Rapid identification of bacteria by real-time amplification and sequencing of the 16S rRNA gene

To allow rapid identification of bacteria in pure cultures and blood culture bottles, an assay was developed which is based on real-time amplification and sequencing of bacterial 16 S rRNA genes. In principle, this assay allows identification of bacteria from pure cultures within 6.5 h, and from blood cultures within approximately 7 h.     

Identification of campylobacteria isolated from Danish broilers by phenotypic tests and species-specific PCR assays

AIMS: To validate a phenotypic Campylobacter species identification method employed to identify campylobacters in broilers by comparison with campylobacterial species identification using various species-specific PCR analyses. METHODS AND RESULTS: From a collection of 2733 phenotypically identified campylobacterial cultures, 108 Campylobacter jejuni cultures and 351 campylobacterial cultures other than Camp. jejuni were subjected to various species-specific PCR assays. On the basis of the genotypic tests, it was demonstrated that Camp. jejuni and Camp. coli constituted approx. 99% of all cultures, while other species identified were Helicobacter pullorum, Camp. lari and Camp. upsaliensis. However, 29% of the 309 Camp. coli cultures identified by phenotypic tests were hippurate-variable or negative Camp. jejuni cultures, whereas some Camp. lari cultures and unspeciated campylobacter cultures belonged to H. pullorum. It was also notable that 2-6% of the cultures were, in fact, mixed cultures. CONCLUSIONS: The phenotypic identification scheme employed failed to appropriately differentiate Campylobacter species and particularly to identify the closely related species, H. pullorum. SIGNIFICANCE AND IMPACT OF THE STUDY: Future phenotypic test schemes should be designed to allow a more accurate differentiation of Campylobacter and related species. Preferably, the phenotypic tests should be supplemented with a genotypic strategy to disclose the true campylobacterial species diversity in broilers.     

Rapid identification of bacteria and candida using pna-fish from blood and peritoneal fluid cultures: a retrospective clinical study

Background

Peptide nucleic acid fluorescent in situ hybridization (PNA-FISH) is a rapid and established method for identification of Candida sp., Gram positive, and Gram negative bacteria from positive blood cultures. This study reports clinical experience in the evaluation of 103 positive blood cultures and 17 positive peritoneal fluid cultures from 120 patients using PNA-FISH. Our study provides evidence as to potential pharmaceutical cost savings based on rapid pathogen identification, in addition to the novel application of PNA-FISH to peritoneal fluid specimens.

Methods

Identification accuracy and elapsed time to identification of Gram positives, Gram negatives, and Candida sp., isolated from blood and peritoneal fluid cultures were assessed using PNA-FISH (AdvanDx), as compared to standard culture methods. Patient charts were reviewed to extrapolate potential pharmaceutical cost savings due to adjustment of antimicrobial or antifungal therapy, based on identification by PNA-FISH.

Results

In blood cultures, time to identification by standard culture methods for bacteria and Candida sp., averaged 83.6 hours (95% CI 56.7 to 110.5). Identification by PNA-FISH averaged 11.2 hours (95% CI 4.8 to 17.6). Overall PNA-FISH identification accuracy was 98.8% (83/84, 95% CI 93.5% to 99.9%) as compared to culture. In peritoneal fluid, identification of bacteria by culture averaged 87.4 hours (95% CI ?92.4 to 267.1). Identification by PNA-FISH averaged 16.4 hours (95% CI ?57.3 to 90.0). Overall PNA-FISH identification accuracy was 100% (13/13, 95% CI 75.3% to 100%). For Candida sp., pharmaceutical cost savings based on PNA-FISH identification could be $377.74/day. For coagulase-negative staphylococcus (CoNS), discontinuation of vancomycin could result in savings of $20.00/day.

Conclusions

In this retrospective study, excellent accuracy of PNA-FISH in blood and peritoneal fluids with reduced time to identification was observed, as compared to conventional culture-based techniques. Species-level identification based on PNA-FISH could contribute to notable cost savings due to adjustments in empiric antimicrobial or antifungal therapy as appropriate to the pathogen identified.     

r/b Expanders: Their Use in Identifying Routinely and Unusually Reacting Members of Enterobacteriaceae

This cooperative study between a large clinical laboratory and a reference laboratory evaluated the performance of the expanded r/b system for identifying Enterobacteriaceae. The 2,200 cultures isolated in the normal hospital routine presented no problem of identification to the r/b system. About 250 "atypical" cultures which were exchanged between the collaborating laboratories were also identified accurately. The expanded r/b system was found to perform as well as most biochemical-physiological identification systems, and when used appropriately was highly satisfactory as a system for identification of Enterobacteriaceae.     

