Abstract
Rhodococcus equi and Arcanobacterium haemolyticum, formerly classified in the genus Corynebacterium, are members of the loosely defined taxon "coryneform" bacteria. Although they are the etiologic agents of distinct human infections, both organisms are frequently overlooked, which results in missed or delayed diagnoses. R. equi, long known as an important pathogen of immature horses, has become in the past three decades an opportunistic pathogen of severely immunosuppressed humans. Most cases are secondary to HIV infection. When specifically sought in throat swab cultures, A. haemolyticum is found responsible for 0.5% to 2.5% of bacterial pharyngitis, especially among adolescents. These two microorganisms represent a spectrum of disease in humans: from a mild, common illness to a rare life-threatening infection. Each organism elaborates lipid hydrolyzing enzymes (cholesterol oxidase by R. equi and sphingomyelinase D by A. haemolyticum) that are toxic to animals and humans and damaging to mammalian cell membranes. The participation of the cytotoxins in pathogenicity is discussed. Greater awareness of the properties of these two bacteria may promote faster, more accurate diagnoses and better clinical management.
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- Banck G., Nyman M. Tonsillitis and rash associated with Corynebacterium haemolyticum. J Infect Dis. 1986 Dec;154(6):1037–1040. doi: 10.1093/infdis/154.6.1037. [DOI] [PubMed] [Google Scholar]
- Bernheimer A. W., Campbell B. J., Forrester L. J. Comparative toxinology of Loxosceles reclusa and Corynebacterium pseudotuberculosis. Science. 1985 May 3;228(4699):590–591. doi: 10.1126/science.3983643. [DOI] [PubMed] [Google Scholar]
- Carlson P., Renkonen O. V., Kontiainen S. Arcanobacterium haemolyticum and streptococcal pharyngitis. Scand J Infect Dis. 1994;26(3):283–287. doi: 10.3109/00365549409011796. [DOI] [PubMed] [Google Scholar]
- Chalupa P., Jezek P., Juránková J., Sevcíková A. Isolation of Arcanobacterium haemolyticum from throat culture samples in the Czech Republic. Infection. 1995 Nov-Dec;23(6):397–397. doi: 10.1007/BF01713582. [DOI] [PubMed] [Google Scholar]
- Collins M. D., Jones D., Schofield G. M. Reclassification of 'Corynebacterium haemolyticum' (MacLean, Liebow & Rosenberg) in the genus Arcanobacterium gen.nov. as Arcanobacterium haemolyticum nom.rev., comb.nov. J Gen Microbiol. 1982 Jun;128(6):1279–1281. doi: 10.1099/00221287-128-6-1279. [DOI] [PubMed] [Google Scholar]
- Coyle M. B., Lipsky B. A. Coryneform bacteria in infectious diseases: clinical and laboratory aspects. Clin Microbiol Rev. 1990 Jul;3(3):227–246. doi: 10.1128/cmr.3.3.227. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cuevas W. A., Songer J. G. Arcanobacterium haemolyticum phospholipase D is genetically and functionally similar to Corynebacterium pseudotuberculosis phospholipase D. Infect Immun. 1993 Oct;61(10):4310–4316. doi: 10.1128/iai.61.10.4310-4316.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Delia S., Mastroianni C. M., Lichtner M., Mengoni F., Moretti S., Vullo V. Defective production of interferon-gamma and tumour necrosis factor-alpha by AIDS mononuclear cells after in vitro exposure to Rhodococcus equi. Mediators Inflamm. 1995;4(4):306–309. doi: 10.1155/S0962935195000494. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Doig C., Gill M. J., Church D. L. Rhodococcus equi--an easily missed opportunistic pathogen. Scand J Infect Dis. 1991;23(1):1–6. doi: 10.3109/00365549109023367. [DOI] [PubMed] [Google Scholar]
