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Matsumoto T, Hashimoto M, Huang WC, Teng CH, Niwa T, Yamada M, Negishi T. Molecular characterization of a carbon dioxide-dependent Proteus mirabilis small-colony variant isolated from a clinical specimen. J Infect Chemother 2024:S1341-321X(24)00072-2. [PMID: 38442770 DOI: 10.1016/j.jiac.2024.02.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 02/23/2024] [Accepted: 02/28/2024] [Indexed: 03/07/2024]
Abstract
INTRODUCTION Carbon dioxide-dependent Proteus mirabilis has been isolated from clinical specimens. It is not clear whether mutations in carbonic anhydrase are responsible for the carbon dioxide dependence of P. mirabilis. The pathogenicity of carbon dioxide-dependent P. mirabilis also remains unclear. The purpose of this study was to determine the cause carbon dioxide dependence of P. mirabilis and its pathogenicity. METHODS The DNA sequence of can encoding carbonic anhydrase of a carbon dioxide-dependent P. mirabilis small colony variant (SCV) isolate was analyzed. To confirm that impaired carbonic anhydrase activity is responsible for the formation of the carbon dioxide-dependent SCV phenotype of P. mirabilis, we performed complementation experiments using plasmids with intact can. Additionally, mouse infection experiments were performed to confirm the change in virulence due to the mutation of carbonic anhydrase. RESULTS We found that the can gene of the carbon dioxide-dependent P. mirabilis SCV isolate showed had a frameshift mutation with a deletion of 1 bp (c. 173delC). The can of P. mirabilis encodes carbonic anhydrase was also found to function in Escherichia coli. The cause of the carbon dioxide-dependent SCV phenotype of P. mirabilis was an abnormality in carbonic anhydrase. Nevertheless, no changes were observed in virulence due to the mutation of carbonic anhydrase in mouse infection experiments. CONCLUSIONS The can gene is essential for the growth of P. mirabilis in ambient air. The mechanisms underlying this fitness advantage in terms of infection warrant further investigation.
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Affiliation(s)
- Takehisa Matsumoto
- Department of Laboratory Sciences, Gunma University Graduate School of Health Sciences, Maebashi, Japan; Department of Biomedical Laboratory Sciences, Shinshu University School of Medicine, School of Health Sciences, Shinshu University, Matsumoto, Japan.
| | - Masayuki Hashimoto
- Institute of Molecular Medicine, College of Medicine, National Cheng-Kung University, Tainan City, Taiwan; Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Wen-Chun Huang
- Institute of Molecular Medicine, College of Medicine, National Cheng-Kung University, Tainan City, Taiwan
| | - Ching-Hao Teng
- Institute of Molecular Medicine, College of Medicine, National Cheng-Kung University, Tainan City, Taiwan; Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Takahiko Niwa
- Department of Laboratory Sciences, Gunma University Graduate School of Health Sciences, Maebashi, Japan; Department of Clinical Laboratory, Gunma University Hospital, Maebashi, Japan
| | - Mariko Yamada
- Department of Laboratory Sciences, Gunma University Graduate School of Health Sciences, Maebashi, Japan
| | - Tatsuya Negishi
- Department of Laboratory Medicine, Shinshu University Hospital, Matsumoto, Japan
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Hoshi S, Niwa T, Ariyoshi E, Matsumoto T. A case of acute bacterial cystitis caused by carbon dioxide-dependent Escherichia coli with a deletion mutation in the can. J Infect Chemother 2023:S1341-321X(23)00101-0. [PMID: 37098379 DOI: 10.1016/j.jiac.2023.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 04/03/2023] [Accepted: 04/17/2023] [Indexed: 04/27/2023]
Abstract
A small-colony variant (SCV) of carbon dioxide-dependent Escherichia coli was isolated from a patient with acute bacterial cystitis. After the urine sample was inoculated on 5% sheep blood agar and incubated overnight at 35 °C in ambient air, no colony formation was observed. However, after overnight incubation at 35 °C in 5% CO2-enhanced ambient air, numerous colonies were obtained. We failed to characterize or identify the SCV isolate using the MicroScan WalkAway-40 System because the isolate did not grow in the system. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry and 16S rRNA sequencing were useful for identifying this SCV isolate. Genome sequencing analysis of the isolates revealed the presence of an 11-bp deletion mutation leading to premature translational truncation in the carbonic anhydrase gene, can, and the presence of 10 known antimicrobial resistance genes. The results of the antimicrobial susceptibility tests performed under CO2-enhanced ambient air were consistent with the presence of antimicrobial resistance genes. Our results also showed that Can is important to grow E. coli in ambient air, and that antimicrobial susceptibility testing of carbon dioxide-dependent SCVs should be performed in 5% CO2-enhanced ambient air. A revertant strain was obtained by passaging the SCV isolate, but the deletion mutation in can remained. To the best of our knowledge, this is the first case in Japan of acute bacterial cystitis caused by carbon dioxide-dependent E. coli with a deletion mutation in can.
