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Nørskov-Lauritsen N. Classification, identification, and clinical significance of Haemophilus and Aggregatibacter species with host specificity for humans. Clin Microbiol Rev 2014; 27:214-40. [PMID: 24696434 PMCID: PMC3993099 DOI: 10.1128/cmr.00103-13] [Citation(s) in RCA: 165] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
The aim of this review is to provide a comprehensive update on the current classification and identification of Haemophilus and Aggregatibacter species with exclusive or predominant host specificity for humans. Haemophilus influenzae and some of the other Haemophilus species are commonly encountered in the clinical microbiology laboratory and demonstrate a wide range of pathogenicity, from life-threatening invasive disease to respiratory infections to a nonpathogenic, commensal lifestyle. New species of Haemophilus have been described (Haemophilus pittmaniae and Haemophilus sputorum), and the new genus Aggregatibacter was created to accommodate some former Haemophilus and Actinobacillus species (Aggregatibacter aphrophilus, Aggregatibacter segnis, and Aggregatibacter actinomycetemcomitans). Aggregatibacter species are now a dominant etiology of infective endocarditis caused by fastidious organisms (HACEK endocarditis), and A. aphrophilus has emerged as an important cause of brain abscesses. Correct identification of Haemophilus and Aggregatibacter species based on phenotypic characterization can be challenging. It has become clear that 15 to 20% of presumptive H. influenzae isolates from the respiratory tracts of healthy individuals do not belong to this species but represent nonhemolytic variants of Haemophilus haemolyticus. Due to the limited pathogenicity of H. haemolyticus, the proportion of misidentified strains may be lower in clinical samples, but even among invasive strains, a misidentification rate of 0.5 to 2% can be found. Several methods have been investigated for differentiation of H. influenzae from its less pathogenic relatives, but a simple method for reliable discrimination is not available. With the implementation of identification by matrix-assisted laser desorption ionization-time of flight mass spectrometry, the more rarely encountered species of Haemophilus and Aggregatibacter will increasingly be identified in clinical microbiology practice. However, identification of some strains will still be problematic, necessitating DNA sequencing of multiple housekeeping gene fragments or full-length 16S rRNA genes.
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Orenga S, James AL, Manafi M, Perry JD, Pincus DH. Enzymatic substrates in microbiology. J Microbiol Methods 2009; 79:139-55. [PMID: 19679151 DOI: 10.1016/j.mimet.2009.08.001] [Citation(s) in RCA: 78] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2009] [Revised: 07/24/2009] [Accepted: 08/03/2009] [Indexed: 11/15/2022]
Abstract
Enzymatic substrates are powerful tools in biochemistry. They are widely used in microbiology to study metabolic pathways, to monitor metabolism and to detect, enumerate and identify microorganisms. Synthetic enzymatic substrates have been customized for various microbial assays, to detect an expanding range of both new enzymatic activities and target microorganisms. Recent developments in synthetic enzymatic substrates with new spectral, chemical and biochemical properties allow improved detection, enumeration and identification of food-borne microorganisms, clinical pathogens and multi-resistant bacteria in various sample types. In the past 20 years, the range of synthetic enzymatic substrates used in microbiology has been markedly extended supporting the development of new multi-test systems (e.g., Microscan, Vitek 2, Phoenix) and chromogenic culture media. The use of such substrates enables an improvement in time to detection and specificity over conventional tests that employ natural substrates. In the era of intense developments in molecular biology, phenotypic tests involving enzymatic substrates remain useful to analyse both simple and complex samples. Such tests are applicable to diagnostic and research laboratories all over the world.
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Affiliation(s)
- Sylvain Orenga
- Research & Development Microbiology, bioMérieux, 3 route de Port Michaud, La Balme-les-Grottes, France.
