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Aerobic Actinomycetes of Clinical Significance

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  • Authors: A. Brian Mochon1, Den Sussland2, Michael A. Saubolle3
  • Editors: Randall T. Hayden4, Donna M. Wolk5, Karen C. Carroll6, Yi-Wei Tang7
  • VIEW AFFILIATIONS HIDE AFFILIATIONS
    Affiliations: 1: Division of Infectious Diseases, Laboratory Sciences of Arizona, Banner Gateway Medical Center/Banner MD Anderson Cancer Center; Department of Pathology, University of Arizona, College of Medicine, Phoenix, AZ 85006; 2: Division of Infectious Diseases, Laboratory Sciences of Arizona, Banner – University Medical Center, Phoenix, AZ 85006; 3: Department of Medicine, University of Arizona, College of Medicine, Phoenix, AZ 85006; 4: St. Jude’s Children’s Research Hospital, Memphis, TN; 5: Geisinger Clinic, Danville, PA; 6: Johns Hopkins University Hospital, Baltimore, MD; 7: Memorial Sloan-Kettering Institute, New York, NY
  • Source: microbiolspec July 2016 vol. 4 no. 4 doi:10.1128/microbiolspec.DMIH2-0021-2015
  • Received 16 July 2015 Accepted 08 February 2016 Published 01 July 2016
  • Michael A. Saubolle, Mike.Saubolle@bannerhealth.com
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  • Abstract:

    The group of Gram-positive bacillary organisms broadly known as “aerobic actinomycetes” consists of heterogeneous and taxonomically divergent genera. They are found in a wide variety of natural and man-made environments but are rarely considered a part of the normal human flora, with infections normally originating from exogenous sources. An extensive number of genera have been described, but only a minority of these has been associated with human or veterinary health. The association with human disease is usually of an opportunistic nature, either through accidental means of inoculation or through involvement with immunocompromising conditions in the host. They cause a wide spectrum of diseases in humans, which may differ greatly between the genera and even between species, but which also may have a great amount of overlap. The occurrence of such infections is probably greater than appreciated, since many may go unrecognized. Etiologic prevalence of specific genera and species varies geographically within the United States and worldwide. Traditional phenotypic identification methods for separation of the many genera and species of aerobic actinomycetes have found great difficulties. Recent use of chemotaxonomic analyses and emerging technologies such as molecular analysis of nucleic acids, and more recently proteomics for identification to the genus/species level, has provided a far more robust technique to understand the organisms’ relatedness, distribution, epidemiology, and pathogenicity in humans.

  • Citation: Mochon A, Sussland D, Saubolle M. 2016. Aerobic Actinomycetes of Clinical Significance. Microbiol Spectrum 4(4):DMIH2-0021-2015. doi:10.1128/microbiolspec.DMIH2-0021-2015.

Key Concept Ranking

Gram-Positive Bacilli
0.5958382
Gram-Positive Coccobacilli
0.56024045
Gram-Positive Bacteria
0.54704237
High-Performance Liquid Chromatography
0.4371184
16s rRNA Sequencing
0.41366646
0.5958382

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/content/journal/microbiolspec/10.1128/microbiolspec.DMIH2-0021-2015
2016-07-01
2017-04-27

Abstract:

The group of Gram-positive bacillary organisms broadly known as “aerobic actinomycetes” consists of heterogeneous and taxonomically divergent genera. They are found in a wide variety of natural and man-made environments but are rarely considered a part of the normal human flora, with infections normally originating from exogenous sources. An extensive number of genera have been described, but only a minority of these has been associated with human or veterinary health. The association with human disease is usually of an opportunistic nature, either through accidental means of inoculation or through involvement with immunocompromising conditions in the host. They cause a wide spectrum of diseases in humans, which may differ greatly between the genera and even between species, but which also may have a great amount of overlap. The occurrence of such infections is probably greater than appreciated, since many may go unrecognized. Etiologic prevalence of specific genera and species varies geographically within the United States and worldwide. Traditional phenotypic identification methods for separation of the many genera and species of aerobic actinomycetes have found great difficulties. Recent use of chemotaxonomic analyses and emerging technologies such as molecular analysis of nucleic acids, and more recently proteomics for identification to the genus/species level, has provided a far more robust technique to understand the organisms’ relatedness, distribution, epidemiology, and pathogenicity in humans.

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Figures

Image of FIGURE 1
FIGURE 1

Direct Gram stain of lower respiratory tract secretions showing polymorphonuclear infiltrates with associated filamentous, branching, beaded Gram-positive bacteria of the genus (1000× magnification).

Source: microbiolspec July 2016 vol. 4 no. 4 doi:10.1128/microbiolspec.DMIH2-0021-2015
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Image of FIGURE 2
FIGURE 2

Direct modified acid-fast stain (MAFS) of lower respiratory tract secretions showing filamentous, branching, beaded Gram-positive bacteria of the genus (1000× magnification).

Source: microbiolspec July 2016 vol. 4 no. 4 doi:10.1128/microbiolspec.DMIH2-0021-2015
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Image of FIGURE 3
FIGURE 3

Algorithm for identification of common aerobic actinomycetes recovered from clinical specimens. Prepare and evaluate modified Kinyoun stain and Gram stain, looking for the following features: branching, character of branching (right or acute angle, simple or multiple branching); filamentous (long, short); and acid-fastness (negative, partial, or complete). Evaluate and record growth of colonies on the media: presence or absence of aerial mycelium (use low-power magnification); describe the colony morphology (color: white, beige, orange, etc.; character: dry, smooth, etc.). * and are weakly acid-fast (Kinyoun) positive.

Source: microbiolspec July 2016 vol. 4 no. 4 doi:10.1128/microbiolspec.DMIH2-0021-2015
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Tables

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TABLE 1

Antimicrobial susceptibility profiles for the genus

Source: microbiolspec July 2016 vol. 4 no. 4 doi:10.1128/microbiolspec.DMIH2-0021-2015
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TABLE 2

Species of more commonly associated with human infection

Source: microbiolspec July 2016 vol. 4 no. 4 doi:10.1128/microbiolspec.DMIH2-0021-2015

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