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Affiliation(s)
- Shiori Hoshi
- Fukuoka City Medical Association, Clinical Laboratory Center, 1-6-9, Momochihama, Sawara-ku, Fukuoka, Fukuoka, 814-0001, Japan
| | - Takahiko Niwa
- Department of Laboratory Sciences, Gunma University Graduate School of Health Sciences, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8514, Japan; Department of Clinical Laboratory, Gunma University Hospital, 3-39-15 Showa-machi, Maebashi, Gunma, 371-8511, Japan
| | - Eiji Ariyoshi
- Fukuoka City Medical Association, Clinical Laboratory Center, 1-6-9, Momochihama, Sawara-ku, Fukuoka, Fukuoka, 814-0001, Japan
| | - Takehisa Matsumoto
- Department of Laboratory Sciences, Gunma University Graduate School of Health Sciences, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8514, Japan.
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Matsumoto T, Hashimoto M, Teng CH, Hsu PC, Ota Y, Takamizawa M, Kato R, Negishi T. Molecular characterization of a carbon dioxide-dependent Escherichia coli small-colony variant isolated from blood cultures. Int J Med Microbiol 2020; 310:151431. [PMID: 32654769 DOI: 10.1016/j.ijmm.2020.151431] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Revised: 04/22/2020] [Accepted: 05/23/2020] [Indexed: 11/23/2022] Open
Abstract
A carbon dioxide-dependent small-colony variant of Escherichia coli SH4888 was isolated from blood cultures of a patient with cholangitis. To date, little is known regarding the molecular mechanisms leading to formation of carbon dioxide-dependent phenotypes in clinical isolates, but abnormalities in the carbonic anhydrase are thought to cause carbon dioxide autotrophy. In this study DNA sequence analysis of the carbonic anhydrase-encoding can locus in the carbon dioxide-dependent E. coli SH4888 revealed that the isolate had a 325-bp deletion spanning from the 3'-terminal region of can to the 3'-terminal region of hpt, which encodes a hypoxanthine phosphoribosyltransferase. To confirm that the carbon dioxide-dependent SCV phenotype of E. coli SH4888 was due to the can mutation, we performed a complementation test with a plasmid carrying an intact can that restored the normal phenotype. However, E. coli SH4888 had increased virulence compared to the can-complemented E. coli SH4888 in a murine infection model. In conclusion, these data confirm that impaired carbonic anhydrase function can cause a carbon dioxide-dependent SCV phenotype in E. coli SH4888 and provides a fitness advantage in terms of infection.