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Lucrecia C, Beatriz M, Montserrat E, Roser P, Ferran S, Pere C, Ferran N. Ability of the new VITEK® 2Neisseria-Haemophilus card for the identification of fastidious organisms. ANN MICROBIOL 2008. [DOI: 10.1007/bf03175589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Multicenter evaluation of the new Vitek 2 Neisseria-Haemophilus identification card. J Clin Microbiol 2008; 46:2681-5. [PMID: 18579712 DOI: 10.1128/jcm.00449-08] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The new Neisseria-Haemophilus identification (NH) card for Vitek 2 was compared with 16S rRNA gene sequencing (16S) as the reference method for accurate identification of Neisseria spp., Haemophilus spp., and other fastidious gram-negative bacteria. Testing was performed on the Vitek 2 XL system with modified software at three clinical trial laboratories. Reproducibility was determined with nine ATCC quality control strains tested 20 times over a minimum of 10 days at all three sites. A challenge set of 30 strains with known identifications and 371 recent fresh and frozen clinical isolates were also tested. Expected positive and negative biochemical reactions were also evaluated for substrate reproducibility. All microorganisms were tested on the NH card, and all clinical and stock isolates were saved for 16S testing. All reproducibility tests yielded expected results within a 95% confidence interval. For challenge microorganisms, there was 98% overall correct identification, including 8% low discrimination, 2% incorrect identification, and 0% unidentified. For clinical strains, there was 96.5% overall correct identification, including 10.2% low discrimination, 2.7% incorrect identification, and 0.8% unidentified. The 2.7% (10/371) of clinical isolates that gave an incorrect identification consisted of 7 isolates correct to genus and 3 strains incorrect to genus. There were an additional 27 strains (primarily Neisseria species) for which the 16S identification result was different from the NH card result. These were all unclaimed species by the system. The new NH card met all performance criteria within a 95% confidence interval compared to identification of clinical isolates by 16S.
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Valenza G, Ruoff C, Vogel U, Frosch M, Abele-Horn M. Microbiological evaluation of the new VITEK 2 Neisseria-Haemophilus identification card. J Clin Microbiol 2007; 45:3493-7. [PMID: 17728469 PMCID: PMC2168501 DOI: 10.1128/jcm.00953-07] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
VITEK 2 is an automated identification system for diverse bacterial and fungal species. A new card (the Neisseria-Haemophilus [NH] card) for the identification of Neisseria spp., Haemophilus spp., and other fastidious gram-negative or gram-variable microorganisms has been developed, but its performance in a routine clinical laboratory has not yet been evaluated. In this study, a total of 188 bacterial strains belonging to the genera Actinobacillus, Campylobacter, Capnocytophaga, Cardiobacterium, Eikenella, Gardnerella, Haemophilus, Kingella, Moraxella, and Neisseria were investigated. The NH card was able to identify 171 strains (91%) correctly without the need for extra tests; one strain (0.5%) was misidentified, and five strains (2.7%) could not be classified. Eleven strains (5.8%) were identified with a low level of discrimination, and simple additional tests were required to increase the correct-identification rate to 96.8%. The results were available within 6 h. Based on these results, the new VITEK 2 NH card appears to be a good method for the identification of diverse groups of fastidious organisms, which would otherwise require testing with multiple systems. However, more work is needed to evaluate the performance of VITEK 2 with regard to Haemophilus, Actinobacillus, Cardiobacterium, Eikenella, and Kingella bacteria because of the insufficient number of strains tested in this study. Moreover, further reduction of the detection time would be desirable.
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Affiliation(s)
- Giuseppe Valenza
- Institute of Hygiene and Microbiology, University of Würzburg, Josef-Schneider-Str 2/E1, 97080, Würzburg, Germany.
