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Journal of Clinical Microbiology, April 2004, p. 1727-1730, Vol. 42, No. 4
0095-1137/04/$08.00+0 DOI: 10.1128/JCM.42.4.1727-1730.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.
Identification of Bacteroides thetaiotaomicron on the Basis of an Unexpected Specific Amplicon of Universal 16S Ribosomal DNA PCR
Lee-Jene Teng,1,2 Po-Ren Hsueh,1 Yu-Hsuan Huang,2 and Jui-Chang Tsai3,4*
Department of Laboratory Medicine,1
Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital,3
School of Medical Technology,2
Center for Optoelectronic Biomedicine, National Taiwan University College of Medicine, Taipei, Taiwan4
Received 31 August 2003/
Returned for modification 24 October 2003/
Accepted 18 December 2003

ABSTRACT
We applied a set of commonly used universal primers (primers
RW01 and DG74) to amplify partial fragments of 16S ribosomal
DNA for bacterial identification and found an unexpected amplicon
(547 bp), in addition to the expected 362-bp product, in samples
containing
Bacteroides thetaiotaomicron. It was demonstrated
that the internal sequence (508 bp, excluding the primers) of
the 547-bp amplicon was identical to the genomic sequence from
nucleotide positions 165800 to 166307 of
B. thetaiotaomicron type strain VPI-5482 by a BLAST search of the sequences in the
GenBank database. The existence of this unexpected yet specific
amplicon strongly indicated the presence of
B. thetaiotaomicron in the sample, and it was found that it could be used to discriminate
B. thetaiotaomicron from closely related species. Another set
of PCR primers specific for
B. thetaiotaomicron was developed
on the basis of the sequence of this 547-bp genomic fragment.
Both PCR-based assays showed the same sensitivity (88%) and
specificity (100%).

TEXT
Identification of pathogens in specimens usually depends on
culture and various phenotypic tests. The phenotypic characteristics
of clinical isolates, which are used for conventional identification,
are not always typical and may lead to ambiguous results (
2).
Many new methods based on molecular techniques for the rapid
and direct identification of microorganisms in specimens have
been developed. Direct sequencing of the PCR-amplified bacterial
16S ribosomal DNA (rDNA) is one of these new molecular identification
methods, and it has been widely used (
4,
7,
13,
15). The 16S
rRNA genes of almost all common bacterial pathogens have been
sequenced and are highly conserved among these bacteria. Consequently,
the 16S rRNA gene is commonly selected as the target for universal
PCR that amplifies partial or nearly full-length 16S rDNA sequences
in almost all bacterial pathogens. Many sets of primers have
been designed to amplify different regions of 16S rDNA and have
been shown to have various sensitivities and specificities.
A universal PCR with primers RW01 and DG74A was developed, and
it was demonstrated to be a sensitive screening method for detection
of bacterial pathogens in cerebrospinal fluid (
4). This set
of universal primers amplified a portion of 16S rDNA (369 bp
in
Escherichia coli) (
4), and it was applied to the identification
of bacterial pathogens in clinical specimens. However, we found
that an unexpected amplicon (547 bp), in addition to the expected
362-bp product, constantly appeared in samples containing
Bacteroides thetaiotaomicron.
B. fragilis and B. thetaiotaomicron are clinically important because they are the first and second most common agents of infections caused by anaerobic gram-negative bacilli, respectively (1, 3, 8). They are opportunistic pathogens commonly associated with peritonitis, septicemia, and wound infections (3, 8). Although B. thetaiotaomicron is part of the indigenous microflora of the gastrointestinal tract, it may cause serious infections such as intra-abdominal sepsis and bacteremia (1, 3, 8). B. thetaiotaomicron is resistant to many antimicrobial agents; for example, it has been reported to be more resistant than B. fragilis to cephalosporins and clindamycin (1, 9, 10, 12). Therefore, rapid and accurate identification of B. thetaiotaomicron in clinical specimens is important, and it may help physicians make rational, rapid choices with respect to antibiotic therapy. In order to establish if we could identify B. thetaiotaomicron on the basis of the detection of this additional PCR product, we performed the tests described here.
Bacterial strains.