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Garbacz K, Kwapisz E, Wierzbowska M. Denture stomatitis associated with small-colony variants of Staphylococcus aureus: a case report. BMC Oral Health 2019; 19:219. [PMID: 31604449 PMCID: PMC6788114 DOI: 10.1186/s12903-019-0910-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 09/13/2019] [Indexed: 11/23/2022] Open
Abstract
Background The small-colony variants (SCVs) of Staphylococcus aureus were isolated from persistent and recurrent infections, especially after placement of medical devices having direct contact with human tissues. The emergence of SCVs is a survival strategy of S. aureus which enables them to hide inside host’s cells and induces a less severe immune response than to wild-type S. aureus. However, contrary to other medical devices, dental prosthesis as a surface potentially colonized by SCVs of S. aureus has not been examined thus far. We reported the first case of SCVs - S. aureus infection in denture wearer. Case presentation A 62-year-old woman with a complete removable acrylic denture presented extensive elevated erythematous lesions on the palate, compatible with denture stomatitis. The patient had a history of arterial hypertension, cigarette smoking and wearing denture at night. The fungal colonies, identified as Candida albicans, were cultured on Sabouraud agar. From three swabs (from hard palate mucosa, denture surface and angular cheilitis lesions) were cultured of pinpoint, clear, non-pigmented, and non-haemolytic colonies on Columbia agar. The small colonies turned out to be Gram-positive cocci, catalase-, Pastorex Staph Plus -, and clumping factor-positive, and oxidase-negative. Suspected phenotypically SCVs forms were definitively identified as S. aureus based on PCR amplification of species specific nuc and coa genes. Methicillin-resistance was verified by mecA gene detection. The isolates turned out to be susceptible to methicillin (MSSA) and resistant to gentamicin. The isolate was identified as menadione-auxotrophic variant. Conclusions This case demonstrated that oral cavity in denture wearers may be a reservoir of small-colony variants of S. aureus, besides C. albicans. The prevalence of these bacteria and their role in the pathogenesis of oral diseases are not understood. Due to problems with their detection and identification, the true prevalence of oral SCVs may be underestimated.
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Affiliation(s)
- Katarzyna Garbacz
- Department of Oral Microbiology, Faculty of Medicine, Medical University of Gdansk, 25 Dębowa St, 80-204, Gdansk, Poland.
| | - Ewa Kwapisz
- Department of Oral Microbiology, Faculty of Medicine, Medical University of Gdansk, 25 Dębowa St, 80-204, Gdansk, Poland
| | - Maria Wierzbowska
- Department of Oral Microbiology, Faculty of Medicine, Medical University of Gdansk, 25 Dębowa St, 80-204, Gdansk, Poland
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Ogihara S, Saito R, Sawabe E, Hagihara M, Tohda S. First Japanese case of infectious endocarditis due to Enterococcus faecalis small-colony variants. J Infect Chemother 2016; 22:716-9. [PMID: 27094238 DOI: 10.1016/j.jiac.2016.03.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 03/13/2016] [Accepted: 03/16/2016] [Indexed: 11/26/2022]
Abstract
A male patient was admitted to our hospital due to infectious endocarditis. He had been treated with levofloxacin for 6 weeks, sulbactam/cefoperazone for 4 weeks, and benzylpenicillin for 2 days prior to valve replacement surgery. Gram-positive cocci, with morphology consistent with γ-Streptococcus, were detected in blood cultures obtained at admission, as well as in vegetation obtained from the aortic valve. However, the strain could not be identified using biochemical methods. Sequencing of the 16S rRNA gene indicated that the culture was a small-colony variant of Enterococcus faecalis. This is the first case in Japan of infectious endocarditis due to E. faecalis small-colony variants. Small-colony variants are subpopulations of bacteria with slow growth, reduced sugar fermentation, and unstable phenotype. As a result, these strains tend to be misidentified. Further, small-colony variants are associated with recurrent and persistent infections such as prosthetic joint infection and infectious endocarditis. These strains are found in various bacterial species, including Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli, and Pseudomonas aeruginosa, but rarely in Enterococcus species. The case highlights the need to be vigilant of E. faecalis small-colony variants, especially in patients who received long-term courses of antibiotics.
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Affiliation(s)
- Shinji Ogihara
- Department of Clinical Laboratory, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-Ku, Tokyo 113-8519, Japan.
| | - Ryoichi Saito
- Department of Microbiology and Immunology, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, Tokyo 113-8519, Japan
| | - Etsuko Sawabe
- Department of Clinical Laboratory, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-Ku, Tokyo 113-8519, Japan
| | - Michio Hagihara
- Department of Clinical Laboratory, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-Ku, Tokyo 113-8519, Japan
| | - Shuji Tohda
- Department of Clinical Laboratory, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-Ku, Tokyo 113-8519, Japan
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