Hotta Fumika, Eguchi Hiroshi, Naito Takeshi, Mitamura Yoshinori, Kusujima Kohei, Kuwahara Tomomi
Department of Ophthalmology, Institute of Health Biosciences, The University of Tokushima Graduate School, 3-18-15, Kuramoto-cho, Tokushima 770-8503, Japan.
BMC Ophthalmol. 2014 Nov 24;14:142. doi: 10.1186/1471-2415-14-142.
In clinical settings, bacterial infections are usually diagnosed by isolation of colonies after laboratory cultivation followed by species identification with biochemical tests. However, biochemical tests result in misidentification due to similar phenotypes of closely related species. In such cases, 16S rDNA sequence analysis is useful. Herein, we report the first case of an Achromobacter-associated buckle infection that was diagnosed by 16S rDNA sequence analysis. This report highlights the significance of Achromobacter spp. in device-related ophthalmic infections.
A 56-year-old woman, who had received buckling surgery using a silicone solid tire for retinal detachment eighteen years prior to this study, presented purulent eye discharge and conjunctival hyperemia in her right eye. Buckle infection was suspected and the buckle material was removed. Isolates from cultures of preoperative discharge and from deposits on the operatively removed buckle material were initially identified as Alcaligenes and Corynebacterium species. However, sequence analysis of a 16S rDNA clone library using the DNA extracted from the deposits on the buckle material demonstrated that all of the 16S rDNA sequences most closely matched those of Achromobacter spp. We concluded that the initial misdiagnosis of this case as an Alcaligenes buckle infection was due to the unreliability of the biochemical test in discriminating Achromobacter and Alcaligenes species due to their close taxonomic positions and similar phenotypes. Corynebacterium species were found to be contaminants from the ocular surface.
Achromobacter spp. should be recognized as causative agents for device-related ophthalmic infections. Molecular species identification by 16S rDNA sequence analysis should be combined with conventional cultivation techniques to investigate the significance of Achromobacter spp. in ophthalmic infections.
在临床环境中，细菌感染通常通过实验室培养后分离菌落，再用生化试验进行菌种鉴定来诊断。然而，由于亲缘关系相近的菌种具有相似的表型，生化试验会导致错误鉴定。在这种情况下，16S rDNA序列分析很有用。在此，我们报告首例通过16S rDNA序列分析诊断的无色杆菌相关性扣带感染病例。本报告强调了无色杆菌属在与器械相关的眼部感染中的重要性。
一名56岁女性，在本研究前18年因视网膜脱离接受了使用硅胶实心轮胎的扣带手术，右眼出现脓性眼分泌物和结膜充血。怀疑为扣带感染，遂取出扣带材料。术前分泌物培养物及手术取出的扣带材料上的沉积物分离出的菌株最初被鉴定为产碱杆菌属和棒状杆菌属。然而，使用从扣带材料上的沉积物中提取的DNA对16S rDNA克隆文库进行序列分析表明，所有16S rDNA序列与无色杆菌属的序列最为匹配。我们得出结论，该病例最初被误诊为产碱杆菌扣带感染，是由于生化试验在区分无色杆菌属和产碱杆菌属时不可靠，因为它们的分类地位相近且表型相似。发现棒状杆菌属是眼表的污染物。
无色杆菌属应被视为与器械相关的眼部感染的病原体。应将通过16S rDNA序列分析进行的分子菌种鉴定与传统培养技术相结合，以研究无色杆菌属在眼部感染中的重要性。
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