Classification of coryneform bacteria associated with human urinary tract infection (group D2) as Corynebacterium urealyticum sp. nov.
ABSTRACT Urealytic strains of coryneform bacteria that are designated Corynebacterium group D2 and are isolated from human urine are a cause of urinary tract infections. Cell wall and lipid analyses confirmed that these organisms are members of the genus Corynebacterium but can be separated from other species in the genus on the basis of DNA base composition and DNA-DNA hybridization values. Biochemically, strains in this taxon can be distinguished from other Corynebacterium spp. by their failure to produce acid from carbohydrates, by their failure to reduce nitrates, and by their ability to hydrolyze urea. We regard these bacteria as a new species of the genus Corynebacterium and propose the name Corynebacterium urealyticum. The type strain is strain NCTC 12011 (= ATCC 43042).
- SourceAvailable from: Tsuneaki Kenzaka[Show abstract] [Hide abstract]
ABSTRACT: A 93-year-old woman with neurogenic bladder was admitted to our hospital because of impaired consciousness. Her urine culture revealed urease-test-positive Corynebacterium urealyticum. She was diagnosed with hyperammonemia due to an obstructive urinary tract infection that was caused by urease-producing bacteria. The patient showed rapid improvement of impaired consciousness and hyperammonemia after urine analysis. It is necessary to consider obstructive urinary tract infection as a differential diagnosis of hyperammonemia, which commonly occurs in urinary tract infections owing to the presence of urease-producing bacteria. Relief from obstruction is the most important treatment for hyperammonemia caused by this mechanism.Central European Journal of Medicine · 0.26 Impact Factor
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ABSTRACT: Urinary stones are prevalent and Corynebacterium urealyticum, a urease-positive bacteria, is a frequent urinary tract pathogen. However, the association of this organism with urinary stones is not sufficiently studied in Iran. This study was carried out to determine the prevalence of C. urealyticum in patients with urinary stones referred to the urology sections of Tehran University of Medical Sciences. This study was performed using case-control method. A total of 150 urine samples from patients with urinary stones and the same number from the control group without urinary stones or infection were collected. The two sets of samples were cultured and biochemically identified. The pH of urine samples also measured with pH paper. C. urealyticum was detected in 11.34% of cases which was significantly higher than that in control group (P < 0.01). The frequency of alkaline urine was four times more in the patients than those in control group which was statistically significant (P< 0.01). According to the results, C. urealyticum, which is known to cause alkaline urine, might enhance formation of stones. Further studies using cohort or experimental methods are recommended. Acta Medica Iranica, 42(4): 285-288; 2004
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ABSTRACT: Background Urinary tract infections caused by Corynebacterium urealyticum are uncommon in veterinary medicine. Encrusted cystitis, encrusted pyelitis and uroliths have been described as complications in humans, but only encrusted cystitis and cystoliths have been reported in dogs so far. Because C. urealyticum is usually resistant to all standard antibacterial drugs, antimicrobial treatment and elimination of this microorganism are challenging.Case reportAn 11-month-old female spayed mixed-breed dog was evaluated because of a C. urealyticum urinary tract infection, mineralisation within both renal pelvises and failure of antimicrobial treatment. Physical examination, haematology and biochemistry were unremarkable. Radiographic and ultrasonographic examinations confirmed bilateral nephrolithiasis. Voided uroliths were composed of 100% carbonate apatite. Urinalysis was indicative of bacterial infection. Aerobic culture of the urine and 16S rRNA sequencing identified significant growth of C. urealyticum and susceptibility testing revealed sensitivity to only vancomycin and linezolid.Conclusion Treatment with the oxazolidinone antibacterial, linezolid, in combination with a urine-acidifying diet resulted in elimination of this multiresistant microorganism and complete resolution of nephrolithiasis.Australian Veterinary Journal 05/2014; 92(5). · 0.92 Impact Factor
JOURNAL OF SYSTEMATIC BACTERIOLOGY, Jan. 1992, p. 178-181
Copyright 0 1992, International Union of Microbiological Societies
Vol. 42, No. 1
Classification of Coryneform Bacteria Associated with
Human Urinary Tract Infection (Group D2) as
Corynebacterium urealyticum sp. nov.