Eight reference strains of Bacteroides species (B. fragilis ATCC 25285, B. fragilis ATCC 29762, B. thetaiotaomicron ATCC 29741, B. caccae ATCC 43185, B. ovatus ATCC 8483, B. distasonis ATCC 8503, B. vulgatus ATCC 8482, and B. uniformis ATCC 8492) were obtained from the American Type Culture Collection (ATCC; Manassas, Va.) A total of 43 clinical isolates initially identified as B. fragilis (n = 7), B. caccae (n = 7), B. thetaiotaomicron (n = 16), B. uniformis (n = 5), B. vulgatus (n = 5), and B. distasonis (n = 3) by conventional methods were included in this study. All the clinical isolates were collected from the Bacteriology Laboratory, National Taiwan University Hospital, a 2,000-bed teaching hospital in northern Taiwan.
Bacteroides species identification.
Clinical Bacteroides species isolates were initially identified by the Presumpto Plates method of the Centers for Disease Control and Prevention and sugar fermentation. Subsequently, PCR was performed with primers 8FPL (5'-AGAGTTTGATCCTGGCTCAG-3') and 1492 (5'-GGTTACCTTGTTACGACTT-3') to amplify the nearly complete length of 16S rDNA in the bacteria. The amplification products obtained by PCR of the nearly complete length of 16S rDNA were sequenced, and the sequences were compared to known 16S rDNA sequences in the GenBank database of the National Center for Biotechnology Information by using the BLAST algorithm. The species with the best match were regarded as pathogenic species in the samples. Three isolates initially identified as B. thetaiotaomicron on the basis of phenotypic tests were reidentified by 16S rDNA sequencing as B. ovatus (two isolates) and B. distasonis (one isolate) (Table 1). Another three isolates initially identified as B. uniformis (two isolates) and B. caccae (one isolate) by phenotypic tests were reidentified as B. thetaiotaomicron by 16S rDNA sequencing (Table 1).
Amplification of partial 16S rDNA using different annealing temperatures.
DNA was prepared from the bacteria by using a DNA isolation
kit (Puregene; Gentra Systems, Inc., Minneapolis, Minn.), according
to the instructions of the manufacturer. Amplification of partial
16S rDNA was performed with the universal primers RW01 (5'-AACTGGAGGAAGGTGGGGAT-3')
and DG74 (5'-AGGAGGTGATCCAACCGCA-3'). The annealing temperature
in the original PCR protocol was 55°C (
4). We used annealing
temperatures of 50, 55, and 60°C in this study. The amplification
reaction mixtures contained 50 µl of 10 mM Tris-HCl (pH
8.3), 50 mM KCl, 1.5 mM MgCl
2, 0.001% gelatin, 1 U of
Taq polymerase
(Perkin-Elmer, Norwalk, Conn.), 200 µM (each) deoxynucleotide
triphosphate (dATP, dCTP, dGTP, and dTTP; Perkin-Elmer), 50
pmol of each of the primers, and 2 µl of the DNA sample.
The PCR was carried out in a DNA thermal cycler (MJ Research
Inc., Watertown, Mass.) with 30 cycles of denaturation (94°C,
1 min), annealing (50, 55, or 60°C, 1 min), and extension
(72°C, 1 min), followed by a final extension step (72°C,
7 min). The amplification products were subsequently subjected
to gel electrophoresis (FMC BioProducts, Rockland, Maine), stained
with ethidium bromide, and photographed under UV light. In addition
to the expected 362-bp amplicon, an unexpected band of 547 bp
was noted in the
B. thetaiotaomicron ATCC 29741 strain but not
in the other
Bacteroides species. This unexpected amplification
product appeared when the annealing temperature was set to 50
or 55°C (Fig.
1A and B) and disappeared when the annealing
temperature was elevated to 60°C (Fig.
1C). We then performed
this PCR with DNA from clinical isolates of
Bacteroides species
at an annealing temperature of 50°C. While certain nonspecific
faint bands of various sizes were noted for the other
Bacteroides species, they were not of the same size as the 547-bp amplicon
found for
B. thetaiotaomicron (Fig.
1D). PCR with primers RW01
and DG74 revealed a single 362-bp band for each of the three
isolates reidentified as
Bacteroides other than
B. thetaiotaomicron and revealed two bands (362 and 547 bp) in each of the three
specimens found on subsequent analysis to contain
B. thetaiotaomicron (Table
1).
