title: Notable alkaline tolerance of Kocuria marina isolate from blood of a pediatric patient with continuous intravenous epoprostenol therapy.
abstract: This study was the first to describe the hitherto deficiently evaluated alkaline tolerance of Kocuria marina isolate from a pediatric patient with continuous intravenous epoprostenol dosing therapy. Our isolate from blood of a 7-year-old Japanese boy was finally identified as K. marina by the morphological, cultural, and biochemical properties together with the comparative sequence analyses of the 16S rRNA genes. The K. marina isolate, the causative agent of catheter-related blood-stream infection, was not only revealed to be salt tolerant (NaCl 15%), but also demonstrated to be stably survived with no apparent decrease of cell counts for long periods (120 h) in an alkaline environment (pH 8, 9, 10, and 11) at 35 °C. Its remarkable tolerance to the stresses of high alkalinity compared with a clinical Staphylococcus aureus strain should provide consistent interpretation that the environment of high alkalinity (pH 10.2-10.8) measures should be insufficient to inactivate almost all the causative agents including K. marina strains in the solution of epoprostenol (pH 10.4) (Flolan(®), GlaxoSmithKline, Ltd., Tokyo, Japan.). To the best of our knowledge, the first description of the property of being tolerant to high alkalinity that the K. marina isolate exhibited was noteworthy and a useful piece of information. In conclusion, we believe that the present study should be a notification regarding the potential risk of catheter-related blood-stream infections due to K. marina, suggestive of an alkalophile, especially in patients receiving continuous intravenous epoprostenol dosing therapy.
authors.affiliation: Department of Laboratory Medicine, Nagano Children's Hospital, Azumino 399-8288, Japan.
authors.forename: Ayaka
authors.initials: A
authors.lastname: Horiuchi
authors.affiliation: Department of Laboratory Medicine, Nagano Children's Hospital, Azumino 399-8288, Japan; Department of Life Science Research Center, Nagano Children's Hospital, Azumino 399-8288, Japan.
authors.forename: Noriko
authors.initials: N
authors.lastname: Kubota
authors.affiliation: Department of Laboratory Medicine, Nagano Children's Hospital, Azumino 399-8288, Japan; Department of Life Science Research Center, Nagano Children's Hospital, Azumino 399-8288, Japan.
authors.forename: Eiko
authors.initials: E
authors.lastname: Hidaka
authors.affiliation: Department of Pediatric Cardiology, Nagano Children's Hospital, Azumino 399-8288, Japan.
authors.forename: Atsuya
authors.initials: A
authors.lastname: Shimabukuro
authors.affiliation: Department of Pediatric Cardiology, Nagano Children's Hospital, Azumino 399-8288, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yasukochi
authors.affiliation: Department of Life Science Research Center, Nagano Children's Hospital, Azumino 399-8288, Japan; Department of Infection Control, Nagano Children's Hospital, Azumino 399-8288, Japan.
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Nakamura
authors.affiliation: Division of Infection Control and Microbiological Regulation, Department of Health and Medical Sciences, Shinshu University Graduate School of Medicine, Matsumoto 390-8621, Japan; Division of Clinical Microbiology, Department of Biomedical Laboratory Sciences, School of Health Sciences, Shinshu University School of Medicine, Matsumoto 390-8621, Japan.
authors.forename: Kozue
authors.initials: K
authors.lastname: Oana
authors.affiliation: Division of Infection Control and Microbiological Regulation, Department of Health and Medical Sciences, Shinshu University Graduate School of Medicine, Matsumoto 390-8621, Japan; Division of Clinical Microbiology, Department of Biomedical Laboratory Sciences, School of Health Sciences, Shinshu University School of Medicine, Matsumoto 390-8621, Japan. Electronic address: yk23724@shinshu-u.ac.jp.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Kawakami
mesh_terms: D016470:Bacteremia / Q000382:microbiology; D055499:Catheter-Related Infections / Q000382:microbiology; D002648:Child; D011464:Epoprostenol / Q000008:administration & dosage / Q000494:pharmacology*; D016908:Gram-Positive Bacterial Infections / Q000382:microbiology*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008826:Microbial Sensitivity Tests; D008835:Micrococcaceae / Q000187:drug effects* / Q000302:isolation & purification / Q000502:physiology*; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000494:pharmacology*; D055049:Salt Tolerance; D013312:Stress, Physiological
chemical_list: D010975:Platelet Aggregation Inhibitors; D011464:Epoprostenol
keywords: Alkaline tolerance; Alkalophilic; Catheter-related blood stream infection; Epoprostenol; Kocuria marina