DAVID PITCHER,'* ALICIA SOT0,2 FRANCISCO SORIAN0,2 AND PEDRO VALERO-GUILLEN3
National Collection of Type Cultures, Central Public Health Laboratory, 61 Colindale Avenue, London NW9 5HT, United
Kingdom, ' and Department of Clinical Microbiology, Fundaci6.n Jimknez Diaz, 28040 Madrid,2 and Department of
Genetics and Microbiology, University of Murcia, 30100 Mur~ia,~ Spain
Urealytic strains of coryneform bacteria that are designated Corynebacterium group D2 and are isolated from
human urine are a cause of urinary tract infections. Cell wall and lipid analyses confirmed that these organisms
are members of the genus Corynebacterium but can be separated from other species in the genus on the basis
of DNA base composition and DNA-DNA hybridization values. Biochemically, strains in this taxon can be
distinguished from other Corynebacterium spp. by their failure to produce acid from carbohydrates, by their
failure to reduce nitrates, and by their ability to hydrolyze urea. We regard these bacteria as a new species of
the genus Corynebacterium and propose the name Corynebacterium urealyticum. The type strain is strain NCTC
12011 (= ATCC 43042).
The identification system for medically important coryne-
form bacteria devised by the Centers for Disease Control,
Atlanta, Ga., designates one group of urealytic, nonfermen-
tative bacteria as Corynebacterium group D2 and suggests
that these organisms may be nitrate-negative variants of
Corynebacterium pseudodiphtheriticum (9). This group has
tentatively been referred to as Corynebacterium urealyticum
(23), but this name has not been validly published previ-
ously. Strains identified as C. urealyticum have been asso-
ciated with cases of encrusted cystitis and other urinary tract
infections in hospital patients (20), where they have been
highly resistant to antibiotics (22). The natural habitat of
these strains is human skin (24), but they readily colonize
urinary tracts (22); strains have also been isolated from
blood (14, 17) and wounds (28). C. urealyticum is relatively
inactive in conventional tests apart from its ability to hydro-
lyze urea rapidly. Colonially and microscopically, this spe-
cies resembles Corynebacterium jeikeium, with which it
shares a common habitat and resistance to antibiotics (4).
However, the latter species is consistently nonurealytic and
acidifies glucose and maltose. Evidence from lipid analysis
(7, 21), from pyrolysis-mass spectrometry (8), and from
rRNA gene restriction fragment polymorphism studies (26)
indicates that there are clear differences between the two
species. Chemotaxonomic evidence that group D2 is related
to the genus Corynebacterium has been provided by Her-
rera-Alcarez et al. ("), who determined that the cell wall type
is chemotype IV, with mycolic acids having chain lengths of
26 to 36 carbon atoms, and that the isoprenoid quinone
MK-9(H2) is present.
In this study, we estimated the DNA base compositions of
Corynebacterium strains and levels of DNA-DNA related-
ness between strains of C. urealyticum and other Coryne-
bacterium species; we concluded that this taxon merits
status as a new species in the genus Corynebacterium.
* Corresponding author.
MATERIALS AND METHODS
Bacterial strains and culture. The strains used in this study
are listed in Table 1. Strains identified as C. urealyticum
were isolated in Madrid, Spain, from the urine (strains
A516/89, A524190, A532/90, A548/90, and NCTC 12011T [T
= type strain]) and skin (strain A545/90) of hospital patients.
Cultures were maintained in the freeze-dried state, plated
onto 5% horse blood nutrient agar, and incubated at 37°C for
48 h. To prepare DNA, strains were subcultured in 100 ml of
brain heart infusion broth (Oxoid, London, United King-
dom) supplemented with 0.4% yeast extract and 0.2% (vol/
vol) Tween 80 and incubated aerobically with shaking at
37°C for 48 h.
