, and C. kutscheri. PCR experiments revealed an absence of the gene coding for diphtheria toxin. This new species can be identified by its mycolic acid pattern, fermentation of sugars, and enzymatic activities. Strain IBS B10697 (CIP 104296) is the type strain of C. argentoratense.

Clinical and molecular study of Corynebacterium diphtheriae systemic infections in France. Coryne Study Group.

Diphtheria is a disease with a long history that almost completely disappeared from developed countries. In addition, until 1987, systemic infections involving Corynebacterium diphtheriae were rare. However, in 1990, an epidemic occurred in Russia. These two circumstances have provided the stimulus to gain insight into the situation in France. In fact, between 1987 and 1993, a total of 59 C. diphtheriae strains were isolated. Epidemiological data were collected for patients from whom 40 strains were isolated from normally sterile sites, including 34 from blood cultures, and half of the bacteremic patients developed endocarditis. Osteoarticular involvement was noted in 11 of these 40 patients, including 5 bacteremic patients. The fatality rate following bacteremia was 36%, despite specific antibiotic treatment (beta-lactams and aminoglycosides). The mean age of the participants was 38 years, with half of the patients subsisting under low socioeconomic conditions and suffering from homelessness or alcoholism. Apparently, the skin turned out to be the major route of transmission in this reemerging disease. Eighty-eight percent of the isolates belonged to the C. diphtheriae biotype mitis. These were found predominantly in the Paris area, and most were of the same ribotype. Those isolates originating from the overseas territories (Guyana and New Caledonia) belonged to C. diphtheriae biotype gravis. No strains were positive for the tox gene by PCR. This study attests to the persistent circulation in France of C. diphtheriae in the form of systemic infections. The matter is especially significant since these strains are nontoxigenic and are of a unique ribotype. The strains are, however, sensitive to most antibiotics, although 20% are rifampin resistant.

Comparison of traditional and molecular methods for typing nontoxigenic strains of Corynebacterium diphtheriae.

Thirty-eight nontoxigenic strains of Corynebacterium diphtheriae isolated between 1987 and 1992 from clinical specimens of French patients were typed by biotyping, antibiograms, bacteriophage typing, ribotyping, and restriction analysis by pulsed-field gel electrophoresis (PFGE). Excellent correlation occurred between the genotypes defined by PFGE SfiI profiles or by ribotype BstEII profiles. Genotyping revealed seven genotype patterns among the 26 biotype mitis isolates, five among the nine biotype gravis isolates, and three among the three biotype belfanti isolates. Phage typing was nonreactive for nine of the 38 isolates. A combination of all the typing methods led to the identification of 19 different types of Corynebacterium diphtheriae.