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Abstract
We report a case of catheter-related bacteremia due to Tsukamurella pulmonis. T. pulmonis is a rare cause of opportunistic infection in immunosuppressed patients and in cases of indwelling foreign materials. This infection was nearly impossible to identify using conventional phenotyping methods because of its similarities to the related genera Nocardia, Rhodococcus, Gordonia, Streptomyces, Corynebacterium, and Mycobacterium. This organism was initially misidentified as Mycobacterium aubagnense through PCR-RFLP analysis. We correctly identified this organism using 16S rRNA sequencing combined with phenotyping tests.
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Fig. 1.
Tsukamurella pulmonis colonies on blood agar isolated from the blood culture The colony was yellow, dry, irregular and rough.
Fig. 2.
Comparison of the DNA sequences of the 16S rRNA genes from the isolate and Tsukamurella species. The accession numbers of the sequences are as follows: T. pulmonis, AY741505; T. tyrosinosolvens, AY238514; T. inshonensis, AF283181; T. strandjordae, AF28-3283; and T. paurometabola, AF2-83280. The nucleotide sequences were deposited in GenBank
Table 1.
Phenotype characteristics of the isolate compared to those of other Tsukamurella species∗
| Tsukamurella species† | ||||||
|---|---|---|---|---|---|---|
| Isolate | T. pulmonis | T. tyrosinosolvens | T. inchonensis | T. starndjordie | T. paurometabola | |
| Growth at 45°C | − | − | − | ＋ | − | − |
| Utilization as sole carbon soource | ||||||
| D-mannose | ＋ | V | ＋ | ＋ | − | − |
| Inositol | − | − | − | ＋ | ＋ | − |
| D-mannitol | ＋ | ＋ | ＋ | ＋ | ＋ | − |
| D-sorbitol | ＋ | ＋ | ＋ | ＋ | ＋ | − |
| Arbutin | − | − | ＋ | − | ||
| Inulin | − | − | ＋ | ＋ | ＋ | − |
| D-melezibose | − | − | ＋ | ＋ | − | − |
| D-arabitol | ＋ | ＋ | ＋ | ＋ | V | − |
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