Preparation of DNA. Cells (0.5 to 1.0 g) were pelleted by
centrifugation, washed once with TE buffer (10 mM Tris-
HC1, 1 mM EDTA; pH KO), and incubated in 0.5 ml of a
lysozyme solution (50 mg . ml-' in TE buffer) at 37°C for 1
h. DNA was extracted as described previously (19), except
that five times the stated volumes of reagents were used. The
DNA was further purified by incubating it in RNase-SET (20
pg of RNase A per ml in 150 mM NaCl-15 mM EDTA-60
mM Tris-HC1 [pH 8.31) at 37°C for 1 h. Proteinase K was
added to a final concentration of 50 pg - ml-', and incuba-
tion was continued for 1 h. The solution was mixed with an
equal volume of TE buffer-saturated phenol-chloroform (1: 1,
vol/vol) and centrifuged at 20,000 x g for 30 min; this was
followed by extractions with equal volumes of chloroform
until all of the visible precipitate was removed.
Purified DNA was precipitated with 1 volume of 2-pro-
panol, washed three times with 70% ethanol, and dried under
a vacuum for 10 min.
DNA base composition. Purified DNA samples were dis-
solved in 0 . 1 ~ SSC (Ix
SSC is 0.15 M NaCl plus 0.015 M
trisodium citrate, pH 7.0), and the A280, A260, and A230 were
determined to estimate concentration and purity. The con-
centration was adjusted to approximately 50 pg - ml-' with
0.1 x SSC, and the guanine-plus-cytosine (G + C) content
was determined by using the thermal denaturation method
(16). A DNA sample from Escherichia coli NCTC 9001 was
used as a standard (52 mol% G+C).
DNA-DNA hybridizations. Nitrocellulose-bound DNA was
VOL. 42, 1992
COR YNEBACTERIUM UREAL YTICUM SP. NOV. 179
TABLE 1. DNA base compositions and levels of DNA relatedness between strains of C. urealyticum
and other Corynebacterium species
Relative % of binding with 3H-labeled DNA from:
Source of unlabeled DNA
“ Data from this study and reference 10.
NCTC 12011T (= ATCC 43042T)
NCTC 3224T (= ATCC 7715T)
NCTC 11863T (= ATCC 29593T)
NCTC 11397T (= ATCC 27010T)
NCIMB 8707T (= ATCC 10340T)
NCTC 11913T (= ATCC 43734T)
NCTC 10254T (= ATCC 14266T)
NCTC 1028gT (= ATCC 2334gT)
NCTC 11862T (= ATCC 29592T)
NCTC 11136T (= ATCC 10700T)
NCTC 3450T (= ATCC 19410T)
NCTC 744gT (= ATCC 19412T)
NCTC 764T (= ATCC 6940T)
NCIMB 9455T (= ATCC 15753T)
NCTC 11861T (= ATCC 373T)
NCTC 10807 (= ATCC 27061)
prepared, and the direct membrane hybridization procedure
was performed as described by Johnson (11). Radiolabeled
DNA was prepared by random primer extension, using a kit
(Boehringer Mannheim Ltd., Lewes, United Kingdom) that
incorporated deoxy [l’ ,2’,5-3H]CTP (Amersham Interna-
tional PLC, Aylesbury, United Kingdom). According to the
manufacturer’s instructions, 25 ng of DNA was labeled for
every 10 hybridization reactions. Labeled DNA was purified
on a Sephadex G-50 spun column (15) and sonicated for 2
min, and volumes containing 20,000 cpm were added to
each membrane filter (diameter, 6 mm). Hybridization was
carried out in 5~ SSC-50% formamide at the optimum
reassociation temperature (45°C) in a shaking water bath for
20 h. Filters were washed three times in 2x SSC at the
stringent temperature (84°C) with agitation. The filters were
placed in scintillation vials containing 2 ml of Ready Pro-
tein+ scintillation cocktail (Beckman Instruments Ltd.,
High Wycombe, United Kingdom) and dissolved overnight,
and radioactivity was measured with a Tri-Carb 4000 liquid
scintillation counter (United Technologies, Packard, Pang-
bourne, United Kingdom), DNA from Alcaligenes xylosox-
idans subsp. denitri$cans NCTC 10807 was used as a
nonhomologous control (G+C content, 69 mol%) (13).
