Gram-Positive Anaerobic Cocci: Clinical Relevance, Changed Taxonomy, Identification and Antibiotic Resistance
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Gram-positive anaerobic cocci: clinical relevance, changed taxonomy, identification and antibiotic resistance © by author ESCMID Online Lecture Library Linda Veloo Contents Introduction Gram-positive anaerobic cocci Peptostreptococcus sp. (formerly) New species and taxonomy Identification © by author Antibiotic resistance ESCMID Online Lecture Library Virulence F. magna Introduction Gram-positive anaerobic cocci (GPAC): Peptococcus P.niger Seldomly isolated from clinical material Ruminococcus Faecel microbiota Seldomly ©isolated by fromauthor clinical material Insufficient culture methods? ESCMIDCoprococcus Online Lecture Library Isolated from faecal samples Gram positive anaerobic cocci, D.A. Murdoch Clinical Microbiology reviews, 1998 Introduction Atopobium Faecal microbiota and clinical material Sarcina Soil, abdominal samples, faecal samples from vegetarians and patients with gastro-intestinal abnormalities Unique cell© morphology: by author Groups of 8 cells which might produce spores ESCMID Online Lecture Library GPAC in general Clinical relevance: ± 30% of all anaerobes recovered from human clinical specimens Most GPAC: - mixed infections - susceptible for antibiotics usually used to treat anaerobic infections © by author Metronidazole-resistance: ESCMID- strict anaerobic Online cocci are Lecturegenerally sensitive Library - micro-aerophilic cocci are generally resistent Peptostreptococcus The genus Peptostreptococcus contained 13 species. Clinically most relevant (literature): P. anaerobius P. asaccharolyticus P. magnus P. micros © by author ESCMID Online Lecture Library New species, changed taxonomy (in chronological order) In 1997 3 new species were added to the genus Peptostreptococcus P. harei P. ivorii P. octavius Clinical relevance unknown© by author ESCMID Online Lecture Library Description of Three New Species of the Genus Peptostreptococcus from Human Clinical Specimens: P. harei sp. nov., P. ivorii sp. nov., and P. octavius sp. nov., D. A. Murdoch et al., Int. J. Syst. Bact. 1997 New taxonomy Reclassification of Peptostreptococcus magnus (Prevot 1933) Holdeman and Moore 1972 as Finegoldia magna comb. nov. and Peptostreptococcus micros (Prevot 1933) Smith 1957 as Micromonas micros comb. nov. Murdoch et al., Anaerobe,5, 1999 Proposal of the genera© Anaerococcus by author gen. nov., Peptoniphilus gen. nov. and Gallicola gen. nov. for members of the genus Peptostreptococcus EzakiESCMID et al., Int J syst Online Evol Microbiol, Lecture 51, 2001 Library A. murdochii Anaerococcus spp. Anaerobic cocci: anaerobic cocci Finegoldia magna MicromonasParvimonas micramicros Gallicola barnesea Helcococcus kunzii Peptoniphilus spp. P. gorbachii P. olsenii © by author ESCMID Online LecturePeptostreptoccus Library stomatis sp. P. stomatis nov., isolated from the human oral cavity. J. Downes et al. Int. J. P. anaerobius Syst. Evol. Microbiol. 2006 New genus and species Peptostreptococcus stomatis Peptostreptococcus anaerobius Peptostreptococcus canis Peptostreptococcus russellii Finegoldia magna Gallicola barnesae Parvimonas micra Murdochiella asaccharolytica Anaerococcus murdochii Anaerococcus lactolyticus Anaerococcus tetradius Anaerococcus prevotii Anaerococcus vaginalis Anaerococcus obensiensis Anaerococcus hydrogenalis Anaerococcus senegalensis Anaerococcus octavius Anaerococcus pacaensis Peptoniphilus indolicus Peptoniphilus asaccharolyticus ©Peptoniphilus by methioninivorax author Peptoniphilus ivorii Peptoniphilus coxii Candidatus Peptoniphilus Peptoniphilus tyrelliae(Peptoniphilus senegalensis) Peptoniphilus allenii ESCMID OnlinePeptoniphilus Lecture grossensis Library Peptoniphilus harei Peptoniphilus gorbachii Peptoniphilus timonensis Peptoniphilus olsenii Peptoniphilus lacrimalis Peptoniphilus koenoeniae Peptoniphilus duerdenii Peptoniphilus obesi Phenotypic identification Enzymatic tests derived from the API 32A (BioMerieux) Table Wadsworth manual Reliable identification: - F. magna - P. micra P. harei – P. asaccharolyticus similar biochemical features The addition of new species made© available by schemes author for the identification of GPAC less useful ESCMID Online Lecture Library Identification GPAC using 16S rRNA sequencing presented in NCBI Species Nucleotide collection 16S rRNA sequences remark Bacteria and Archaea A. murdochii only strain nr no A. tetradius species name yes A. lactolyticus species name yes A. octavius species name yes A. prevotii species name yes A. vaginalis species name yes A. hydrogenalis species name no sequence similarity with A. senegalensis is >99% A. pacaensis only strain nr no link with accession number yields species name A. senegalensis only strain nr no sequence similarity with