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6
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Janda WM, Montero MC, Wilcoski LM. Evaluation of the BactiCard Neisseria for identification of pathogenic Neisseria species and Moraxella catarrhalis. Eur J Clin Microbiol Infect Dis 2002; 21:875-9. [PMID: 12525923 DOI: 10.1007/s10096-002-0838-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The BactiCard Neisseria (Remel, USA) is a chromogenic enzyme substrate system for identifying Neisseria gonorrhoeae, Neisseria meningitidis, Neisseria lactamica, and Moraxella catarrhalis. The identification system consists of a card with four test circles impregnated with chromogenic substrates for indoxyl butyrate esterase (IB), prolyl aminopeptidase (PRO), gamma-glutamyl aminopeptidase (GLUT), and ss-galactosidase (BGAL). These substrates permit the identification of Moraxella catarrhalis, Neisseria gonorrhoeae, Neisseria meningitidis, and Neisseria lactamica, respectively. After hydration of the circles with buffer, colonies from growth on selective media or a subculture are applied to the four circles. IB and BGAL reactions are read for a blue-green color after 2 and 15 min, respectively. PRO and GLUT reactions are read at 15 min for a red color after addition of a developer reagent. Identifications obtained with the BactiCard Neisseria were compared with those obtained using conventional procedures for 558 isolates in a blinded fashion. The BactiCard Neisseria identified 100% of 254 Neisseria gonorrhoeae, 100% of 125 Neisseria meningitidis, 53 (98.2%) of 54 Neisseria lactamica, and 123 (98.4%) of 125 Moraxella catarrhalis isolates. The BactiCard Neisseria is an accurate and rapid system for identification of these microorganisms in the clinical laboratory.
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Affiliation(s)
- W M Janda
- Department of Pathology, University of Illinois Medical Center at Chicago, 840 S Wood Street, Chicago, IL 60612-7312, USA.
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Cobb CM, Helber JT, Hirschberg R. Scanning electron microscopy of Eikenella corrodens colony morphology variants. J Periodontal Res 1994; 29:410-7. [PMID: 7877077 DOI: 10.1111/j.1600-0765.1994.tb01242.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Eikenella corrodens is a gram-negative, human pathogen which exhibits colony morphology variation. Scanning electron microscopy (SEM) was used to examine large (non-corroding) and small (corroding) colony variants from the type strain (ATCC 23834) and two clinical isolates (strains VA1 and CM1). Large colonies were large, flatter, and appeared relatively featureless compared to small colonies and had even, smooth colony margins. Small colonies were more raised from the medium surface, and often had a central raised region surrounded by flatter border. Cells on the surface of large colonies were more regularly arranged at the colony edge, and end-to-end rows of cells around the colony were seen in some strains. Cells in the center of the upper surface of small colonies were usually randomly arranged. Within cross sections of small colonies, cells were arranged randomly or perpendicular to the medium; in large colonies, cells were random or arranged horizontally. Amorphous, "slime" material was often seen covering groups of cells in large and small variants. An unusual variant, possibly a mutant, which combined features of both colony types was isolated.
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Affiliation(s)
- C M Cobb
- Department of Periodontics, School of Dentistry, University of Missouri-Kansas City 64108
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Janda WM, Wilcoski LM, Mandel KL, Ruther P, Stevens JM. Comparison of monoclonal antibody methods and a ribosomal ribonucleic acid probe test for Neisseria gonorrhoeae culture confirmation. Eur J Clin Microbiol Infect Dis 1993; 12:177-84. [PMID: 7685283 DOI: 10.1007/bf01967108] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Recently, a chemiluminescent nucleic acid probe test that specifically detects the ribosomal ribonucleic acid of Neisseria gonorrhoeae has been released for clinical laboratory use (AccuProbe Neisseria gonorrhoeae). In this study, three coagglutination tests (GonoGen I, Meritec GC, and GC Omni), the GonoGen II immunofiltration method and the Micro Trak Neisseria gonorrhoeae fluorescent monoclonal antibody test were compared with AccuProbe for identification of gonococci. Strains tested (n = 376) included 194 Neisseria gonorrhoeae, 82 Neisseria meningitidis, 32 Neisseria lactamica, 32 Neisseria species, 32 Moraxella catarrhalis, 2 Moraxella spp. and 2 Kingella denitrificans. The GonoGen I, Meritec GC and GC Omni coagglutination tests produced clearly positive results for 93.8%, 92.3% and 95.9% of the gonococci, respectively. The GonoGen II unequivocally identified 91.8% and the MicroTrak fluorescent antibody test identified 90.7% with 2+ or greater fluorescence. AccuProbe identified 100% of the gonococci tested. GonoGen I and GonoGen II were 98% specific, Meritec GC was 99% specific and the specificity of the GC Omni, MicroTrak fluorescent antibody and AccuProbe tests was 100%. While antibody-based tests were reliable when results were clearly interpretable, the AccuProbe was the only confirmatory test that was 100% accurate. Serotyping studies indicate that an array of beta-lactamase positive and negative gonococcal serotypes fail to react with the monoclonal antibody-based tests in general and with the fluorescent antibody test in particular.
