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Journal of Clinical Microbiology, September 1998, p. 2530-2534, Vol. 36, No. 9
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.

Chronic Prosthetic Hip Infection Caused by a Small-Colony Variant of Escherichia coli

Andreas Roggenkamp,1,* Andreas Sing,1 Mathias Hornef,1 Ulrich Brunner,2 Ingo B. Autenrieth,1 and Jürgen Heesemann1

Max von Pettenkofer-Institute for Hygiene and Medical Microbiology1 and Department of Surgery, Clinic Innenstadt,2 Ludwig Maximilians University Munich, 80336 Munich, Germany

Received 12 March 1998/Returned for modification 14 May 1998/Accepted 28 May 1998

From two different specimens of a chronic prosthetic hip infection taken at an interval of 2 months a slow-growing gram-negative bacterium was isolated in pure culture. The strain grew with the typical features of a small-colony variant (SCV). 16S rRNA sequencing identified the bacterium as Escherichia coli. Biochemical characterization demonstrated multiple phenotypic alterations of a mutant carrying a defect in the heme biosynthetic pathway (Hem-): (i) catalase and nitrate reductase reactions were both negative, (ii) a negative benzidine reaction demonstrated the lack of heme-containing cytochromes, and (iii) growth stimulation under anaerobic conditions as well as gentamicin resistance indicated defective aerobic respiration. PCR and Southern hybridization demonstrated that the mutation of the SCV of E. coli was localized in the hemB gene and was most likely due to a deletion of the hemB gene. On blood agar plates revertants were recognized growing as normal-sized colonies between the dominant small colonies of the strain. Feeding experiments indicated that the revertants but not the small colonies were permeable for hemin. A strong antibody response against the infecting SCV of E. coli was found. To our knowledge, this is the first report of a Hem- E. coli strain as the etiological agent of a chronic bacterial infection.

* Corresponding author. Mailing address: Max von Pettenkofer-Institute for Hygiene and Medical Microbiology, Ludwig Maximilians University Munich, Pettenkoferstr. 9a, 80336 Munich, Germany. Phone: 49-89-51605200. Fax: 49-89-5380584. E-mail: rogge{at}m3401.mpk.med.uni-muenchen.de.

Journal of Clinical Microbiology, September 1998, p. 2530-2534, Vol. 36, No. 9
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.


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