Assessment of Partial Sequencing of the 65-Kilodalton Heat Shock Protein Gene ( <i>hsp65</i> ) for Routine Identification of <i>Mycobacterium</i> Species Isolated from Clinical Sources

  • Alan McNabb
    Laboratory Services, British Columbia Centre for Disease Control
  • Diane Eisler
    Laboratory Services, British Columbia Centre for Disease Control
  • Kathy Adie
    Laboratory Services, British Columbia Centre for Disease Control
  • Marie Amos
    Laboratory Services, British Columbia Centre for Disease Control
  • Mabel Rodrigues
    Laboratory Services, British Columbia Centre for Disease Control
  • Gwen Stephens
    Laboratory Services, British Columbia Centre for Disease Control
  • William A. Black
    Laboratory Services, British Columbia Centre for Disease Control
  • Judith Isaac-Renton
    Laboratory Services, British Columbia Centre for Disease Control

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<jats:title>ABSTRACT</jats:title> <jats:p> We assessed the ability of an in-house database, consisting of 111 <jats:italic>hsp65</jats:italic> sequences from putative and valid <jats:italic>Mycobacterium</jats:italic> species or described groups, to identify 689 mycobacterial clinical isolates from 35 species or groups. A preliminary assessment indicated that <jats:italic>hsp65</jats:italic> sequencing confirmed the identification of 79.4% of the isolates from the 32 species examined, including all <jats:italic>Mycobacterium tuberculosis</jats:italic> complex isolates, all isolates from 13 other species, and 95.6% of all <jats:italic>M. avium</jats:italic> - <jats:italic>M. intracellulare</jats:italic> complex isolates. Identification discrepancies were most frequently encountered with isolates submitted as <jats:italic>M. chelonae</jats:italic> , <jats:italic>M. fortuitum</jats:italic> , <jats:italic>M. gordonae</jats:italic> , <jats:italic>M. scrofulaceum</jats:italic> , and <jats:italic>M. terrae</jats:italic> . Reexamination of isolates with discrepant identifications confirmed that <jats:italic>hsp65</jats:italic> identifications were correct in a further 40 isolates. This brought the overall agreement between <jats:italic>hsp65</jats:italic> sequencing and the other identification methods to 85.2%. The remaining 102 isolates had sequence matches below our acceptance criterion, had nondifferential sequence matches between two or more species, were identified by 16S rRNA sequencing as a putative taxonomic group not contained in our database, or were identified by <jats:italic>hsp65</jats:italic> and 16S rRNA gene sequencing as a species not in our biochemical test database or had conflicting identifications. Therefore, to incorporate the unconfirmed isolates it was necessary to create 29 additional entries in our <jats:italic>hsp65</jats:italic> identification database: 18 associated with valid species, 7 indicating unique sequences not associated with valid or putative species or groups, and 4 associated with unique, but currently described taxonomic groups. Confidence in the <jats:italic>hsp65</jats:italic> sequence identification of a clinical isolate is best when sequence matches of 100% occur, but our data indicate that correct identifications can be confidently made when unambiguous matches exceeding 97% occur, but are dependent on the completeness of the database. Our study indicates that for <jats:italic>hsp65</jats:italic> sequencing to be an effective means for identifying mycobacteria a comprehensive database must be constructed. <jats:italic>hsp65</jats:italic> sequencing has the advantage of being more rapid and less expensive than biochemical test panels, uses a single set of reagents to identify both rapid- and slow-growing mycobacteria, and can provide a more definitive identification. </jats:p>

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