1887

Abstract

The ‘’ group (SMG) has recently been recognized as a contributor to bronchopulmonary disease in cystic fibrosis (CF). Routine detection and quantification is limited by current CF microbiology protocols. McKay agar was developed previously for the semi-selective isolation of this group. Here, McKay agar was validated against a panel of clinical SMG isolates, which revealed improved SMG recovery compared with Columbia blood agar. The effectiveness of this medium was evaluated by appending it to the standard CF sputum microbiology protocols in a clinical laboratory for a 6-month period. All unique colony types were isolated and identified by 16S rRNA gene sequencing. Whilst a wide variety of organisms were isolated, members of the SMG were the most prevalent bacteria cultured, and McKay agar allowed routine quantification of the SMG from 10 to >10 c.f.u. ml directly from sputum. All members of the SMG were detected [ (40.7 %), (34.3 %) and (25 %)] with an overall prevalence rate of 40.6 % in our adult CF population. Without exception, samples where SMG isolates were cultured at 10 c.f.u. ml or greater were associated with pulmonary exacerbations. This study demonstrates that McKay agar can be used routinely to quantify the SMG from complex clinical samples.

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2010-05-01
2024-03-28
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References

  1. Bittar F., Richet H., Dubus J. C., Reynaud-Gaubert M., Stremler N., Sarles J., Raoult D., Rolain J. M. 2008; Molecular detection of multiple emerging pathogens in sputa from cystic fibrosis patients. PLoS One 3:e2908 [CrossRef]
    [Google Scholar]
  2. Brogan O., Malone J., Fox C., Whyte A. S. 1997; Lancefield grouping and smell of caramel for presumptive identification and assessment of pathogenicity in the Streptococcus milleri group. J Clin Pathol 50:332–335 [CrossRef]
    [Google Scholar]
  3. Cooke R. P., O'Neill W. A. 1998; Laboratory identification of Streptococcus milleri . J Clin Pathol 51:174
    [Google Scholar]
  4. Daley P., Church D. L., Gregson D. B., Elsayed S. 2005; Species-level molecular identification of invasive “ Streptococcus milleri ” group clinical isolates by nucleic acid sequencing in a centralized regional microbiology laboratory. J Clin Microbiol 43:2987–2988 [CrossRef]
    [Google Scholar]
  5. Gilligan P. H. 1991; Microbiology of airway disease in patients with cystic fibrosis. Clin Microbiol Rev 4:35–51
    [Google Scholar]
  6. Grinwis M. E., Sibley C. D., Parkins M. D., Eshaghurshan C. S., Rabin H. R., Surette M. G. 2010; Characterization of Streptococcus milleri group isolates from expectorated sputum of adult cystic fibrosis patients. J Clin Microbiol 48:395–401 [CrossRef]
    [Google Scholar]
  7. Harris J. K., De Groote M. A., Sagel S. D., Zemanick E. T., Kapsner R., Penvari C., Kaess H., Deterding R. R., Accurso F. J., Pace N. R. 2007; Molecular identification of bacteria in bronchoalveolar lavage fluid from children with cystic fibrosis. Proc Natl Acad Sci U S A 104:20529–20533 [CrossRef]
    [Google Scholar]
  8. Ishida T., Hashimoto T., Arita M., Ito I., Osawa M. 1998; Etiology of community-acquired pneumonia in hospitalized patients: a 3-year prospective study in Japan. Chest 114:1588–1593 [CrossRef]
    [Google Scholar]
  9. Laupland K. B., Ross T., Church D. L., Gregson D. B. 2006; Population-based surveillance of invasive pyogenic streptococcal infection in a large Canadian region. Clin Microbiol Infect 12:224–230 [CrossRef]
    [Google Scholar]
  10. Liu W. T., Marsh T. L., Cheng H., Forney L. J. 1997; Characterization of microbial diversity by determining terminal restriction fragment length polymorphisms of genes encoding 16S rRNA. Appl Environ Microbiol 63:4516–4522
    [Google Scholar]
  11. Lyczak J. B., Cannon C. L., Pier G. B. 2002; Lung infections associated with cystic fibrosis. Clin Microbiol Rev 15:194–222 [CrossRef]
    [Google Scholar]
  12. Maskell N. A., Davies C. W., Nunn A. J., Hedley E. L., Gleeson F. V., Miller R., Gabe R., Rees G. L., Peto T. E. other authors 2005; U.K. controlled trial of intrapleural streptokinase for pleural infection. N Engl J Med 352:865–874 [CrossRef]
    [Google Scholar]