- Donisi A., Suardi M. G., Casari S., Longo M., Cadeo G. P., Carosi G. Rhodococcus equi infection in HIV-infected patients. AIDS. 1996 Apr;10(4):359–362. doi: 10.1097/00002030-199604000-00002. [DOI] [PubMed] [Google Scholar]
- FRASER G. THE EFFECT ON ANIMAL ERYTHROCYTES OF COMBINATIONS OF DIFFUSIBLE SUBSTANCES PRODUCED BY BACTERIA. J Pathol Bacteriol. 1964 Jul;88:43–53. doi: 10.1002/path.1700880105. [DOI] [PubMed] [Google Scholar]
- Gaston D. A., Zurowski S. M. Arcanobacterium haemolyticum pharyngitis and exanthem. Three case reports and literature review. Arch Dermatol. 1996 Jan;132(1):61–64. [PubMed] [Google Scholar]
- Gotoh K., Mitsuyama M., Imaizumi S., Kawamura I., Yano I. Mycolic acid-containing glycolipid as a possible virulence factor of Rhodococcus equi for mice. Microbiol Immunol. 1991;35(3):175–185. doi: 10.1111/j.1348-0421.1991.tb01546.x. [DOI] [PubMed] [Google Scholar]
- Harvey R. L., Sunstrum J. C. Rhodococcus equi infection in patients with and without human immunodeficiency virus infection. Rev Infect Dis. 1991 Jan-Feb;13(1):139–145. doi: 10.1093/clinids/13.1.139. [DOI] [PubMed] [Google Scholar]
- Hietala S. K., Ardans A. A. Interaction of Rhodococcus equi with phagocytic cells from R. equi-exposed and non-exposed foals. Vet Microbiol. 1987 Aug;14(3):307–320. doi: 10.1016/0378-1135(87)90118-0. [DOI] [PubMed] [Google Scholar]
- Hondalus M. K., Mosser D. M. Survival and replication of Rhodococcus equi in macrophages. Infect Immun. 1994 Oct;62(10):4167–4175. doi: 10.1128/iai.62.10.4167-4175.1994. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kanaly S. T., Hines S. A., Palmer G. H. Cytokine modulation alters pulmonary clearance of Rhodococcus equi and development of granulomatous pneumonia. Infect Immun. 1995 Aug;63(8):3037–3041. doi: 10.1128/iai.63.8.3037-3041.1995. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Linder R., Bernheimer A. W. Enzymatic oxidation of membrane cholesterol in relation to lysis of sheep erythrocytes by corynebacterial enzymes. Arch Biochem Biophys. 1982 Feb;213(2):395–404. doi: 10.1016/0003-9861(82)90565-3. [DOI] [PubMed] [Google Scholar]
- Mackenzie A., Fuite L. A., Chan F. T., King J., Allen U., MacDonald N., Diaz-Mitoma F. Incidence and pathogenicity of Arcanobacterium haemolyticum during a 2-year study in Ottawa. Clin Infect Dis. 1995 Jul;21(1):177–181. doi: 10.1093/clinids/21.1.177. [DOI] [PubMed] [Google Scholar]
- Mastroianni C. M., Lichtner M., Vullo V., Delia S. Humoral immune response to Rhodococcus equi in AIDS patients with R. equi pneumonia. J Infect Dis. 1994 May;169(5):1179–1180. doi: 10.1093/infdis/169.5.1179. [DOI] [PubMed] [Google Scholar]
- McNamara P. J., Bradley G. A., Songer J. G. Targeted mutagenesis of the phospholipase D gene results in decreased virulence of Corynebacterium pseudotuberculosis. Mol Microbiol. 1994 Jun;12(6):921–930. doi: 10.1111/j.1365-2958.1994.tb01080.x. [DOI] [PubMed] [Google Scholar]
- McNeil M. M., Brown J. M. Distribution and antimicrobial susceptibility of Rhodococcus equi from clinical specimens. Eur J Epidemiol. 1992 May;8(3):437–443. doi: 10.1007/BF00158580. [DOI] [PubMed] [Google Scholar]
