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REVIEW 10.1111/j.1469-0691.2004.00784.x
Rothia dentocariosa: taxonomy and differential diagnosis A. von Graevenitz
Gloriastrasse 32, Zu¨ rich, Switzerland
ABSTRACT As recent external quality control results have shown, the diagnosis of Rothia dentocariosa infection still presents problems for clinical laboratories. This review describes the taxonomy, as well as the chemotaxonomic, morphological and biochemical characteristics, of this organism, and surveys bacteria that may be confused with Rothia dentocariosa. Keywords Identification, Rothia dentocariosa, taxonomy Accepted: 25 March 2003 Clin Microbiol Infect 2004; 10: 399–402
lum and ⁄ or the catalase test may not have INTRODUCTION been correct in individual cases. Thus, it was In 2001, the Swiss External Quality Assessment obvious that R. dentocariosa was also a problem Scheme in Bacteriology and Mycology, which organism. operates under the direction of the author [1], sent These observed difficulties were surprising in out a strain of Rothia dentocariosa to 50 laboratories view of the fact that R. dentocariosa has been participating in the scheme. The organism was known for over 35 years. In 1967, Georg and described as a bacterium isolated from a case of Brown proposed the genus Rothia [4] for a group vertebral osteomyelitis, similar to a case reported of coccoid to diphtheroid to filamentous Gram- in the literature [2]. Only 36 (72%) of the partic- positive organisms isolated from the human oral ipants arrived at a correct diagnosis, mostly by cavity, naming the genus after Roth [5], who had use of the API Coryne system, v.2 (bioMe´rieux, La performed basic studies on organisms, isolated Balme-les-Grottes, France). This score was below from carious lesions, that had been described the average for the yearly performance of all the initially by Onisi [6] as Actinomyces dentocariosus. participating laboratories [3], and was similar to Subsequently, similar organisms were isolated in scores obtained for ‘problem organisms’ such as several laboratories from a variety of human Lactobacillus spp., Clostridium tertium, Neisseria sources, mostly from the oral cavity, but also weaveri, Capnocytophaga spp., Eikenella corrodens from blood, respiratory secretions, abscesses, and Moraxella spp. [1,3]. Five participants would wounds, peritoneal dialysates and the eye [7,8]. have sent the strain to a reference laboratory; four Reports of human disease caused by R. dentocar- participants identified it as a species of coagulase- iosa started to be published in the late 1970s [9], negative staphylococci by means of the API Staph and at least 30 case reports can now be found in or ID32 Staph systems; three participants identi- the literature, many of which describe patients fied it as Stomatococcus mucilaginosus (which is an with endocarditis. These reports have been organism now classified as Rothia mucilaginosa) reviewed recently [10,11], and interested readers with ID32 Staph; and three participants identified are referred to these previous reviews for further it, respectively, as Propionibacterium spp., Acti- details. nomyces spp. and Rhodococcus equi by means of API Coryne; however, incubation times, inocu- TAXONOMY The taxonomic position of the genus Rothia has Corresponding author and reprint requests: A. von Graeve- nitz, Gloriastrasse 32, CH 8028 Zu¨ rich, Switzerland undergone a number of changes since Georg and E-mail: [email protected] Brown first assigned it to the family Actinomy-