This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrowReprints and Permissions
Right arrow Copyright Information
Right arrow Books from ASM Press
Right arrow MicrobeWorld
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Kidd, T. J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Kidd, T. J.

 Previous Article  |  Next Article 

Journal of Clinical Microbiology, May 2009, p. 1503-1509, Vol. 47, No. 5
0095-1137/09/$08.00+0     doi:10.1128/JCM.00014-09
Copyright © 2009, American Society for Microbiology. All Rights Reserved.

Low Rates of Pseudomonas aeruginosa Misidentification in Isolates from Cystic Fibrosis Patients{triangledown}

Timothy J. Kidd,1,2* Kay A. Ramsay,1,2 Honghua Hu,3 Peter T. P. Bye,4,5 Mark R. Elkins,4 Keith Grimwood,2,6 Colin Harbour,3 Guy B. Marks,5 Michael D. Nissen,2,6 Philip J. Robinson,7 Barbara R. Rose,3 Theo P. Sloots,2 Claire E. Wainwright,6,8 Scott C. Bell,1,9 and the ACPinCF Investigators,{dagger}

School of Medicine, University of Queensland, Brisbane, Queensland, Australia,1 Qpid Laboratory, Queensland Children's Medical Research Institute, Royal Children's Hospital and Clinical Medical Virology Centre, University of Queensland, Brisbane, Queensland, Australia,2 Department of Infectious Diseases and Immunology, The University of Sydney, Sydney, New South Wales, Australia,3 Department of Respiratory Medicine, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia,4 The Woolcock Institute of Medical Research, Sydney, New South Wales, Australia,5 Discipline of Paediatrics and Child Health, University of Queensland, Queensland, Australia,6 Department of Respiratory Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia,7 Department of Respiratory Medicine, Royal Children's Hospital and Queensland Children's Medical Research Institute, Brisbane, Queensland, Australia,8 Adult Cystic Fibrosis Centre, Department of Thoracic Medicine, The Prince Charles Hospital, Brisbane, Queensland, Australia9

Received 5 January 2009/ Returned for modification 13 February 2009/ Accepted 20 February 2009

Pseudomonas aeruginosa is an important cause of pulmonary infection in cystic fibrosis (CF). Its correct identification ensures effective patient management and infection control strategies. However, little is known about how often CF sputum isolates are falsely identified as P. aeruginosa. We used P. aeruginosa-specific duplex real-time PCR assays to determine if 2,267 P. aeruginosa sputum isolates from 561 CF patients were correctly identified by 17 Australian clinical microbiology laboratories. Misidentified isolates underwent further phenotypic tests, amplified rRNA gene restriction analysis, and partial 16S rRNA gene sequence analysis. Participating laboratories were surveyed on how they identified P. aeruginosa from CF sputum. Overall, 2,214 (97.7%) isolates from 531 (94.7%) CF patients were correctly identified as P. aeruginosa. Further testing with the API 20NE kit correctly identified only 34 (59%) of the misidentified isolates. Twelve (40%) patients had previously grown the misidentified species in their sputum. Achromobacter xylosoxidans (n = 21), Stenotrophomonas maltophilia (n = 15), and Inquilinus limosus (n = 4) were the species most commonly misidentified as P. aeruginosa. Overall, there were very low rates of P. aeruginosa misidentification among isolates from a broad cross section of Australian CF patients. Additional improvements are possible by undertaking a culture history review, noting colonial morphology, and performing stringent oxidase, DNase, and colistin susceptibility testing for all presumptive P. aeruginosa isolates. Isolates exhibiting atypical phenotypic features should be evaluated further by additional phenotypic or genotypic identification techniques.

* Corresponding author. Mailing address: Qpid Laboratory, Level 7, Sir Albert Sakzewski Virus Research Centre, Queensland Children's Medical Research Institute, Royal Children's Hospital, Herston, QLD, Australia 4029. Phone: 61 7 3636 1400. Fax: 61 7 3636 1401. E-mail: Tim_Kidd{at}health.qld.gov.au

{triangledown} Published ahead of print on 4 March 2009.

{dagger} The ACPinCF Investigators are listed in Acknowledgments.

Journal of Clinical Microbiology, May 2009, p. 1503-1509, Vol. 47, No. 5
0095-1137/09/$08.00+0     doi:10.1128/JCM.00014-09
Copyright © 2009, American Society for Microbiology. All Rights Reserved.





Copyright © 2009 by the American Society for Microbiology.   For an alternate route to Journals.ASM.org, visit: http://intl-journals.asm.org | More Info»