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Affiliation(s)
- W M Janda
- Department of Pathology, University of Illinois, Chicago 60612
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Quentin R, Dubarry I, Martin C, Cattier B, Goudeau A. Evaluation of four commercial methods for identification and biotyping of genital and neonatal strains of Haemophilus species. Eur J Clin Microbiol Infect Dis 1992; 11:546-9. [PMID: 1526240 DOI: 10.1007/bf01960812] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Four commercial methods for identification of Haemophilus species were evaluated in comparison to conventional methods using 188 genital and neonatal Haemophilus strains. In the case of discrepancies between results obtained by the different methods, DNA-DNA hybridization was performed. The four commercial systems and conventional methods showed excellent correlation of results in 167 strains (88%). DNA-DNA hybridization was performed in 8 strains with discrepant identification results and 13 strains with discrepant biotyping results. In 15 cases discrepancies could be explained by the fact that the strains belonged to a newly recognised species of Haemophilus.
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Affiliation(s)
- R Quentin
- Départment de Microbiologie Médicale et Moléculaire, URA CNRS 1334, Centre Hospitalier Universitaire Bretonneau, Tours, France
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Ainsworth SM, Nagy SB, Morgan LA, Miller GR, Perry JL. Interpretation of gram-stained sputa containing Moraxella (Branhamella) catarrhalis. J Clin Microbiol 1990; 28:2559-60. [PMID: 1701446 PMCID: PMC268224 DOI: 10.1128/jcm.28.11.2559-2560.1990] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Sputum specimens culture positive for Moraxella (Branhamella) catarrhalis were Gram stained with three decolorizer solutions (slow, 95% ethyl alcohol; intermediate, 1:1 ratio of 95% ethyl alcohol and acetone; and fast, acetone alone) for 5, 10, 20, and 30 s. Optimal results were obtained with acetone alone after 10 s or with a 1:1 mixture of acetone and ethanol after 20 s. Inadequate decolorization of M. catarrhalis in sputa is likely if the decolorization solution and exposure time are not optimal and may contribute to underreporting of this organism.
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Affiliation(s)
- S M Ainsworth
- Department of Biological Sciences, Wichita State University, Kansas 67208
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Palladino S, Leahy BJ, Newall TL. Comparison of the RIM-H rapid identification kit with conventional tests for the identification of Haemophilus spp. J Clin Microbiol 1990; 28:1862-3. [PMID: 2203817 PMCID: PMC268061 DOI: 10.1128/jcm.28.8.1862-1863.1990] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
A commercially available system, the RIM-H system (Austin Biological Laboratories, Austin, Tex.), was evaluated for its ability to rapidly and accurately identify various Haemophilus spp. A total of 110 clinical isolates were tested by both the RIM and conventional identification procedures. The RIM agreed with the standard identification for 100% of the Haemophilus influenzae (76 of 76) and 92.0% of the Haemophilus parainfluenzae (23 of 25) isolates tested. The identifications of Haemophilus parahaemolyticus, Haemophilus aphrophilus, and Haemophilus haemolyticus also correlated with those obtained by conventional methods. The RIM was found to be rapid and easy to use and was considered a suitable alternative to conventional identification procedures.
