title: Granulicatella adiacens and Abiotrophia defectiva bacteraemia characterized by 16S rRNA gene sequencing.
abstract: Traditionally, the identification, epidemiology and spectrum of clinical diseases caused by Granulicatella adiacens and Abiotrophia defectiva are dependent upon their phenotypic characterization. During a 6-year period (July 1995-June 2001), seven and two alpha-haemolytic streptococci were identified as G. adiacens and A. defectiva, respectively, by 16S rRNA gene sequencing. Three patients with haematological malignancies and neutropenic fever had primary bacteraemia. Three patients with valvular problems or congenital heart disease had infective endocarditis. A patient with ischemic heart disease and cerebrovascular accident had infected aortic atheroma with dissection. A patient with recurrent pyogenic cholangitis had acute cholangitis and a patient with polypoid cystitis and benign prostatic hypertrophy had acute prostatitis. Four of the nine patients died, including all three with G. adiacens infective endocarditis or infected atheroma. For the seven G. adiacens isolates, the API 20 STREP system successfully identified one and five isolates as G. adiacens with >95 % and 80-90 % confidence, respectively, whereas the Vitek System (GPI) and ATB Expression system (ID32 STREP) successfully identified none and one isolate as G. adiacens. Of the two A. defectiva isolates, none of the three systems successfully identified either of them as A. defectiva. 16S rRNA gene sequencing is the technique of choice for identifying G. adiacens and A. defectiva, and early surgical intervention should be considered when G. adiacens endocarditis is diagnosed.
authors.affiliation: Department of Microbiology, The University of Hong Kong, University Pathology Building, Queen Mary Hospital, Hong Kong 2Department of Microbiology, Tuen Mun Hospital, Hong Kong 3Department of Microbiology, Pamela Youde Nethersole Eastern Hospital, Hong Kong 4HKU-Pasteur Research Centre, Hong Kong.
authors.forename: Patrick Chiu-Yat
authors.initials: PC
authors.lastname: Woo
authors.affiliation: Department of Microbiology, The University of Hong Kong, University Pathology Building, Queen Mary Hospital, Hong Kong 2Department of Microbiology, Tuen Mun Hospital, Hong Kong 3Department of Microbiology, Pamela Youde Nethersole Eastern Hospital, Hong Kong 4HKU-Pasteur Research Centre, Hong Kong.
authors.forename: Ami Mei-Yuk
authors.initials: AM
authors.lastname: Fung
authors.affiliation: Department of Microbiology, The University of Hong Kong, University Pathology Building, Queen Mary Hospital, Hong Kong 2Department of Microbiology, Tuen Mun Hospital, Hong Kong 3Department of Microbiology, Pamela Youde Nethersole Eastern Hospital, Hong Kong 4HKU-Pasteur Research Centre, Hong Kong.
authors.forename: Susanna Kar-Pui
authors.initials: SK
authors.lastname: Lau
authors.affiliation: Department of Microbiology, The University of Hong Kong, University Pathology Building, Queen Mary Hospital, Hong Kong 2Department of Microbiology, Tuen Mun Hospital, Hong Kong 3Department of Microbiology, Pamela Youde Nethersole Eastern Hospital, Hong Kong 4HKU-Pasteur Research Centre, Hong Kong.
authors.forename: Benedict Yin-Leung
authors.initials: BY
authors.lastname: Chan
authors.affiliation: Department of Microbiology, The University of Hong Kong, University Pathology Building, Queen Mary Hospital, Hong Kong 2Department of Microbiology, Tuen Mun Hospital, Hong Kong 3Department of Microbiology, Pamela Youde Nethersole Eastern Hospital, Hong Kong 4HKU-Pasteur Research Centre, Hong Kong.
authors.forename: Siu-Kau
authors.initials: SK
authors.lastname: Chiu
authors.affiliation: Department of Microbiology, The University of Hong Kong, University Pathology Building, Queen Mary Hospital, Hong Kong 2Department of Microbiology, Tuen Mun Hospital, Hong Kong 3Department of Microbiology, Pamela Youde Nethersole Eastern Hospital, Hong Kong 4HKU-Pasteur Research Centre, Hong Kong.
authors.forename: Jade Lee-Lee
authors.initials: JL
authors.lastname: Teng
authors.affiliation: Department of Microbiology, The University of Hong Kong, University Pathology Building, Queen Mary Hospital, Hong Kong 2Department of Microbiology, Tuen Mun Hospital, Hong Kong 3Department of Microbiology, Pamela Youde Nethersole Eastern Hospital, Hong Kong 4HKU-Pasteur Research Centre, Hong Kong.
authors.forename: Tak-Lun
authors.initials: TL
authors.lastname: Que
authors.affiliation: Department of Microbiology, The University of Hong Kong, University Pathology Building, Queen Mary Hospital, Hong Kong 2Department of Microbiology, Tuen Mun Hospital, Hong Kong 3Department of Microbiology, Pamela Youde Nethersole Eastern Hospital, Hong Kong 4HKU-Pasteur Research Centre, Hong Kong.
authors.forename: Raymond Wai-Hung
authors.initials: RW
authors.lastname: Yung
authors.affiliation: Department of Microbiology, The University of Hong Kong, University Pathology Building, Queen Mary Hospital, Hong Kong 2Department of Microbiology, Tuen Mun Hospital, Hong Kong 3Department of Microbiology, Pamela Youde Nethersole Eastern Hospital, Hong Kong 4HKU-Pasteur Research Centre, Hong Kong.
authors.forename: Kwok-Yung
authors.initials: KY
authors.lastname: Yuen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000175:diagnosis / Q000382:microbiology*; D001483:Base Sequence; D004275:DNA, Ribosomal / Q000737:chemistry; D004697:Endocarditis, Bacterial / Q000175:diagnosis / Q000382:microbiology; D005260:Female; D005798:Genes, Bacterial; D006801:Humans; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D010641:Phenotype; D010802:Phylogeny; D016133:Polymerase Chain Reaction / Q000379:methods; D012336:RNA, Ribosomal, 16S / Q000235:genetics*; D012680:Sensitivity and Specificity; D013290:Streptococcal Infections / Q000175:diagnosis / Q000382:microbiology*; D013291:Streptococcus / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*
chemical_list: D004275:DNA, Ribosomal; D012336:RNA, Ribosomal, 16S