Affiliation:
1. Department of Pathology, University of Utah School of Medicine, Salt Lake City, Utah
2. ARUP Laboratories, Salt Lake City, Utah
3. Loyola University Medical Center, Maywood, Illinois
Abstract
ABSTRACT
Traditional methods for microbial identification require the recognition of differences in morphology, growth, enzymatic activity, and metabolism to define genera and species. Full and partial 16S rRNA gene sequencing methods have emerged as useful tools for identifying phenotypically aberrant microorganisms. We report on three bacterial blood isolates from three different College of American Pathologists-certified laboratories that were referred to ARUP Laboratories for definitive identification. Because phenotypic identification suggested unusual organisms not typically associated with the submitted clinical diagnosis, consultation with the Medical Director was sought and further testing was performed including partial 16S rRNA gene sequencing. All three patients had endocarditis, and conventional methods identified isolates from patients A, B, and C as a
Facklamia
sp.,
Eubacterium tenue
, and a
Bifidobacterium
sp. 16S rRNA gene sequencing identified the isolates as
Enterococcus faecalis
,
Cardiobacterium valvarum
, and
Streptococcus mutans
, respectively. We conclude that the initial identifications of these three isolates were erroneous, may have misled clinicians, and potentially impacted patient care. 16S rRNA gene sequencing is a more objective identification tool, unaffected by phenotypic variation or technologist bias, and has the potential to reduce laboratory errors.
Publisher
American Society for Microbiology
Cited by
181 articles.
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