RESULTS AND DISCUSSION
The DNA base compositions of the six strains of C.
urealyticum which we used ranged from 61 to 62 mol%
G+C. A comparison with the type strains of 15 Coryne-
bacterium species (Table 1) showed that Corynebacterium
jlavescens NCIMB 8707, C. jeikeium NCTC 11913, Coryne-
bacterium minutissimum NCTC 10288, Corynebacterium
pilosum NCTC 11862, Corynebacterium renale NCTC 7448,
Corynebacterium striatum NCTC 764, and Corynebacterium
variabilis NCIMB 9455 all had DNA base composition
values within 5% of this range, which is consistent with the
range for strains within a species (3, 12). However, the
results of DNA pairing experiments (Table 1) showed that
none of the type strains of the Corynebacterium species
tested, including the type species, Corynebacterium diphthe-
riae, exhibited close DNA relatedness with C. urealyticum.
The levels of interstrain homology among the six strains of
this species (>60%) are consistent with the criterion for a
homogeneous species (12), and the particularly low values
obtained in the comparisons of C. urealyticum DNA with
DNAs of other species (<23%) suggest that the proposed
species has no close relatives among the other species which
we examined. In addition, the low DNA base composition of
C. urealyticum, together with the presence of mycolic acids
(c26 to c 3 6 ) that yield low-molecular-weight pyrolysis prod-
ucts (C, to C,, methyl esters), excludes this organism from
the genera Rhodococcus and Gordona.
Our data confirmed previous findings which indicated that
the taxon designated Corynebacterium group D2 by the
Centers for Disease Control (9) and referred to as C.
urealyticum (23) could represent a single species on the basis
of evidence from phenotypic tests (including API profiles) (5,
27), pyrolysis-mass spectrometry (8), fatty acid, isoprenoid
quinone, and phospholipid analyses (7, 21), and rRNA gene
profiling (26). The presence of a meso-diaminopimelic acid-
based peptidoglycan, the presence of a cell wall arabinoga-
lactan, and the presence of short-chain mycolic acids are
characteristics which C. urealyticum shares with the type
species of the genus Corynebacterium, C. diphtheriae, indi-
cating that the new species should be placed in this genus (2).
C. urealyticum contains tuberculostearic acid (10-methyl-
octadecanoic acid) (21), a lipid that is associated with the
genera Rhodococcus, Gordona , Nocardia, Mycobacterium,
and Tsukamurella (“aurantiaca” taxon) (6). However, the
presence of tuberculostearic acid has been detected in other
180 PITCHER ET AL. INT. J. SYST. BACTERIOL.
TABLE 2. Some characteristics that are useful for differentiating C. urealyticurn from other commensal
Corynebacterium species found on human skin
Aerobic acid production froma:
N D ~
MK-8(HJ + MK-9(H2)
a Data from reference 9.
Data from reference 3.
+, positive; -, negative; v, variable.
ND, not determined.
Corynebacterium species, notably Corynebacterium bovis
(6) and C. variabilis (1). Although the presence of tubercu-
lostearic acid in C. minutissimum has been reported by
Collins (l), this compound was not detected by Herrera-
Alcarez et al. (7). The latter authors also found that this fatty
acid is present in Corynebacterium cystitidis and C. pseudo-
diphtheriticum in small amounts. Another lipid which has
been suggested as a taxonomic marker is phosphatidyletha-
nolamine. This compound was found by Minnikin et al. (18)
to be absent in the genus Corynebacterium but present in the
genera Rhodococcus, Gordona, Nocardia, and Mycobacte-
rium, although sometimes it was present in trace amounts.
However, Herrera-Alcarez et al. (7) have reported the
presence of phosphatidylethanolamine in C. bovis, C. cysti-
tidis, Corynebacterium ammoniagenes, and C. pseudodiph-
theriticum. These findings suggest that the presence of
tuberculostearic acid and the presence of phosphatidyletha-
nolamine are unreliable as taxonomic markers and may
depend on culture conditions.
