Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
Int J Antimicrob Agents. 2011 Dec;38(6):534-7. doi: 10.1016/j.ijantimicag.2011.07.018. Epub 2011 Oct 19.
To investigate the clinical and microbiological characteristics of infections caused by Tsukamurella spp., the computerised database of the Bacteriology Laboratory at National Taiwan University Hospital (Taipei, Taiwan) was reviewed retrospectively to identify patients with infections caused by this species during the period January 1997 to December 2008. All of the isolates had been initially misidentified as Rhodococcus spp. Identification of Tsukamurella isolates to species level was carried out by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis of the heat shock protein gene (hsp65) as well as 16S rRNA gene sequencing. During the study period, a total of eight patients with Tsukamurella infection and two patients with Tsukamurella colonisation were identified. Tsukamurella tyrosinosolvens (n=6) was the most prevalent species, followed by Tsukamurella spumae (n=3) and Tsukamurella pulmonis (n=1). Keratitis was the most common type of infection (n=3), followed by catheter-related bloodstream infection (n=2). One of the patients with Tsukamurella infection died due to bacteraemia; the other seven patients with Tsukamurella infection had favourable outcomes. The three species had different drug susceptibility patterns; T. pulmonis was the most resistant pathogen, with higher minimum inhibitory concentrations of clindamycin (>2 mg/L), erythromycin (2 mg/L) and tetracycline (8 mg/L) than those for the other Tsukamurella spp. In conclusion, strains of Tsukamurella spp., including T. spumae, are uncommon causative agents of ocular infections and bacteraemia in cancer patients. Molecular diagnostic methods are essential to distinguish species in the Tsukamurella genus from species in other phylogenetically related genera such as Rhodococcus.
为了研究土拉弗朗西斯菌属感染的临床和微生物学特征，我们回顾性地分析了台湾大学医院细菌学实验室的计算机数据库，以确定 1997 年 1 月至 2008 年 12 月期间由该菌种引起感染的患者。所有分离株最初均被错误鉴定为罗霍氏菌属。通过聚合酶链反应-限制性片段长度多态性（PCR-RFLP）分析热休克蛋白基因（hsp65）以及 16S rRNA 基因测序，对土拉弗朗西斯菌属分离株进行种水平鉴定。在研究期间，共发现 8 例土拉弗朗西斯菌感染和 2 例土拉弗朗西斯菌定植患者。最常见的菌种是酪氨酸土拉弗朗西斯菌（n=6），其次是泡土拉弗朗西斯菌（n=3）和肺土拉弗朗西斯菌（n=1）。角膜炎是最常见的感染类型（n=3），其次是导管相关血流感染（n=2）。1 例土拉弗朗西斯菌感染患者因菌血症死亡，其余 7 例土拉弗朗西斯菌感染患者预后良好。这 3 个菌种具有不同的药物敏感性模式；肺土拉弗朗西斯菌对克林霉素（>2 mg/L）、红霉素（2 mg/L）和四环素（8 mg/L）的最低抑菌浓度最高，耐药性最强，高于其他土拉弗朗西斯菌属菌种。总之，土拉弗朗西斯菌属菌株，包括泡土拉弗朗西斯菌，是癌症患者眼部感染和菌血症的不常见病原体。分子诊断方法对于将土拉弗朗西斯菌属与其他系统发育相关属（如罗霍氏菌属）中的菌种区分开来至关重要。
