Department of Microbiology, Sanjay Gandhi Post-Graduate Institute of Medical Sciences, Lucknow, India.
Indian J Med Res. 2012 Mar;135(3):341-5.
BACKGROUND & OBJECTIVES: Indole negative Proteus species are invariably incorrectly identified as P. mirabilis, missing isolates of Proteus penneri. P. penneri is an invasive pathogen capable of causing major infectious diseases still seldom reported in individual cases. We report here the isolation, differentiation, characterization and typing of P. penneri from patients with different clinical infections.
Urine, pus and body fluids collected from patients in intensive care units, wards and out patients departments of a tertiary health care institute from north India were cultured. A total of 61 indole negative Proteus isolates were subjected to extended biochemical tests to differentiate and identify P. penneri from P. mirabilis including failure to produce ornithine decarboxylase (by 0% strains of P. penneri and 100% strains of P. mirabilis) besides P. penneri being uniformly salicin negative, non-utilizer of citrate but ferments sucrose and maltose. Antibiograms and Dienes phenomenon were performed to characterize and type P. penneri isolates besides screening for β-lactamase production.
Eight isolates of P. penneri were identified; four from urine, three from abdominal drain-fluid and one from diabetic foot ulcer. P. penneri was isolated as the sole pathogen in all patients having underlying disease; post-operatively. Swarming was not seen in the first strain on primary isolation and was poor in strain-4. All eight isolates were biochemically homologous but multi-drug resistant (MDR) with resistance to 6-8 drugs (up to 12). β-lactamase production was seen in three of five isolates while Dienes phenomenon found four distinct types and discriminated strains differing in resistance even with a single drug.
INTERPRETATION & CONCLUSIONS: A few additional biochemical tests identified P. penneri isolates; it infected patients with underlying disease and strains were MDR and heterogenous.
吲哚阴性变形杆菌属的种属总是被错误地鉴定为普通变形杆菌，从而漏掉了朋纳氏变形杆菌的分离株。朋纳氏变形杆菌是一种侵袭性病原体，能够引起重大传染病，但在个别病例中仍很少报道。我们在此报告从不同临床感染患者中分离、区分、鉴定和分型朋纳氏变形杆菌的情况。
从印度北部的一家三级保健机构的重症监护病房、病房和门诊患者采集尿液、脓液和体液进行培养。对 61 株吲哚阴性变形杆菌属进行了扩展生化试验，以区分和鉴定朋纳氏变形杆菌与普通变形杆菌，包括（朋纳氏变形杆菌的 0%菌株和普通变形杆菌的 100%菌株）均不能产生鸟氨酸脱羧酶，以及朋纳氏变形杆菌属均匀地不利用水杨苷，不利用柠檬酸盐但发酵蔗糖和麦芽糖。对朋纳氏变形杆菌属的分离株进行了抗生素图谱和 Dienes 现象分析，以进行特征和分型，同时还进行了β-内酰胺酶产生的筛选。
鉴定出 8 株朋纳氏变形杆菌属，其中 4 株来自尿液，3 株来自腹腔引流液，1 株来自糖尿病足溃疡。所有患者都存在基础疾病，且都在术后分离出朋纳氏变形杆菌属。在首次分离时，第一株菌没有出现菌苔，而第四株菌的菌苔较差。所有 8 株菌的生化特征均相同，但对 6-8 种药物（最高达 12 种）均表现出多药耐药（MDR）。5 株菌中有 3 株产生β-内酰胺酶，Dienes 现象发现了 4 种不同的类型，甚至在使用单一药物时，也能区分出具有不同耐药性的菌株。
通过一些额外的生化试验可以鉴定出朋纳氏变形杆菌属的分离株；它感染了有基础疾病的患者，且菌株具有 MDR 和异质性。
