Corynebacterium striatum is a nosocomial opportunistic pathogen increasingly associated with a wide range of human infections and is often resistant to several antibiotics. We investigated the susceptibility of 63 C. All strains were susceptible to vancomycin, linezolid, and daptomycin. High rates of resistance to penicillin Fifty-nine Twenty-nine resistance profiles were distinguished among the 59 resistant C.
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A year-old woman visited our emergency department because of exertional dyspnea due to severe left ventricular functional failure. It progressed to disseminated intravascular coagulation and disturbance of consciousness on day 67 of admission.
Gram-positive bacilli were detected from two different blood culture samples on day 67 of admission. The bacterium was detected from the removed central venous catheter tip too, and the patient was diagnosed with catheter-related bloodstream infection by C.
However, treatment was not effective, and the patient died on day 73 of admission. The Corynebacteria are a group of aerobic, Gram-positive, catalase-positive, nonsporulating, generally nonmotile rods [ 1 ]. The Corynebacteria are divided into two groups: Corynebacterium diphtheriae and nondiphtherial Corynebacteria , collectively referred to as diphtheroids. When isolated from clinical specimens, nondiphtherial Corynebacteria , such as Corynebacterium striatum , Corynebacterium amycolatum , Corynebacterium minutissimum , Corynebacterium xerosis , and Corynebacterium freneyi , were originally thought to be contaminants [ 2 ], as these strains are commonly considered as part of the normal flora of human skin and mucous membranes.
However, in recent years, they have been reported as emerging opportunistic pathogens in immunocompromised patients with end-stage cancer, hematologic malignancy, and critical condition [ 2 ]. There are several reports of C. In the present case, we report a catheter-related bloodstream infection caused by C.
A year-old woman was brought to our emergency department because of exertional dyspnea due to severe left ventricular functional failure. Her vital signs were unstable; hence, she was immediately admitted to the intensive care unit ICU. She had two comorbidities: one was diastole cardiomyopathy, and the other was complete atrioventricular block c-AVB , already treated with a pacemaker implantation PM.
Although an implantable cardioverter defibrillator CRT-D, Cardiac Resynchronization Therapy-Defibrillation , with biventricular pacing function, was replaced with PM for severe left ventricular functional decline, on day 12 of admission, an intra-aortic balloon pump IABP was also inserted because of multiple organ failure. The IABP was removed on day 16 of admission. Thereafter, there was no obvious fever, signs of infection, so no antibiotics were administered.
However, intermittent hemodialysis was continued due to liver failure and renal failure, and an IABP was necessary again after a worsening of cardiac function on day The illness progressed to disseminated intravascular coagulation DIC and disturbance of consciousness on day 67 of admission. Therefore, two sets of blood samples for blood culture were collected. Gram-positive bacilli were detected in both blood culture samples; each set included aerobic and anaerobic cultures Figures 1 b and 1 c.
No bacteria species could be identified at this time. Some asynergy in wall motion was detected by echocardiography, but no vegetation was seen. At this time, another two sets of blood samples were collected and blood cultures were negative. However, the patient died on day 73 of admission. This method is based on the assessment of biochemical properties. The bacterium was detected from the removed central venous catheter tip too.
Thus, the patient was diagnosed with a C. The C. The majority of cases of C. However, most of these cases are represented by patients with implanted indwelling devices or who present an immunosuppression [ 2 , 6 ]. Because her general condition worsened, implanted indwelling devices as central venous catheter might cause bacteremia by C. To our knowledge, this is the second report which found both blood cultures and cultures from a central venous catheter tip positive for the same strain of C.
Since C. Outbreaks caused by multidrug-resistant C. Approximately 0. Although patients with implanted CRT-D may develop infectious endocarditis, obvious vegetation was never observed on echocardiography in these cases [ 11 ].
In addition, there is a report of a patient who underwent hemodialysis and developed sepsis caused by a Corynebacterium sp. As the same type of bacteria was detected by the catheter tip culture, the cervical catheter was withdrawn during the hemodialysis, as it was presumed to be the port of entry in this case. Although the biochemical properties of C. However, this compound can only be detected by special analyses, for example, gas chromatography; thus C.
Since most of reports classified C. This would eventually lead this strain to become a secondary colonizer in immunocompromised hosts [ 8 ]. In general, C. In a previous report, vancomycin was recommended as empirical therapy for serious infections caused by Corynebacterium spp. Although C. Therefore, in this case, appropriate antibiotics could not be judged in vivo.
However, the optimal antimicrobial therapy for these infections is still controversial. In vitro susceptibility tests showed that linezolid and tigecycline are active against coryneform bacteria, revealing a potential therapeutic value [ 15 , 16 ] of these compounds. Currently, there are no guidelines for the treatment of Corynebacterium spp. Appropriate susceptibility tests and interpretive criteria are critically needed, in light of the growing emergence of multidrug resistance and its involvement in nosocomial infections.
In conclusion, although Corynebacterium could be isolated from a blood culture as a common contaminant, in certain case this observation could conceal a dangerous infection.
Patients with a history of exposure to broad-spectrum antibiotics or immunosuppression, as well as critically ill patients with an implanted indwelling device or a central venous catheter, must be considered at high risk of severe infection for this type of bacteria and it is necessary to recognize C.
In conclusion, we encountered a case of catheter-related bloodstream infection caused by C. Unfortunately, we could not successfully treat the patient because of her poor general condition and comorbidity.
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We will be providing unlimited waivers of publication charges for accepted articles related to COVID Sign up here as a reviewer to help fast-track new submissions. Journal overview. Academic Editor: Alexandre Rodrigues Marra. Received 23 Oct Revised 13 Dec Accepted 04 Jan Published 18 Jan Abstract A year-old woman visited our emergency department because of exertional dyspnea due to severe left ventricular functional failure.
Introduction The Corynebacteria are a group of aerobic, Gram-positive, catalase-positive, nonsporulating, generally nonmotile rods [ 1 ]. Case Presentation A year-old woman was brought to our emergency department because of exertional dyspnea due to severe left ventricular functional failure. Figure 1. Table 1. Minimum Inhibitory Concentration of the C. References C. Severo, L. Guazzelli, M. Barra, B.
Hochhegger, and L. Chen, P. Hsueh, S. Teng, T. Ou, and W. View at: Google Scholar L. Bernard, and M. Mizoguchi, M. Sakaki, K. Inoue et al. Funke and K. Versalovic, Ed. View at: Google Scholar A. Brandenburg, A. Van Belkum, C. Van Pelt, H. Bruining, J. Mouton, and H. View at: Google Scholar R. Leonard, D. Nowowiejski, J. Warren, D. Finn, and M. View at: Google Scholar K.
Knox and A.
Metrics details. Corynebacterium striatum is an emerging multidrug-resistant MDR pathogen associated with immunocompromised and chronically ill patients, as well as nosocomial outbreaks. In this study, we characterized 23 MDR C. The dissemination of these isolates was accomplished by pulsed-field gel electrophoresis PFGE.
Corynebacterium striatum is an emerging multidrug-resistant bacteria. We retrospectively identified isolates in a clinical database. Clinical relevance, in vitro susceptibility, and length of parenteral antimicrobial drug use were obtained from patient records. For patients with hardware- or device-associated infections, those with C.