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Historical Perspectives and Identification of Neisseria and Related Species JOAN S

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Historical Perspectives and Identification of Neisseria and Related Species JOAN S CLINICAL MICROBIOLOGY REVIEWS, OCt. 1988, p. 415-431 Vol. 1, No. 4 0893-8512/88/040415-17$02.00/0 Historical Perspectives and Identification of Neisseria and Related Species JOAN S. KNAPP Sexually Transmitted Diseases Laboratory Program, Center for Infectious Diseases, Centers for Disease Control, Atlanta, Georgia 30333 INTRODUCTION............................................415 HISTORICAL PERSPECTIVES ON THE TAXONOMY OF THE FAMILY NEISSERIACEAE........o ... 416 Taxonomy of the Family Neisseriaceae......................416 Taxonomy of Neisseria spp. and B. catarrhalis...................................16 Early Studies........417............. .................... ....... 417 Pathogenic Neisseria spp ................................. ......................- ..........417 Saccharolytic Neisseria spp....... o.... 418 Asaccharolytic Neisseria spp.....................................................................419 Modern Studies ........4.19...................................... 419 Pathogenic Neisseria spp......................................... .......................... .....420 Saccharolytic Neisseria spp .................................................... o.................420 Asaccharolytic Neisseria spp.........................................................................421 "New" Species...................421 N. flavescens ..........................................o ............... ...... ...... 421 N. mucosa.42............................................1...........................421 N. liactamica ..........................................................................421 N. elongate .................................. ..... .......4....21o.............. 421 N. polysaccharea ...................................................421 N. gonorrhoeae subsp. ochii....................421 NEISSERIA AND RELATED SPECIES: PATHOGENS OR SAPROPHYTES? o... 421 HABITAT AND PREVALENCE OF NEISSERIA SPP .............422....-.-.................... 422 IDENTIFICATION OF NEISSERIA AND RELATED SPECIES............................... ...............422 Bacteriology .......................................... ................. oooo 422 Selection of Tests ... ..................................................................2.....43 Traditional Tests... ........................................................................ 424 Rapid Tests for Identification of Neisseria and Related Species.........................................-oooo- o.424 Acid production tests ...... .... o ........................... 424 Enzyme substrate tests .......................................................... .. ............... 425 Serologic tests for laboratory identification of N. gonorrhoeae .....o............... ..............425 New Technologies for Identification of N. gonorrhoeae........ ......427 Nucleic Acid Probes......................................................... o. 427 Interpretation of Results ....................... ..................................................427 Mules, Horses, or Donkeys .........................................................................428 SUMMARY ......................................................................... 428 ACKNOWLEDGMENTS............-..-.........................................................428 LITERATURE CITED..................... ......................................, 428 INTRODUCTION media have been inappropriately tested in rapid diagnostic tests specifically designed to identify strains isolated on Neisseria spp. are pathogens and normal flora in humans selective media (100). Some problems may have resulted (73). Because the diagnosis of gonorrhea in a person may because several either have been combined into a have important social and medicolegal consequences (100), species or have not been described it is important that clinical isolates of Neisseria spp. be single species (80) previously (46, correctly identified. Rapid tests provide timely 47) or recognized (63, 96). laboratory the of the confirmation of a clinical diagnosis of gonorrhea (30). How- This paper reviews the history of taxonomy on ever, problems have occurred with most rapid diagnostic genus Neisseria to provide an historical perspective the tests which may result in the misidentification of nonpatho- difficulties faced in previous studies of the species, the genic Neisseria spp. as Neisseria gonorrhoeae (18, 26, 30, taxonomic changes that have been made within the genus, 34). and the prevalence of the nonpathogenic species and to Strains of nonpathogenic Neisseria spp. isolated on selec- discuss the procedures that may be used to identify Neis- tive media for the gonococcus have been misidentified (34, seria and related species. Discussions of other genera are 63) because they can give reactions similar to the gono- limited to Kingella denitrificans and Branhamella catarr- coccus in rapid tests for the confirmation of N. gonorrhoeae halis, which may be misidentified as N. gonorrhoeae (100). (18, 34). Nonpathogenic strains isolated on nonselective The bibliography for this review is extensive but selective 415 416 KNAPP CLIN. MICROBIOL. REV. and provides key references that will guide the reader to TABLE 1. Taxonomy of the family Neisseriaceae, 1939 to 1984 additional readings on this subject. Edition of Bergey's Manual (yr of publication) Genus and species HISTORICAL PERSPECTIVES ON THE TAXONOMY OF 5th 6th 7th 8th 1st THE FAMILY NEISSERIACEAE (1939) (1948) (1957) (1974) (1984)a Neisseria gonorrhoeae Yes Yes Yes Yes Yes Taxonomy of the Family Neisseriaceae N. meningitidisb Yes Yes Yes Yes Yes N. catarrhalis Yes Yes Yes Noc INo The genus Neisseria belongs to the family Neisseriaceae N. sicca Yes Yes Yes Yes Yes (95), which has undergone many taxonomic changes (14, 15, N. perflava Yes Yes Yes Nod rNod 19, 74, 75, 80) that are summarized in Table 1. The genus N. flava Yes Yes Yes Nod INod until 1948 N. subflava Yes Yes Yes Yes Yes Neisseria was assigned to the family Coccaceae N. flavescens Yes Yes Yes Yes Yes (74), when it was reassigned as the type genus in the family N. discoidese Yes Yes No No ?No Neisseriaceae (75). The family Neisseriaceae at that time N. reniformise Yes Yes No No INO also contained the strictly anaerobic Veillonella spp. (14, N. orbiculatae Yes Yes No No INO 19). The family Neisseriaceae now contains the genera N. haemolysansf No No Yes No INO Neisseria, Moraxella, Acinetobacter, and Kingella (14), N. caviae No No Yes (Yes)9 ((Yes)h which are differentiated from each other by cell morphology, N. mucosa No No No Yes IYes oxidase and catalase reactions, the presence of carbonic N. animalis No No No (Yes) INo anhydrase, the production of acid from glucose, the ability to N. canis No No No (Yes) IYes reduce nitrite, the presence of thymidine phosphorylase, N. cinerea No No No (Yes) IYes N. cuniculi No No No (Yes) (Yes)h nucleoside deoxyribosyl transferase, and thymidine kinase, N. denitrificans No No No (Yes) IYes and the presence of true waxes in the cell wall (14). N. elongata No No No (Yes) IYes The genus Neisseria contains species that are isolated N. lactamica' No No No (Yes) IYes from humans and other animals. The human species have N. ovis No No No (Yes) (Yes)h undergone few taxonomic changes. The most notable change N. suis No No No (Yes) INo in the taxonomy of the family has been a result of genetic N. kochii No No No No INo studies. These led to the reassignment of N. catarrhalis to N. polysaccharea' No No No No INo the genus Branhamella (25) and the inclusion of B. catarr- Veillonellak parvula Yes Yes Yes No INo in Because V. gazogenes Yes Yes Yes No INo halis as a subgenus the genus Moraxella (14, 15). Branhamella catarrhalisc No No No Yes INo subgenus and subspecific epithets are not used (90), strains Moraxella lacunata No No No Yes Yes of B. catarrhalis should correctly be called Moraxella ca- M. bovis No No No Yes Yes tarrhalis. However, because B. catarrhalis is distinctly M. nonliquefacians No No No Yes Yes different from the Moraxella spp. in cell morphology and has M. phenylpyruvica No No No Yes Yes recently been recognized as a pathogen (21, 27, 68), the M. osloensis No No No Yes Yes name B. catarrhalis is commonly used, although no formal M. kingii No No No (Yes) INo request has been made to have the name conserved taxo- M. "urethralis" No No No (Yes) (Yes) nomically. M. atlantae No No No No Yes Acinetobacter calcoaceticus No No No Yes Yes Kingella kingae No No No No Yes Taxonomy of Neisseria spp. and B. catarrhalis K. indologenes No No No No Yes K. denitrificans No No No No Yes The genus Neisseria contains 12 species and biovars (95) isolated from humans. They can be identified by many a Bergey's Manual of Determinative Bacteriology was renamed Bergey's Manual of Systematic Bacteriology in 1984. characteristics, including their patterns of acid production b N. meningitidis was named N. intracellularis in the 3rd and 4th editions of from carbohydrates and their ability to reduce nitrate and to Bergey's Manual of Determinative Bacteriology. produce polysaccharide from sucrose (Table 2). Although c N. catarrhalis was transferred to the genus Branhamella in 1974. Al- several human Neisseria species were described in the late though this species was reassigned as a subgenus in the genus Moraxella in most were in 1984 (14, 15), the name B. catarrhalis is still used; no application has been 1800s, described 1906, when von Lingelsheim made to have this name retained as nomen conservandum. cultured specimens to determine the etiology of meningitis d N. perflava and N. flava were
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