Sequence analysis of the unexpected 547-bp amplified product from B. thetaiotaomicron.
The PCR products from four clinical isolates of
B. thetaiotaomicron were separated by gel electrophoresis. The 362- and 547-bp bands
were excised from the gel and purified. The purified DNA fragments
were subsequently sequenced on a sequencing system (model 377;
Applied Biosystems, Foster City, Calif.) with a
Taq BigDye-Deoxy
Terminator cycle sequencing kit (Applied Biosystems), according
to the instructions of the manufacturer. The internal sequence
(323 bp, excluding the primers) of the 362-bp band in each isolate
was shown to be identical to a fragment of the
B. thetaiotaomicron 16S rDNA gene, as expected, while the internal sequence (508
bp) of the 547-bp product was 100% identical to the genomic
sequence from positions 165800 to 166307 of
B. thetaiotaomicron type strain VPI-5482 (ATCC 29148) on the basis of a search against
the sequences in the GenBank database with the BLAST program
(Table
2). The complete genome sequence of
B. thetaiotaomicron has recently been published (
16). According to the sequence
data (GenBank accession number
AE016926), the fragment from
positions
165800 to
166307 contains the partial sequence predicted
to encode a hypothetical protein (complement, positions
165668 to
166102) and a putative permease (complement, positions
166150 to
167325). The complete genome contains five copies of the
16S rRNA gene. We aligned the sequences of the 16S rDNA universal
primers (primers RW01 and DG74) to the genomic sequence of
B. thetaiotaomicron and found that the 15 nucleotides at the 3'
end of primer RW01 were 100% identical to a region of the 16S
rDNA gene (Table
2). Apart from the 16S rDNA gene, the primer
sequence was also similar (identical at 16 of 20 nucleotides)
to the sequence of a genomic fragment of
B. thetaiotaomicron (Table
2). The sequence of reverse primer DG74 was found to
be similar to a region of the 16S rDNA gene (identical at 17
of 19 nucleotides) and a genomic site (identical at 10 nucleotides
at the 3' end) not related to the 16S rDNA gene. Accordingly,
the 547-bp amplification product was caused by cross-reaction
of the 16S rDNA primers (primers RW01 and DG74) with sequences
other than the 16S rDNA in the genome, and it was specific to
B. thetaiotaomicron.
View this table:
[in this window]
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TABLE 2. Alignment of the sequences of PCR primers RW01 and DG74 with those of E. coli 16S rDNA, B. thetaiotaomicron 16S rDNA, and the B. thetaiotaomicron genome
|
Identification of B. thetaiotaomicron species on the basis of the 547-bp amplicon.
Although the 547-bp amplicon was not the expected product of
the PCR with universal primers RW01 and DG74, it was consistently
present in PCRs with
B. thetaiotaomicron isolates and may have
practical value in differentiating
B. thetaiotaomicron from
phenotypically similar species, such as
B. uniformis and
B. ovatus. This 547-bp amplicon was clearly seen for 14 of 16 clinical
isolates of
B. thetaiotaomicron but not for any of the other
Bacteroides species (Fig.
1D).
B. thetaiotaomicron,
B. uniformis,
and
B. ovatus are all indole-positive species and are closely
genetically related to each other (
6,
14). We have applied this
PCR to a wide range of other common bacterial pathogens found
in clinical specimens and detected only the expected

370-bp
band in PCRs with most of the isolates. Although certain nonspecific
bands of various sizes, in addition to the

370-bp band, were
noted for some species other than
B. thetaiotaomicron, they
were faint and not of the same size as the 547-bp amplicon.
Thus, the identification of
B. thetaiotaomicron on the basis
of detection of this 547-bp band had a sensitivity of 88% (14
of 16 isolates) and a specificity of 100%.