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Affiliation(s)
- S Palladino
- Department of Microbiology, Royal Perth Hospital, Western Australia
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Janda WM, Bradna JJ, Ruther P. Identification of Neisseria spp., Haemophilus spp., and other fastidious gram-negative bacteria with the MicroScan Haemophilus-Neisseria identification panel. J Clin Microbiol 1989; 27:869-73. [PMID: 2501351 PMCID: PMC267445 DOI: 10.1128/jcm.27.5.869-873.1989] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
The Haemophilus-Neisseria identification (HNID) panel (American MicroScan, Sacramento, Calif.) is a 4-h microdilution format system for identification of Haemophilus and Neisseria spp., Branhamella (Moraxella) catarrhalis, and Gardnerella vaginalis. The HNID panel was evaluated by using 423 clinical isolates and stock strains of these organisms, and HNID identifications were compared with those obtained by conventional methods. In addition, 32 isolates representing six genera not included in the HNID data base were tested to determine whether these organisms would produce unique biotype numbers for possible inclusion in the data base. The HNID panel correctly identified 95.3% of 86 Neisseria gonorrhoeae strains, 96% of 25 G. vaginalis strains, and 100% of 28 Neisseria lactamica strains and 48 B. catarrhalis strains. Only 64.7% of 68 Neisseria meningitidis isolates were identified correctly owing to false-negative or equivocal carbohydrate and/or aminopeptidase reactions. Among the Haemophilus spp., 98.8% of 83 H. influenzae strains, 97.1% of 34 H. parainfluenzae strains, and 80% of 15 H. aphrophilus and H. paraphrophilus strains were correctly identified. Eight strains of Neisseria cinerea, a species not included in the data base, produced profiles identical with those for B. catarrhalis and N. gonorrhoeae. Isolates of other species not included in the data base, including Eikenella corrodens, Kingella spp., and Cardiobacterium hominis, produced unique biochemical reaction patterns on the panel. Modification of interpretative criteria for certain tests, expansion of the data base to include other species, and suggestions for additional confirmatory tests will increase the accuracy and utility of the HNID panel.
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Affiliation(s)
- W M Janda
- Department of Medical Laboratory Sciences, College of Associated Health Professions, University of Illinois, Chicago 60612
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Knapp JS. Historical perspectives and identification of Neisseria and related species. Clin Microbiol Rev 1988; 1:415-31. [PMID: 3069201 PMCID: PMC358063 DOI: 10.1128/cmr.1.4.415] [Citation(s) in RCA: 94] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
The pathogenic Neisseria spp., N. gonorrhoeae and N. meningitidis, have been studied extensively and rapid identification procedures have been designed to distinguish these species from the commensal Neisseria and related species that are normal flora of the oro- and nasopharynx. The commensal Neisseria spp. have been largely ignored except for isolated studies. It is important that we know about these species, however, because not only may some be misidentified as pathogenic species if identified with inappropriate procedures, but also they may occasionally be isolated from unusual sites and must be correctly identified to the species level for clinical purposes.
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Affiliation(s)
- J S Knapp
- Sexually Transmitted Diseases Laboratory Program, Centers for Disease Control, Atlanta, Georgia 30333
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Janda WM, Sobieski V. Evaluation of a ten-minute chromogenic substrate test for identification of pathogenic Neisseria species and Branhamella catarrhalis. Eur J Clin Microbiol Infect Dis 1988; 7:25-9. [PMID: 3132371 DOI: 10.1007/bf01962166] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
A ten-minute chromogenic substrate test was evaluated for its ability to rapidly identify pathogenic Neisseria spp. and Branhamella catarrhalis. Identifications obtained with this system were compared to those obtained using conventional procedures. The test correctly identified 98.9% of 90 Neisseria gonorrhoeae, 98.3% of 60 Neisseria meningitidis, 96.2% of 26 Neisseria lactamica, and 100% of 36 Branhamella catarrhalis strains. Eight Neisseria subflava strains that grew on modified Thayer-Martin agar were prolyl aminopeptidase positive and were misidentified as Neisseria gonorrhoeae. Other strains of saprophytic Neisseria spp. also reacted with the chromogenic substrates. The system was accurate and reliable for identifying the commonly encountered pathogenic species. In light of recent reports describing new species and atypical Neisseria strains, however, careful attention to the salient features of both common and atypical organisms is necessary for proper use of rapid enzymatic identification tests.
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Affiliation(s)
- W M Janda
- Department of Medical Laboratory Sciences, University of Illinois, Chicago
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