Frequency of genes speA,speB, and speC in Streptococcus pyogenes strains and the identification of the infective agent by polymerase chain reaction

In cultures of S. pyogenes isolated from patients and carriers in different territories of the Russian Federation the genes of erythorogenic toxins A, B and C (speA, speB and specC) were detected. The possibility of the identification of S. pyogenes by means of PCR on the basis of primers to erythrogenic toxin B was determined. Gene speB was detected in all S. pyogenes cultures under study and proved to be species specific. Genes speA and speC were detected, respectively, in 29.4% and 9.35% of the S. pyogenes cultures under study. A test system for the identification of S. pyogenes on the basis of primers to gene speB was developed. The prospects for the detection of genes speA and speC for intraspecific typing of this infective agent were evaluated.     

Design of a PCR test based on the gyrA gene sequence for the identification of closely related species of the Bacillus subtilis group

A method for the taxonomic identification of seven closely related bacterial species of the Bacillus subtilis group (B. subtilis, B. amyloliquefaciens, B. licheniformis, B. vallismortis, B. atrophaeus, B. sonorensis, and B. mojavensis) using specific primers selected on the basis of the gyrA gene sequences was developed. The effectiveness of this method both for the identification of pure cultures of type strains of this group and for the precise species identification of collection and industrial bacterial strains was demonstrated. The principal possibility of using this method for detecting B. subtilis group bacteria in mixed cultures was shown.     

Identification ofStaphylococcus aureus nuclease by seroinhibition in blood culture supernatant fluid

A rapid (2 h) method forStaphylococcus aureus identification by seroinhibition of staphylococcal thermonuclease has been developed and applied to blood cultures. No false positive reaction occurred in blood cultures containing isolates other thanS. aureus, and only one false negative among 31S. aureus-positive blood cultures was found.     

Rapid identification, virulence analysis and resistance profiling of Staphylococcus aureus by gene segment-based DNA microarrays: application to blood culture post-processing

Up to now, blood culturing systems are the method of choice to diagnose bacteremia. However, definitive pathogen identification from positive blood cultures is a time-consuming procedure, requiring subculture and biochemical analysis. We developed a microarray for the identification of Staphylococcus aureus comprising PCR generated gene-segments, which can reduce the blood culture post-processing time to a single day. Moreover, it allows concomitant identification of virulence factors and antibiotic resistance determinants directly from positive blood cultures without previous amplification by PCR. The assay unambiguously identifies most of the important virulence genes such as tsst-1, sea, seb, eta and antibiotic resistance genes such as mecA, aacA-aphD, blaZ and ermA. To obtain positive signals, 20 ng of purified genomic S. aureus DNA or 2 microg of total DNA extracted from blood culture was required. The microarray specifically distinguished S. aureus from gram-negative bacteria as well as from closely related coagulase negative staphylococci (CoNS). The microarray-based identification of S. aureus can be accomplished on the same day blood cultures become positive in the Bactec. The results of our study demonstrate the feasibility of microarray-based systems for the direct identification and characterization of bacteria from cultured clinical specimens.     

Picoplankton culture assessment using single strand conformation polymorphism and partial 18S sequencing

Environmental water samples were taken throughout 2001 fromfractioned water samples at the Helgoland time series site.The less than 3-µm fraction was inoculated into variousmedia. Serial dilutions from these inoculations produced a largenumber of rough cultures from which several hundred well-growingpicoplankton cultures were started. We established a combinationof crude DNA extraction, single strand conformation polymorphism(SSCP) fingerprinting and subsequent sequence analysis to screenthese large numbers of cultures, assess their purity/clonalityand determine their identity. Picoplankton species (i.e., cellssmaller than 3 µm) are difficult to distinguish becauseof their small size and the lack of morphological characters.Therefore, molecular techniques provide the most reliable methodto achieve their identification. Cultures were enriched forphotoautotroph cells, i.e., no carbon source was added, andcultures were grown in the light. From these cultures, crudeDNA was extracted, which was used for partial 18S polymerasechain reaction (PCR). On average, 50% of the cultures produceda PCR product. SSCP analysis of PCR products revealed the clonalityof a given culture. If clonal, then there was only a singleSSCP band; if not clonal, then there were multiple SSCP bands.Single SSCP bands were subsequently sequenced, and sequenceswere used to identify the culture. For this study, 300 cultureswere screened resulting in the identification of 63 potentiallyclonal cultures. These methods proved to be relatively easyto apply to assess the clonality and purity of the cultures.     