B. thetaiotaomicron-specific PCR.
In order to increase the sensitivity of the PCR for the identification of B. thetaiotaomicron, PCR primers based on this 547-bp genomic target (positions 165780 to 166326; GenBank accession number AE016926) were designed. This new set of primers, primers 5'-AACAGGTGGAAGCTGCGGA-3' (corresponding to nucleotide positions 165780 to 165798) and 5'-AGCCTCCAACCGCATCAA-3' (corresponding to nucleotide positions 166321 to 166304), was used to amplify a 542-bp fragment of B. thetaiotaomicron. The PCR was carried out in a DNA thermal cycler (MJ Research, Inc.) with 35 cycles of denaturation (94°C, 1 min), annealing (60°C, 30 s), and extension (72°C, 1 min), followed by a final extension step (72°C, 7 min). This PCR was positive for the B. thetaiotaomicron ATCC 29741 strain and all the B. thetaiotaomicron strains (n = 14) which showed the 547-bp band by PCR with primers RW01 and DG74 (Fig. 2). The two B. thetaiotaomicron clinical isolates which failed to show the 547-bp band by PCR with primers RW01 and DG74 did not show the expected 542-bp band by PCR with this new set of primers. We have used several other sets of primers based on this 547-bp genomic target (positions 165780 to 166326; GenBank accession number AE016926) to amplify this region of DNA in these two clinical isolates, but all failed to show the corresponding fragment. It seems possible that the region from nucleotides 165780 to 166326 is missing in these two isolates. The 542-bp PCR products were not detected when bacterial DNA other than that of B. thetaiotaomicron was used as the template (Fig. 2). Although the newly designed primers do not increase the sensitivity of the PCR for the identification of B. thetaiotaomicron, they do increase the specificity of the PCR assay because the additional products originally observed in Fig. 1 (by PCR with universal primers RW01 and DG74) were no longer detected in Fig. 2 (by PCR with the newly designed specific primers).
Phenotypic identification versus molecular identification.
Identification of
Bacteroides species by conventional biochemical
identification often requires 3 to 7 days, and the results are
sometimes inconclusive (
14). Moreover, the automated methods
commonly used for the identification of
B. thetaiotaomicron from clinical isolates are not always reliable (
2). This problem
is caused by the similarity of the phenotypic and biochemical
characteristics of closely related species. For the identification
of
B. thetaiotaomicron, genotypic methods such as 16S rDNA PCR
(this study) or PCR hybridization (other studies [
5,
11]) are
more specific and rapid than conventional methods.
In this study, we found an unexpected yet specific amplification of a fragment by PCR caused by cross-reaction of the universal primers (primers RW01 and DG74) with genomic sites of B. thetaiotaomicron other than 16S rDNA. The existence of this 547-bp PCR product strongly indicated the presence of B. thetaiotaomicron in the samples, and this could subsequently be confirmed by sequence analysis. PCR primers specific for B. thetaiotaomicron were developed on the basis of the sequence of this 547-bp genomic fragment. However, the sensitivity and specificity of the new PCR remained the same as those of the original PCR. In conclusion, the PCR-based assays described in this study can be used to discriminate B. thetaiotaomicron from the closely related Bacteroides species.

FOOTNOTES
* Corresponding author. Mailing address: Division of Neurosurgery, Department of Surgery, National Taiwan University College of Medicine, Rm. 824, 8th Floor, No. 7, Chung-Shan S. Rd., Taipei 100, Taiwan. Phone: 886-2-23123456, ext. 5422. Fax: 886-2-23582009. E-mail:
jctsai{at}ha.mc.ntu.edu.tw.


REFERENCES
1 - Aldridge, K. E., and M. O'Brien. 2002. In vitro susceptibilities of the Bacteroides fragilis group species: change in isolation rates significantly affects overall susceptibility data. J. Clin. Microbiol. 40:4349-4352.[Abstract/Free Full Text]
2 - Arzese, A., R. Minisini, and G. A. Botta. 1994. Evaluation of an automated system for identification of anaerobic bacteria. Eur. J. Clin. Microbiol. Infect. Dis. 13:135-141.[CrossRef][Medline]
3 - Goldstein, E. J. 1996. Anaerobic bacteremia. Clin. Infect. Dis. 23:S97-S101.
