Misidentification of a mucoid strain of Salmonella enterica serotype choleraesuis as Hafnia alvei by the Vitek GNI+ card system

J Clin Microbiol. 2006 Dec;44(12):4605-8. doi: 10.1128/JCM.01488-06. Epub 2006 Oct 18.

Abstract

Nontyphoidal salmonellae are among the most common causes of bacterial gastroenteritis worldwide. They are also notable causes of extraintestinal infections, including bacteremia and vascular infections. Salmonella enterica serotype Choleraesuis is typically associated with invasive infections. We report a patient who had an infected intra-abdominal aortic aneurysm due to an unusually mucoid strain of Salmonella enterica serotype Choleraesuis. The isolate was erroneously identified as Hafnia alvei by the Vitek GNI+ card system. A blood culture isolate taken from the same patient 9 months earlier was also identified as H. alvei by the Vitek GNI+ card system. Despite an apparent cure with intravenous amoxicillin-clavulanic acid at that time, the Salmonella infection had not been cleared and manifested as a ruptured infected abdominal aortic aneurysm. Repeated passage of the strain yielded nonmucoid colonies, which were correctly identified by the API and PHOENIX systems. The isolates from the aneurysm and the former bacteremic episode were found to be identical using pulsed field gel electrophoresis. The fallibility of automated bacterial identification systems is highlighted. Such errors are especially important for isolates in which in vitro antibiotic susceptibility testing does not correlate with the clinical success of treatment, as illustrated by Salmonella infections.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Amoxicillin-Potassium Clavulanate Combination / therapeutic use
  • Aortic Aneurysm, Abdominal / microbiology*
  • Bacteriological Techniques*
  • Blood / microbiology
  • DNA Fingerprinting
  • DNA, Bacterial / genetics
  • Diagnostic Errors*
  • Electrophoresis, Gel, Pulsed-Field
  • Enterobacteriaceae Infections / diagnosis*
  • Enterobacteriaceae Infections / drug therapy
  • Enterobacteriaceae Infections / microbiology
  • Hafnia alvei / classification
  • Hafnia alvei / isolation & purification*
  • Humans
  • Male
  • Salmonella Infections / diagnosis*
  • Salmonella Infections / drug therapy
  • Salmonella Infections / microbiology
  • Salmonella enterica / classification
  • Salmonella enterica / isolation & purification*
  • Salmonella enterica / physiology

Substances

  • DNA, Bacterial
  • Amoxicillin-Potassium Clavulanate Combination