AhpC is an enzyme that converts various alkyl hydroperoxides to their corresponding alcohols, and can change hydrogen peroxide to water. This enzyme contributes PD0332991 price to microorganism survival in host conditions via the protection of the cells from oxidative stress [42]. During our investigation to

determine the complete genome sequence of a human clinical isolate (PAGU 611) from the blood sample of a cellulitis subject, we revealed that the microorganism holds a Type VI secretion system (T6SS) which is thought to be related to its virulence [43]. T6SS is a kind of complex multi-component secretion machine, often called a “needle” or “molecular syringe”. In many cases, T6SS delivers bacteriolytic isocitrate dehydrogenase inhibitor effectors to target cells, such as other bacteria or eukaryotic hosts, and in some cases is involved in symbiotic interactions with eukaryotic hosts [44] and [45]. In the case of Helicobacter hepaticus, another enterohepatic species that is harbored in mouse intestines, T6SS was reported to play an important role in persistent colonization to promote a balanced relationship with the host via the T6SS directed anti-inflammatory gene expression profiles in intestinal epithelial cells and CD4+ T cells [46]. Another report described an association between VgrG1, a secreted protein of T6SS, and bacterial colitogenic potential [47]. The role of the T6SS in H. cinaedi infection Fossariinae is not clear; however,

there might be a similar virulence function. The PAGU 611 chromosome encodes two known virulence factors, described above, cdt and ahpC genes, and also several putative virulence-related proteins, such as fibronectin- and fibrinogen-binding proteins, neutrophil activation protein, and Campylobacter jejuni invasion antigen B [43]. The type strain of H. cinaedi, another complete genome determined strain [48], has all of the above-mentioned

(putative) virulence factors; thus, these factors might be commonly harbored within the human isolates. Further investigation is needed to clarify the virulence of this microorganism. It is well known that H. cinaedi is a fastidious and slow-growing organism and that detection and cultivation are extremely difficult. In this section, methods of detection, culture, and identification are described, as well as the description of new taxon for the genus Helicobacter. Isolates of H. cinaedi are mainly obtained from blood and, to a lesser extent, fecal samples. In fact, H. cinaedi is in many cases first detected from blood culture using an automatic blood culture system. Nowadays, many hospital laboratories employ an automatic blood culture system, such as the BACTEC or BacT/ALERT systems. Recently, another blood culture system, VersaTREK, has been introduced in Japan. Because H. cinaedi are slow-growing organisms, a relatively prolonged incubation time is generally required.