  13. Miller M. B., Gilligan P. H. 2003; Laboratory aspects of management of chronic pulmonary infections in patients with cystic fibrosis. J Clin Microbiol 41:4009–4015 [CrossRef]
    [Google Scholar]
  14. Moore-Gillon J. C., Eykyn S. J., Phillips I. 1981; Microbiology of pyogenic liver abscess. Br Med J (Clin Res Ed) 283:819–821 [CrossRef]
    [Google Scholar]
  15. Parkins M. D., Sibley C. D., Surette M. G., Rabin H. R. 2008a; The Streptococcus milleri group – an unrecognized cause of disease in cystic fibrosis: a case series and literature review. Pediatr Pulmonol 43:490–497 [CrossRef]
    [Google Scholar]
  16. Parkins M. D., Sibley C. D., Surette M. G., Gregson D. B., Rabin H. R. 2008b; Streptococcus milleri endobronchial colonization is associated with an increased rate of pulmonary disease progression in cystic fibrosis. Pediatr Pulmonol 43 (Suppl. S31):S339
    [Google Scholar]
  17. Poole P. M., Wilson G. 1979; Occurrence and cultural features of Streptococcus milleri in various body sites. J Clin Pathol 32:764–768 [CrossRef]
    [Google Scholar]
  18. Prasad K. N., Mishra A. M., Gupta D., Husain N., Husain M., Gupta R. K. 2006; Analysis of microbial etiology and mortality in patients with brain abscess. J Infect 53:221–227 [CrossRef]
    [Google Scholar]
  19. Rogers G. B., Hart C. A., Mason J. R., Hughes M., Walshaw M. J., Bruce K. D. 2003; Bacterial diversity in cases of lung infection in cystic fibrosis patients: 16S ribosomal DNA (rDNA) length heterogeneity PCR and 16S rDNA terminal restriction fragment length polymorphism profiling. J Clin Microbiol 41:3548–3558 [CrossRef]
    [Google Scholar]
  20. Rogers G. B., Carroll M. P., Serisier D. J., Hockey P. M., Jones G., Bruce K. D. 2004; Characterization of bacterial community diversity in cystic fibrosis lung infections by use of 16S ribosomal DNA terminal restriction fragment length polymorphism profiling. J Clin Microbiol 42:5176–5183 [CrossRef]
    [Google Scholar]
  21. Rogers G. B., Carroll M. P., Serisier D. J., Hockey P. M., Kehagia V., Jones G. R., Bruce K. D. 2005; Bacterial activity in cystic fibrosis lung infections. Respir Res 6:49 [CrossRef]
    [Google Scholar]
  22. Rogers G. B., Carroll M. P., Serisier D. J., Hockey P. M., Jones G., Kehagia V., Connett G. J., Bruce K. D. 2006; Use of 16S rRNA gene profiling by terminal restriction fragment length polymorphism analysis to compare bacterial communities in sputum and mouthwash samples from patients with cystic fibrosis. J Clin Microbiol 44:2601–2604 [CrossRef]
    [Google Scholar]
  23. Shinzato T., Saito A. 1995; The Streptococcus milleri group as a cause of pulmonary infections. Clin Infect Dis 21:S238–S243 [CrossRef]
    [Google Scholar]
  24. Sibley C. D., Rabin H., Surette M. G. 2006; Cystic fibrosis: a polymicrobial infectious disease. Future Microbiol 1:53–61 [CrossRef]
    [Google Scholar]
  25. Sibley C. D., Duan K., Fischer C., Parkins M. D., Storey D. G., Rabin H. R., Surette M. G. 2008a; Discerning the complexity of community interactions using a Drosophila model of polymicrobial infections. PLoS Pathog 4:e1000184 [CrossRef]
    [Google Scholar]
  26. Sibley C. D., Parkins M. D., Rabin H. R., Duan K., Norgaard J. C., Surette M. G. 2008b; A polymicrobial perspective of pulmonary infections exposes an enigmatic pathogen in cystic fibrosis patients. Proc Natl Acad Sci U S A 105:15070–15075 [CrossRef]
    [Google Scholar]
  27. Sibley C. D., Parkins M. D., Rabin H. R., Surette M. G. 2009; The relevance of the polymicrobial nature of airway infection in the acute and chronic management of patients with cystic fibrosis. Curr Opin Investig Drugs 10:787–794
    [Google Scholar]
  28. Tunney M. M., Field T. R., Moriarty T. F., Patrick S., Doering G., Muhlebach M. S., Wolfgang M. C., Boucher R., Gilpin D. F. other authors 2008; Detection of anaerobic bacteria in high numbers in sputum from patients with cystic fibrosis. Am J Respir Crit Care Med 177:995–1001 [CrossRef]
    [Google Scholar]
  29. Whiley R. A., Beighton D., Winstanley T. G., Fraser H. Y., Hardie J. M. 1992; Streptococcus intermedius , Streptococcus constellatus , and Streptococcus anginosus (the Streptococcus milleri group): association with different body sites and clinical infections. J Clin Microbiol 30:243–244
    [Google Scholar]
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