Chang Yi-Cheng, Lo Hsueh-Hsia, Hsieh Hsiu-Ying, Chang Shan-Min
Department of Internal Medicine, Fong-Yuan Hospital, Taichung, Taiwan.
Department of Medical Laboratory Science and Biotechnology, Central Taiwan University of Science and Technology, Taichung, Taiwan.
J Microbiol Immunol Infect. 2014 Aug;47(4):318-23. doi: 10.1016/j.jmii.2013.03.007. Epub 2013 May 28.
Elizabethkingia meningoseptica is an opportunistic pathogen. Identification of E. meningoseptica based on conventional methods is rather labor- and time-consuming. The information on epidemiological relatedness and microbiological characteristics of E. meningoseptica isolates from central Taiwan was limited.
Forty E. meningoseptica isolates identified by conventional methods were collected by the Central Laboratory of Central Region Hospital Alliance between 2007 and 2011. The amplification of 16S ribosomalDNA gene by polymerase chain reaction with species-specific or universal primers following DNA sequencing was used as a standard identification method. The feasibility of Vitek 2 GN card was also evaluated. Some clinical information of the patients and the drug susceptibilities and epidemiological relatedness of the isolates were analyzed.
For the 40 isolates, 39 E. meningoseptica and one Chryseobacterium indologenes were identified using 16S rDNA sequencing. Among the 39 isolates, all could be identified using species-specific primers, whereas only 84.6% could be identified by Vitek 2 GN card with excellent discrimination. All E. meningoseptica isolates were susceptible to minocycline but resistant to many drugs examined including ceftazidime, amikacin, colistin, and imipenem. The pulsed field gel electrophoresis (PFGE) patterns demonstrated that most isolates were quite genetic diversity. The patients had average age of 72.2 ± 14.5 years old (excluded one child patient of 1 year old) and 79.5% of patients were male. Twenty-three patients (59.0%) had underlying diseases.
The designed species-specific primers could be used to identify E. meningoseptica with 100% of specificity and sensitivity, whereas the Vitek 2 GN card showed considerable ability in E. meningoseptica identification. The PFGE patterns showed that most isolates were genetic diversity enough to exclude the possibility of intrahospital spread.
脑膜败血伊丽莎白菌是一种机会致病菌。基于传统方法鉴定脑膜败血伊丽莎白菌相当耗费人力和时间。来自台湾中部的脑膜败血伊丽莎白菌分离株的流行病学相关性和微生物学特征信息有限。
2007年至2011年间，中部地区医院联盟中央实验室收集了40株经传统方法鉴定的脑膜败血伊丽莎白菌分离株。以聚合酶链反应结合物种特异性或通用引物扩增16S核糖体DNA基因并进行DNA测序作为标准鉴定方法。同时评估了Vitek 2 GN卡的可行性。分析了患者的一些临床信息以及分离株的药敏情况和流行病学相关性。
对于这40株分离株，通过16S rDNA测序鉴定出39株脑膜败血伊丽莎白菌和1株产吲哚金黄杆菌。在这39株分离株中，所有菌株均可使用物种特异性引物鉴定，而Vitek 2 GN卡仅能鉴定出84.6%的菌株，鉴别能力良好。所有脑膜败血伊丽莎白菌分离株对米诺环素敏感，但对包括头孢他啶、阿米卡星、黏菌素和亚胺培南在内的多种检测药物耐药。脉冲场凝胶电泳（PFGE）图谱显示大多数分离株具有相当大的遗传多样性差异。患者的平均年龄为72.2±14.5岁（不包括1名1岁儿童患者），79.5%的患者为男性。23名患者（59.0%）有基础疾病。
所设计的物种特异性引物可用于鉴定脑膜败血伊丽莎白菌，特异性和敏感性均为100%，而Vitek 2 GN卡在鉴定脑膜败血伊丽莎白菌方面显示出相当的能力。PFGE图谱显示大多数分离株具有足够的遗传多样性差异，可排除医院内传播的可能性。