A. hydrogenalis is >99% © by author link with accession number yields species name A. obesiensis species name no P. coxii species name no P. tyrelliae species name no sequence similarity with P. senegalensis is >99% P. harei species name yes P. ivorii species name yes also in NCBI under the species name P. ivoricus P. olsenii ESCMID only strain nr Online no Lecture type strain onlyLibrary mentioned with WAL number in NCBI clinical isolate with species name present in NCBI P. gorbachii only strain nr no type strain only mentioned with WAL number in NCBI clinical isolate with species name present in NCBI P. duerdenii species name no P. koenoeniae species name yes P. timonensis species name no Identification GPAC using 16S rRNA sequencing presented in NCBI Species Nucleotide collection 16S rRNA sequences remark Bacteria and Archaea P. grossensis species name no P. lacrimalis species name yes P. asaccharolyticus species name yes ………….. P. indolicus species name yes Candidatus P. massiliensis species name no this species is not officially described Candidatus P. allenii only strain nr no this species is not officially described P. rhinitidis no sequence of 16S rRNA gene available P. senegalensis only strain nr no sequence similarity with P. tyrelliae is >99% link with accession number yields species name P. obesi species name no P. micra species name ©yes by author F. magna species name yes P. anaerobius species name yes P. stomatis species name yes M. asaccharolytica species name no ESCMID Online Lecture Library Matrix Assisted Laser Desorption/Ionization time-of-flight Mass Spectrometry (MALDI-TOF MS) Vacuum flight tube Target at 15-25 kV Detector Ion source © by author ESCMID- “Time of flight” Online of individual Lecture proteins is converted Library into mass information. - Spectrum is produced - Database is built Veloo et al. Anaerobe 2011; 17:211-212 Identification of GPAC by MALDI-TOF MS Bruker system • 75% of GPAC encountered in human clinical specimens is identified by MALDI- TOF MS (estimated) • On target extraction with 70% formic acid is recommended • A. vaginalis is misidentifed as A. hydrogenalis • P. harei is correctly identified © by author • New species are not represented in de MALDI-TOF MS database ESCMID Online Lecture Library Identification of Gram-positive anaerobic cocci by MALDI-TOF mass spectrometry Veloo et al. Syst Appl Microbiol 2011; 34:58-62 Shimatzu/BioMerieux MS system Construction database: sequenced clinical isolates (n=77) and reference strains (n=12) reference strain P. harei is different compared to the clinical isolates P. harei © by author ValidationESCMID of constructed Online database: Lecture Library 107 genotypically identified clinical isolates of GPAC Validation database MALDI-TOF ID (n) Strain (n) correct ID no ID F. magna (32) 29 3 1 strain sequence similarity <98 % A. vaginalis (3) 2 1 P. ivorii (3) 1 2 sequence similarity <98 % P. octavius (1) 1 Bacterium N14-24 (1) 1 Not present in database GPAC (3) 3 © by author All other GPAC were correctly identified: P. micra (29) P. gorbachii (3) A. tetradius (1) ESCMIDP. harei (15) Online A. Lectureparvulum (3) LibraryP. lacrimalis (1) A. murdochii (6) P. niger (1) P. anaerobius (4) A. lactolyticus (1) Correctly identified: 96 strains No identification: 11 strains - 2 strains, no reference spectra present in database - 6 strains, <98 % sequence similarity with closest relative - 3 strains, unknown © by author 90 % correctly identified ESCMID Online Lecture Library Clustering P. anaerobius P. niger © by author P. micra ESCMID Online Lecture Library P. ivorii 100 Atopobium parvulum, AF292372 Dendrogram MALDI-TOF Peptococcus niger, X55797 100 RuminococcusPhylogeneticAtopobium gnavus, treeparvulum,X94967 AF292372 100 PeptostreptococcusPeptococcus niger, anaerobius,X55797 L04168 PeptostreptococcusRuminococcus gnavus, stomatis,X94967DQ160208 100 gpac228Peptostreptococcus94.8 % anaerobius, L04168 100Peptostreptococcus stomatis,Atopobium parvulum, AF292372 gpac216 94.4Peptococcus % niger, DQ160208 gpac228 X55797 97 gpac103 94.694.8 Ruminococcus %% gnavus, X94967 gpac216 10094.4Peptostreptococcus % anaerobius, L04168 gpac003 95.0Peptostreptococcus % stomatis, DQ160208 gpac103 94.6 % 97 gpac007 94.7gpac228 % 94.8 % gpac003 95.0gpac216 % 94.4 % gpac0749794.1gpac103 % 94.6 % 95 gpac007gpac018A94.7gpac003 % 95.0 % 100 gpac074 94.3 % Peptoniphilus94.1gpac007 %ivorii,94.7Y07840 % 100 95 gpac018A 94.3gpac074 % 94.1 % 100 Peptoniphilus100 95 gpac018A harei,94.3 % Y07839 Peptoniphilus ivorii, Y07840 gpac090Peptoniphilus97.8 % ivorii, Y07840 100 Peptoniphilus100 Peptoniphilus harei, Y07839harei, Y07839 Peptoniphilusgpac090 gorbachii,97.8 % DQ911241 gpac090 97.8 % gpac055 97.4Peptoniphilus % gorbachii, DQ911241 Peptoniphilusgpac055 gorbachii,97.4 % DQ911241 gpac018B 97.8 % gpac055 97.4gpac018B % 97.8 % 100 gpac121100 gpac12196.3 %