.7% of all samples tested, and no significant differences in sensitivity or specificity were noted between HSCT and non-HSCT patients. IAs, while not as sensitive as direct fecal CBA, produce reasonable predictive values, especially when both antigen and toxin are detected. They also offer significant advantages over CBA in terms of turnaround time and ease of use.

We report 6 cases of bacteremia due to Tsukamurella species, all of which were in immunosuppressed patients with indwelling central venous catheters (CVCs). Fewer than 20 cases of serious illness due to these gram-positive bacilli have been reported in the medical literature; these cases have mostly been ascribed to the species Tsukamurella paurometabola. Tsukamurella species are frequently misidentified as Rhodococcus or Corynebacterium species. We used high-performance liquid chromatography to identify these organisms to the genus level and 16S ribosomal RNA gene sequencing and DNA-DNA dot blots for species identification. Three of our isolates were identified as Tsukamurella pulmonis, 1 was identified as Tsukamurella tyrosinosolvans, and 1 was identified as a unique species. One isolate was not maintained long enough for species identification. All patients were successfully treated with antimicrobial therapy and CVC removal. Infection with this organism should be considered in the immunosuppressed patient with an indwelling CVC and gram-positive bacilli in the blood.

BordeteUla spp. cause respiratory tract diseases in warm-blooded animals. Only BordeteUla bronchiseptica has been reported to cause bacteremia in humans, and this rare infection usually occurs with pneumonia in immunocompromised patients. We describe "Bordetella hinzii" bacteremia in an AIDS patient without a respiratory illness. Combining biochemical phenotyping with fatty acid analysis permitted preliminary identification of this previously undescribed pathogen; identity was confirmed by DNA-DNA hybridization. This report extends the spectrum of human infections caused by the bordetellae.

We have isolated a gram-positive, weakly acid-alcohol-fast, irregular rod-shaped bacterium from cultures of blood from a 5-year-old girl with acute myelogenous leukemia. This isolate was compared with 14 other strains including reference strains of Tsukamurella species by a polyphasic approach based on physiological and biochemical properties, whole-cell short-chain fatty acid and mycolic acid analyses, DNA-DNA hybridization, and sequencing of the 16S rRNA gene. This isolate represents a new taxon within the genus Tsukamurella for which we propose the name Tsukamurella strandjordae sp. nov. Our study also revealed that Tsukamurella paurometabola ATCC 25938 represents a misnamed Tsukamurella inchonensis isolate and confirms that Tsukamurella wratislaviensis belongs to the genus Rhodococcus.Tsukamurellae are members of the mycolic acid-containing aerobic actinomycetes. The genus was created in 1988 to accommodate a group of chemically unique organisms characterized by a series of very long chain (68 to 76 carbons) highly unsaturated (two to six double bonds) mycolic acids, in addition to possessing meso-diaminopimelic acid and arabinogalactan, common to the genus Corynebacterium (6). The type species, Tsukamurella paurometabola, described by Steinhaus as Corynebacterium paurometabolum in 1941, was originally isolated from the mycetomes and ovaries of bed bugs (27). The first human isolate of Tsukamurella was reported in 1971 as Gordona aurantiaca (33). Four additional species were proposed in the 1990s. Tsukamurella wratislaviensis was isolated from soil (10). Strains of Tsukamurella inchonensis, Tsukamurella pulmonis, and Tsukamurella tyrosinosolvens have been isolated only from human specimens, and all were associated with clinical disease (34-36). We have encountered an unusual isolate in multiple cultures of blood from a 5-year-old girl with acute myelogenous leukemia who presented with sepsis. On the basis of physiological and biochemical characteristics, analysis of cell components, DNA-DNA hybridizations, and the 16S rRNA gene sequence, we propose that this strain represents a new taxon within the genus Tsukamurella to which we assign the name Tsukamurella strandjordae sp. nov. Our study compared this isolate to reference and clinical strains of the other Tsukamurella species and found that T. paurometabola ATCC 25938 is a misnamed T. inchonensis isolate. MATERIAL AND METHODSStrains. The study included type strains of all proposed Tsukamurella species. T. paurometabola ATCC 8368 and T. wratislaviensis ATCC 51786 were purchased from the American Type Culture Collection (ATCC). A. F. Yassin generously provided the type strains T. pulmonis ATCC 700081 and T. inchonesis ATCC 700082. Type strain T. tyrosinosolvens DSMZ 44234 was purchased from the Deutsche Sammlung von Mikroorganismen und Zellkulturen GmbH (DSMZ; Braunschweig, Germany). Other purchased reference strains included strains T. paurometabola ATCC 25938 and T. tyrosinosolvens DSMZ 44316. The strain of T. strandjordae, the subject of this study, was is...

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