title: First Isolation of carbon dioxide-dependent Proteus mirabilis from an uncomplicated cystitis patient with Sjögren's syndrome.
abstract: An uncomplicated cystitis caused by CO2-dependent Proteus mirabilis was observed in a 64-year-old Japanese female patient with Sjögren's syndrome in the Aomori Kyoritsu Hospital, Aomori, Japan. The initial P. mirabilis isolate came from a midstream urine specimen containing large numbers of Gram-negative, rod-shaped organisms that failed to grow on both Drigalski agar and sheep blood agar incubated in ambient air. The organism did grow when the urine was cultured overnight on blood agar under anaerobic conditions. Hence, we believed that the organism was an anaerobe. Further investigation revealed that the isolate grew on sheep blood agar along with swarming when the atmospheric CO2 concentrations were increased to 5%. Initially, we failed to characterize or identify the P. mirabilis isolate or determine its antimicrobial susceptibilities using the MicroScan WalkAway-40 System because the isolate did not grow in the system. However, the isolate was subsequently identified as P. mirabilis based on its morphological, cultural, and biochemical properties by using the commercially available kit systems, Quick ID-GN and ID-Test EB-20. This identification of the isolate was confirmed by sequencing the 16S rRNA gene of the organism. To our knowledge, this is the first clinical isolation of capnophilic P. mirabilis.
authors.affiliation: Division of Infection Control and Microbiological Regulation, Department of Health and Medical Sciences, Shinshu University Graduate School of Medicine, Matsumoto, Japan.
authors.forename: Kozue
authors.initials: K
authors.lastname: Oana
authors.forename: Michiko
authors.initials: M
authors.lastname: Yamaguchi
authors.forename: Mika
authors.initials: M
authors.lastname: Nagata
authors.forename: Kei-Ichi
authors.initials: K
authors.lastname: Washino
authors.forename: Takayuki
authors.initials: T
authors.lastname: Akahane
authors.forename: Yu-Uki
authors.initials: YU
authors.lastname: Takamatsu
authors.forename: Chie
authors.initials: C
authors.lastname: Tsutsui
authors.forename: Takehisa
authors.initials: T
authors.lastname: Matsumoto
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Kawakami
mesh_terms: D001431:Bacteriological Techniques / Q000379:methods; D002245:Carbon Dioxide / Q000378:metabolism*; D003556:Cystitis / Q000150:complications* / Q000382:microbiology*; D004269:DNA, Bacterial / Q000737:chemistry / Q000235:genetics; D004275:DNA, Ribosomal / Q000737:chemistry / Q000235:genetics; D005260:Female; D006801:Humans; D007564:Japan; D008875:Middle Aged; D011512:Proteus Infections / Q000150:complications* / Q000382:microbiology*; D011513:Proteus mirabilis / Q000145:classification / Q000235:genetics / Q000302:isolation & purification* / Q000378:metabolism; D012336:RNA, Ribosomal, 16S / Q000235:genetics; D017422:Sequence Analysis, DNA; D012859:Sjogren's Syndrome / Q000150:complications*; D014556:Urine / Q000382:microbiology
chemical_list: D004269:DNA, Bacterial; D004275:DNA, Ribosomal; D012336:RNA, Ribosomal, 16S; D002245:Carbon Dioxide