4 - Greisen, K., M. Loeffelholz, A. Purohit, and D. Leong. 1994. PCR primers and probes for the 16S rRNA gene of most species of pathogenic bacteria, including bacteria found in cerebrospinal fluid. J. Clin. Microbiol. 32:335-351.[Abstract/Free Full Text]
5 - Kreader, C. A. 1995. Design and evaluation of Bacteroides DNA probes for the specific detection of human fecal pollution. Appl. Environ. Microbiol. 61:1171-1179.[Abstract]
6 - Paster, B. J., F. E. Dewhirst, I. Olsen, and G. J. Fraser. 1994. Phylogeny of Bacteroides, Prevotella, and Porphyromonas spp. and related bacteria. J. Bacteriol. 176:725-732.[Abstract/Free Full Text]
7 - Qian, Q., Y. W. Tang, C. P. Kolbert, C. A. Torgerson, J. G. Hughes, E. A. Vetter, W. S. Harmsen, S. O. Montgomery, F. R. Cockerill III, and D. H. Persing. 2001. Direct identification of bacteria from positive blood cultures by amplification and sequencing of the 16S rRNA gene: evaluation of BACTEC 9240 instrument true-positive and false-positive results. J. Clin. Microbiol. 39:3578-3582.[Abstract/Free Full Text]
8 - Redondo, M. C., M. D. Arbo, J. Grindlinger, and D. R. Snydman. 1995. Attributable mortality of bacteremia associated with the Bacteroides fragilis group. Clin. Infect. Dis. 20:1492-1496.[Medline]
9 - Snydman, D. R., L. McDermott, G. J. Cuchural, Jr., D. W. Hecht, P. B. Iannini, L. J. Harrell, S. G. Jenkins, J. P. O'Keefe, C. L. Pierson, J. D. Rihs, V. L. Yu, S. M. Finegold, and S. L. Gorbach. 1996. Analysis of trends in antimicrobial resistance patterns among clinical isolates of Bacteroides fragilis group species from 1990 to 1994. Clin. Infect. Dis. 23:S54-S65.
10 - Tanaka-Bandoh, K., N. Kato, K. Watanabe, and K. Ueno. 1995. Antibiotic susceptibility profiles of Bacteroides fragilis and Bacteroides thetaiotaomicron in Japan from 1990 to 1992. Clin. Infect. Dis. 20:S352-S355.
11 - Teng, L. J., P. R. Hsueh, J. C. Tsai, F. L. Chiang, C. Y. Chen, S. W. Ho, and K. T. Luh. 2000. PCR assay for species-specific identification of Bacteroides thetaiotaomicron. J. Clin. Microbiol. 38:1672-1675.[Abstract/Free Full Text]
12 - Teng, L. J., P. R. Hsueh, J. C. Tsai, S. J. Liaw, S. W. Ho, and K. T. Luh. 2002. High incidence of cefoxitin and clindamycin resistance among anaerobes in Taiwan. Antimicrob. Agents Chemother. 46:2908-2913.[Abstract/Free Full Text]
13 - Tunney, M. M., S. Patrick, M. D. Curran, G. Ramage, D. Hanna, J. R. Nixon, S. P. Gorman, R. I. Davis, and N. Anderson. 1999. Detection of prosthetic hip infection at revision arthroplasty by immunofluorescence microscopy and PCR amplification of the bacterial 16S rRNA gene. J. Clin. Microbiol. 37:3281-3290.[Abstract/Free Full Text]
14 - Whaley, D. N., L. S. Wiggs, P. H. Miller, P. U. Srivastava, and J. M. Miller. 1995. Use of Presumpto Plates to identify anaerobic bacteria. J. Clin. Microbiol. 33:1196-1202.[Abstract]
15 - Woo, P. C. Y., K. H. L. Ng, S. K. P. Lau, K.-T. Yip, A. M. Y. Fung, K.-W. Leung, D. M. W. Tam, T.-L. Que, and K.-Y. Yuen. 2003. Usefulness of the MicroSeq 500 16S ribosomal DNA-based bacterial identification system for identification of clinically significant bacterial isolates with ambiguous biochemical profiles. J. Clin. Microbiol. 41:1996-2001.[Abstract/Free Full Text]
16 - Xu, J., M. K. Bjursell, J. Himrod, S. Deng, L. K. Carmichael, H. C. Chiang, L. V. Hooper, and J. I. Gordon. 2003. A genomic view of the human-Bacteroides thetaiotaomicron symbiosis. Science 299:2074-2076.[Abstract/Free Full Text]
Journal of Clinical Microbiology, April 2004, p. 1727-1730, Vol. 42, No. 4
0095-1137/04/$08.00+0 DOI: 10.1128/JCM.42.4.1727-1730.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.
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