- McNeil M. M., Brown J. M. The medically important aerobic actinomycetes: epidemiology and microbiology. Clin Microbiol Rev. 1994 Jul;7(3):357–417. doi: 10.1128/cmr.7.3.357. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Nordmann P., Nicolas M. H., Gutmann L. Penicillin-binding proteins of Rhodococcus equi: potential role in resistance to imipenem. Antimicrob Agents Chemother. 1993 Jul;37(7):1406–1409. doi: 10.1128/aac.37.7.1406. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Nordmann P., Zinzendorf N., Keller M., Lair I., Ronco E., Guenounou M. Interaction of virulent and non-virulent Rhodococcus equi human isolates with phagocytes, fibroblast- and epithelial-derived cells. FEMS Immunol Med Microbiol. 1994 Sep;9(3):199–205. doi: 10.1111/j.1574-695X.1994.tb00494.x. [DOI] [PubMed] [Google Scholar]
- Prescott J. F. Rhodococcus equi: an animal and human pathogen. Clin Microbiol Rev. 1991 Jan;4(1):20–34. doi: 10.1128/cmr.4.1.20. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Scott M. A., Graham B. S., Verrall R., Dixon R., Schaffner W., Tham K. T. Rhodococcus equi--an increasingly recognized opportunistic pathogen. Report of 12 cases and review of 65 cases in the literature. Am J Clin Pathol. 1995 May;103(5):649–655. doi: 10.1093/ajcp/103.5.649. [DOI] [PubMed] [Google Scholar]
- Soucek A., Michalec C., Soucková A. Identification and characterization of a new enzyme of the group "phospholipase D" isolated from Corynebacterium ovis. Biochim Biophys Acta. 1971 Jan 13;227(1):116–128. doi: 10.1016/0005-2744(71)90173-2. [DOI] [PubMed] [Google Scholar]
- Sutor G. C., Fibich C., Kirscher P., Kuske M., Schmidt R. E., Schedel I., Deicher H. Poststenotic cavitating pneumonia due to Rhodococcus equi in HIV infection. AIDS. 1996 Mar;10(3):339–340. doi: 10.1097/00002030-199603000-00015. [DOI] [PubMed] [Google Scholar]
- Takai S., Madarame H., Matsumoto C., Inoue M., Sasaki Y., Hasegawa Y., Tsubaki S., Nakane A. Pathogenesis of Rhodococcus equi infection in mice: roles of virulence plasmids and granulomagenic activity of bacteria. FEMS Immunol Med Microbiol. 1995 Jun;11(3):181–190. doi: 10.1111/j.1574-695X.1995.tb00115.x. [DOI] [PubMed] [Google Scholar]
- Takai S., Sasaki Y., Ikeda T., Uchida Y., Tsubaki S., Sekizaki T. Virulence of Rhodococcus equi isolates from patients with and without AIDS. J Clin Microbiol. 1994 Feb;32(2):457–460. doi: 10.1128/jcm.32.2.457-460.1994. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Tkachuk-Saad O., Prescott J. Rhodococcus equi plasmids: isolation and partial characterization. J Clin Microbiol. 1991 Dec;29(12):2696–2700. doi: 10.1128/jcm.29.12.2696-2700.1991. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Verville T. D., Huycke M. M., Greenfield R. A., Fine D. P., Kuhls T. L., Slater L. N. Rhodococcus equi infections of humans. 12 cases and a review of the literature. Medicine (Baltimore) 1994 May;73(3):119–132. doi: 10.1097/00005792-199405000-00001. [DOI] [PubMed] [Google Scholar]
- Wickremesinghe R. S. Corynebacterium haemolyticum infections in Sri Lanka. J Hyg (Lond) 1981 Oct;87(2):271–276. doi: 10.1017/s0022172400069485. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Zink M. C., Yager J. A., Prescott J. F., Fernando M. A. Electron microscopic investigation of intracellular events after ingestion of Rhodococcus equi by foal alveolar macrophages. Vet Microbiol. 1987 Aug;14(3):295–305. doi: 10.1016/0378-1135(87)90117-9. [DOI] [PubMed] [Google Scholar]