Automatic identification of algae: neural network analysis of flow cytometric data

The performance of an artificial neural network for automaticidentification of phytoplankton was investigated with data fromalgal laboratory cultures, analysed on the Optical PlanktonAnalyser (OPA), a flow cytometer especially developed for theanalysis of phytoplankton. Data from monocultures of eight algalspecies were used to train a neural network. The performanceof the trained network was tested with OPA data from mixturesof laboratory cultures. The network could distinguish Cyanobacteriafrom other algae with 99% accuracy. The identification of specieswas performed with less accuracy, but was generally >90%.This indicates that a neural network under supervised learningcan be used for automatic identification of species in relativelycomplex mixtures. Incorporation of such a system may also increasethe operational size range of a flow cytometer. The combinationof the OPA and neural network data analysis offers the elementsto build an operational automatic algal identification system.     

Agar Block Technique for Identification of Mycoplasmas by Use of Fluorescent Antibody

A procedure for staining mycoplasmata colonies directly on agar blocks for examination by fluorescent microscopy is described. Areas of the agar surface appropriate for staining were demarcated by use of Lucite cylinders. Direct fluorescent-antibody staining was superior to indirect staining. The technique was very useful for determining whether cultures were mixed and for identification of mycoplasmas in either pure or mixed cultures.     

Use of in-house PCR for identification of Mycobacterium tuberculosis in BACTEC broth cultures of respiratory specimens

We evaluated the ability of a PCR assay to identify Mycobacterium tuberculosis complex (MTBC) from positive BACTEC(R) 12B broth cultures. A total of 107 sputum samples were processed and inoculated into Ogawa slants and BACTEC(R) 12B vials. At a growth index (GI) > 30, 1.0 ml of the 12B broth was removed, stored, and assayed with PCR. Molecular results were compared to those obtained by phenotypic identification methods, including the BACTEC(R) NAP method. The average times required to perform PCR and NAP were compared. Of the 107 broth cultures evaluated, 90 were NAP positive, while 91 were PCR positive for MTBC. Of particular interest were three contaminated BACTEC(R) 12B broth cultures yielding microorganisms other than acid-fast bacilli growth with a MTBC that were successfully identified by PCR, resulting in a mean time of 14 days to identify MTBC before NAP identification. These results suggest that PCR could be used as an alternative to the NAP test for the rapid identification of MTBC in BACTEC(R) 12B cultures, particularly in those that contained both MTBC and nontuberculous mycobacteria.     

Micronucleus formation in different lymphocyte subpopulations in peplomycin-treated and control cultures

Spontaneous micronucleus formation and micronucleus induction by peplomycin in B and T lymphocytes was studied by a recently developed MAC (Morphology, Antibody, Chromosomes) method allowing the immunologic identification of different cell lineages. Blood samples from 3 healthy donors were cultured in the presence of phytohaemagglutinin and pokeweed mitogen. An increased frequency of micronuclei was observed in peplomycin cultures compared with controls. B cells were found to be more sensitive to peplomycin induction than were T lymphocytes. In control cultures, pokeweed mitogen yielded a higher frequency of micronuclei than did phytohaemagglutinin. In both pokeweed- and phytohaemagglutinin-stimulated cultures, B cells showed a higher frequency of micronuclei than did T cells. The relative proportion of mitotic B cells was equal in pokeweed and phytohaemagglutinin cultures. In peplomycin cultures, the proportion of B cells decreased as compared with control cultures.     

Decontamination of bacterial infection of monolayer cultures with a specific bacteriophage

A few cell lines and primary monolayer cultures were accidentally infected by bacteria. These cultures were successfully decontaminated by means of the specific bacteriophage virus after quick identification of the responsible bacteria. This method presents a practical interest for preservation of valuable cultures.     

Direct matrix-assisted laser desorption ionization time-of-flight mass spectrometry improves appropriateness of antibiotic treatment of bacteremia

Matrix assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) allows the identification of microorganisms directly from positive blood culture broths. Use of the MALDI-TOF MS for rapid identification of microorganisms from blood culture broths can reduce the turnaround time to identification and may lead to earlier appropriate treatment of bacteremia. During February and April 2010, direct MALDI-TOF MS was routinely performed on all positive blood cultures. During December 2009 and March 2010 no direct MALDI-TOF MS was used. Information on antibiotic therapy was collected from the hospital and intensive care units' information systems from all positive blood cultures during the study period. In total, 253 episodes of bacteremia were included of which 89 during the intervention period and 164 during the control period. Direct performance of MALDI-TOF MS on positive blood culture broths reduced the time till species identification by 28.8-h and was associated with an 11.3% increase in the proportion of patients receiving appropriate antibiotic treatment 24 hours after blood culture positivity (64.0% in the control period versus 75.3% in the intervention period (p0.01)). Routine implementation of this technique increased the proportion of patients on adequate antimicrobial treatment within 24 hours.     