The most significant phenotypic characteristic which C.
urealyticum shares with some other Corynebacterium spe-
cies is the possession of a potent urease activity. This
property is considered to be important in the ability of the
organism to infect human urinary tracts and to induce the
formation of struvite (ammonium magnesium phosphate)
stones (22, 23), a property that so far has not been reported
for other Corynebacteriurn species. Other urealytic species
(C. renale, C. cystitidis, and C. pilosum) which may be
urinary tract pathogens in animals differ from C. urealyticum
in their ability to produce acid from sugars. C. pseudodiph-
theriticum, a ureallytic, nonfermentative commensal of hu-
man skin, differs from C. urealyticum in being able to reduce
nitrate. Most C. urealyticum isolates are resistant to antibi-
otics, but a few (4%)
harbor plasmids (25); strains of this
species appear to colonize the skin of hospital patients and
are similar in this respect to isolates of C. jeikeium, which
they resemble morphologically and colonially. In addition,
the growth of both species is considerably enhanced by
including Tween 80 in the media, and these properties may
make the two taxa difficult to distinguish on initial isolation.
However, C. jeikeium is consistently nonurealytic and pro-
duces acid from glucose, and on this basis an identification
can be made. Table 2 lists some of the characteristics that
distinguish C. urealyticum from other commensal Coryne-
bacterium species that are commonly encountered on human
We believe that there is sufficient evidence to justify the
creation of a new species in the genus Corynebacterium to
accommodate strains that were previously designated group
D2 strains. The name Corynebacterium urealyticum is pro-
posed for this taxon.
Description of Corynebacterium urealyticum sp. nov. Cory-
nebacterium urealyticum (u.re.a.ly’ti.cum. M. L. fem. n.
urea, urea; Gr. adj. lyticus, dissolving; M.L. neut. adj.
urealyticum, urea dissolving). Gram-positive cells that are
not acid fast and are nonsporing and after prolonged culture
may be coccoid. Cells (diameter, 0.5 to 1 pm) are arranged in
palisades and V shapes with no tendency to branch. The
bacteria grow on blood agar as pinpoint colonies after 48 h of
incubation at 25,37, and 42°C. Colonies are whitish, opaque,
smooth, convex, and nonhemolytic. Does not grow on blood
agar incubated anaerobically for 48 h or on MacConkey agar.
Nonmotile, catalase positive, and oxidase negative. Acid is
not produced from glucose, sucrose, maltose, mannitol,
xylose, ribose, L-arabinose, sorbitol, lactose, trehalose, in-
ulin, raffinose, starch, and glycogen. Does not hydrolyze
gelatin or esculin. Nitrate is not reduced. Does not degrade
DNA. Possesses strong urease activity. Hydrolyzes Tween
80. Growth is stimulated by Tween 80. A few strains
hydrolyze hippurate or give a positive Voges-Proskauer
reaction. The peptidoglycan contains meso-diaminopimelic
acid. The cell wall contains arabinose and galactose. The
saturated and nonsaturated fatty acids (CI4 to CIS) consist of
tetradecanoic, hexadecanoic, hexadecenoic, octadecanoic,
octadecenoic, octadecadienoic, and 10-methyloctadecanoic
(tuberculostearic) acids. Mycolic acids c 2 6 to c 3 6 are
present. The major menaquinone is MK-9(H2). Contains
diphosphatidylglycerol, phosphatidylglycerol, phosphatidyl-
ethanolamine, phosphatidylinositol, and phosphatidylinosi-
The DNA base composition is 61 to 62 mol% G+C.
Source: human urine, skin, and blood.
The type strain is strain NCTC 12011 (= ATCC 43042),
which has a G+C content of 62 mol% (as determined by the
thermal denaturation method).
A.S. was supported by funds from the Conchita Rabago de
JimCnez Diaz Foundation and the British Council.
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