Affinity of chick microglia in vitro for ricin 120

Summary The distribution of binding sites for ricin 120 in cell cultures of spinal cord from the chick embryo was examined. A characteristic pattern was observed, which remained similar in cultures fixed by a variety of methods. Light microscopy demonstrated that the most prominent staining was of small rounded or amoeboid cells. Electron microscopy showed that ricin was bound over their entire surfaces. The ultrastructural characteristics of these cells suggest their identification as microglia.     

Heteroduplex mobility assay of the D1/D2 region of the 26S rDNA for differentiation of Saccharomyces species

AIMS: We present the HMA method for Saccharomyces differentiation using the PCR amplified D1/D2 26S rDNA. METHODS AND RESULTS: This methodology is based on heteroduplex formation when two different DNAs are hybridized. We tested 11 type cultures of Saccharomyces, 27 different cultures of S. cerevisiae and four other ascomycetic genera. CONCLUSION: The method was capable of differentiating Saccharomyces species and was mainly very efficient for S. cerevisiae identification. HMA can probably be applied in other genera, where identification is sometimes difficult only by conventional traits, which are based on physiology and morphology. SIGNIFICANCE AND IMPACT OF THE STUDY: HMA provides a rapid and relatively simple molecular tool, contributing for yeast taxonomy.     

Gas chromatographic assay of cellular fatty acids and alcohols for the identification of Mycobacterium species.

Ten mycobacterial species obtained from 141 cultures isolated from clinical specimens were studied. The cultures were grown on solid medium and then analysed-after saponification, methylation, extraction with organic solvent and washing of the organic phase--by capillary gas-liquid chromatography for fatty acid and secondary alcohol composition. The absence of secondary alcohols was characteristic of M. genavense, M. tuberculosis and the following Mycobacterium species with specific branched-chain fatty acids allowing their direct identification: M. gordonae, M. kansasii and M. marinum. The presence of secondary alcohols was characteristic of M. avium, M. phlei, M. scrofulaceum, M. terrae and M. xenopi. In the case of M. xenopi direct identification was made possible by the presence of a specific alcohol.     

Identification of bacteria in blood culture broths using matrix-assisted laser desorption-ionization Sepsityper™ and time of flight mass spectrometry

Matrix-assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF MS) is a novel method for the direct identification of bacteria from blood culture broths. We evaluate for the first time, the performance of the MALDI Sepsityper? Kit and MS for the identification of bacteria compared to standard phenotypic methods using the manufacturer's specified bacterial identification criteria (spectral scores ≥1.700-1.999 and ≥2.000 indicated identification to genus and species level, respectively). Five hundred and seven positive blood culture broths were prospectively examined, of which 379 (74.8%; 358 monomicrobial, 21 polymicrobial) were identified by MALDI-TOF MS; 195 (100%) and 132 (67.7%) of 195 gram-positive; and 163 (100%) and 149 (91.4%) of 163 gram-negative organisms from monomicrobial blood cultures were correctly identified to genus and species level, respectively. Spectral scores <1.700 (no identification) were obtained in 128/507 (25.2%) positive blood culture broths, including 31.6% and 32.3% of gram-positive and polymicrobial blood cultures, respectively. Significantly more gram-negative organisms were identified compared to gram-positive organisms at species level (p<0.0001). Five blood cultures were misidentified, but at species level only; including four monomicrobial blood cultures with Streptococcus oralis/mitis that were misidentified as Streptococcus pneumoniae. Positive predictive values for the direct identification of both gram-positive and gram-negative bacteria from monomicrobial blood culture broths to genus level were 100%. A diagnostic algorithm for positive blood culture broths that incorporates gram staining and MALDI-TOF MS should identify the majority of pathogens, particularly to genus level.     

Micromethod System for Identification of Anaerobic Bacteria

A micromethod multitest system prepared by Analytab Products, Inc. and conventional tests employed at the Center for Disease Control for identification of anaerobes were compared. All procedures were conducted in an anaerobic glove box. A total of 104 cultures, including 18 reference strains and 86 diagnostic cultures, were examined. Ninety-one percent of the total tests performed with the two systems were in agreement. Greater than 90% agreement between the two systems was obtained with 12 of the 17 differential tests compared. The tests for nitrate reduction and H(2)S production gave the poorest agreement, 77.8 and 80.8%, respectively. Only 66% of the 86 diagnostic cultures could be presumptively identified with the micromethod system supplemented only with microscopy and colonial characteristics. However, when appropriate supplementary tests and gas-liquid chromatography were used with the micromethod system, 85% of the 86 strains could be identified. When Ehrlich reagent, instead of Kovac reagent, was used with the micromethod to test for indole, the agreement in identification was raised to 93%.