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Zhao X, Liu X, Wang Z, Wei S, Wu Z. Metagenomic next-generation sequencing for the diagnosis of Corynebacterium striatum meningitis: case report and literature review. BMC Neurol 2025; 25:127. [PMID: 40140741 PMCID: PMC11938648 DOI: 10.1186/s12883-025-04138-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2024] [Accepted: 03/14/2025] [Indexed: 03/28/2025] Open
Abstract
OBJECTIVE To report a case of Corynebacterium striatum meningitis and conduct a comprehensive literature review to determine the clinical presentation, microbiology, and treatment approaches for these patients. MATERIALS AND METHODS A 75-year-old male patient presented with headache and fever; however, bacterial cultures of cerebrospinal fluid (CSF) yielded negative results. Metagenomic next-generation sequencing (mNGS) of CSF subsequently identified Corynebacterium striatum meningitis as the causative agent for meningitis. A systematic search was performed across various databases encompassing systematic reviews, cohort studies, case series, and case reports involving patients diagnosed with Corynebacterium striatum meningitis regardless of age. Clinical presentation characteristics and the most frequently employed diagnostic technologies were obtained. A narrative summary of the findings is presented. RESULTS Corynebacterium striatum meningitis patients do not exhibit any specific age or sex predisposition or distinctive symptoms or signs. In patients with Corynebacterium striatum meningitis, CSF tests typically reveal an increased number of white blood cells (predominantly polymorphonuclear cells), elevated protein levels, and decreased glucose levels. Notably, the prevalence of antibiotic-resistant strains of Corynebacterium striatum has increased in recent years, leading to a gradual rise in antibiotic treatment failure rates. It is predicted that by 2030, vancomycin may be the sole effective drug available. CONCLUSION The possibility of Corynebacterium striatum infection should be considered during clinical diagnosis and laboratory testing procedures for bacterial meningitis. mNGS can serve as a supplementary gold standard in the diagnosis of bacterial meningitis, effectively enhancing the detection rate of rare pathogens.
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Affiliation(s)
- Xinran Zhao
- Shanxi Bethune Hospital, Third Hospital of Shanxi Medical University, Shanxi Academy of Medical Sciences Tongji Shanxi Hospital, 99 Longcheng Street, Taiyuan, 030032, China
| | - Xiaolei Liu
- Shanxi Bethune Hospital, Third Hospital of Shanxi Medical University, Shanxi Academy of Medical Sciences Tongji Shanxi Hospital, 99 Longcheng Street, Taiyuan, 030032, China.
| | - Zhijun Wang
- Shanxi Bethune Hospital, Third Hospital of Shanxi Medical University, Shanxi Academy of Medical Sciences Tongji Shanxi Hospital, 99 Longcheng Street, Taiyuan, 030032, China
| | - Shaoli Wei
- Shanxi Bethune Hospital, Third Hospital of Shanxi Medical University, Shanxi Academy of Medical Sciences Tongji Shanxi Hospital, 99 Longcheng Street, Taiyuan, 030032, China
| | - Zelin Wu
- Shanxi Bethune Hospital, Third Hospital of Shanxi Medical University, Shanxi Academy of Medical Sciences Tongji Shanxi Hospital, 99 Longcheng Street, Taiyuan, 030032, China
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Galanis A, Karampitianis S, Vlamis J, Karampinas P, Vavourakis M, Vlachos C, Papagrigorakis E, Zachariou D, Sakellariou E, Varsamos I, Patilas C, Tsiplakou S, Papaioannou V, Kamariotis S. Corynebacterium striatum Periprosthetic Hip Joint Infection: An Uncommon Pathogen of Concern? Healthcare (Basel) 2024; 12:273. [PMID: 38275553 PMCID: PMC10815444 DOI: 10.3390/healthcare12020273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 01/08/2024] [Accepted: 01/19/2024] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Total hip arthroplasty is indubitably a dominant elective surgery in orthopaedics, contributing to prodigious improvement in the quality of life of patients with osteoarthritis. One of the most potentially devastating complications of this operation is periprosthetic joint infection. Immunocompromised patients might be afflicted by infrequent low-virulence organisms not typically detected with conventional procedures. Consequently, employing advanced identification methods, such as the circumstantial sonication of orthopaedic implants, could be crucial to managing such cases. CASE PRESENTATION We present a peculiar case of a 72-year-old female patient suffering from a chronic periprosthetic hip infection due to Corynebacterium striatum. The pathogen was only identified after rigorous sonication of the extracted implants. The overall management of this case was immensely exacting, primarily because of the patient's impaired immune system, and was finally treated with two-stage revision in our Institution. LITERATURE REVIEW Although copious literature exists concerning managing periprosthetic hip infections, no concrete guidelines are available for such infections in multimorbid or immunocompromised patients with rare low-virulence microorganisms. Hence, a diagnostic work-up, antibiotic treatment and appropriate revision timeline must be determined. Sonication of extracted implants could be a powerful tool in the diagnostic arsenal, as it can aid in identifying rare microbes, such as Corynebacterium spp. Pertinent antibiotic treatment based on antibiogram analysis and apposite final revision-surgery timing are the pillars for effective therapy of such infections. CLINICAL RELEVANCE Corynebacterium striatum has been increasingly recognized as an emerging cause of periprosthetic hip infection in the last decade. A conspicuous rise in such reports has been observed in multimorbid or immunocompromised patients after the COVID-19 pandemic. This case is the first report of Corynebacterium striatum periprosthetic hip infection diagnosed solely after the sonication of extracted implants. This paper aims to increase awareness surrounding Corynebacterium spp. prosthetic joint infections, while highlighting the fields for further apposite research.
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Affiliation(s)
- Athanasios Galanis
- 3rd Department of Orthopaedic Surgery, National & Kapodistrian University of Athens, KAT General Hospital, Kifisia, 14561 Athens, Greece; (A.G.); (S.K.); (J.V.); (P.K.); (C.V.); (E.P.); (D.Z.); (E.S.); (I.V.); (C.P.)
| | - Spyridon Karampitianis
- 3rd Department of Orthopaedic Surgery, National & Kapodistrian University of Athens, KAT General Hospital, Kifisia, 14561 Athens, Greece; (A.G.); (S.K.); (J.V.); (P.K.); (C.V.); (E.P.); (D.Z.); (E.S.); (I.V.); (C.P.)
| | - John Vlamis
- 3rd Department of Orthopaedic Surgery, National & Kapodistrian University of Athens, KAT General Hospital, Kifisia, 14561 Athens, Greece; (A.G.); (S.K.); (J.V.); (P.K.); (C.V.); (E.P.); (D.Z.); (E.S.); (I.V.); (C.P.)
| | - Panagiotis Karampinas
- 3rd Department of Orthopaedic Surgery, National & Kapodistrian University of Athens, KAT General Hospital, Kifisia, 14561 Athens, Greece; (A.G.); (S.K.); (J.V.); (P.K.); (C.V.); (E.P.); (D.Z.); (E.S.); (I.V.); (C.P.)
| | - Michail Vavourakis
- 3rd Department of Orthopaedic Surgery, National & Kapodistrian University of Athens, KAT General Hospital, Kifisia, 14561 Athens, Greece; (A.G.); (S.K.); (J.V.); (P.K.); (C.V.); (E.P.); (D.Z.); (E.S.); (I.V.); (C.P.)
| | - Christos Vlachos
- 3rd Department of Orthopaedic Surgery, National & Kapodistrian University of Athens, KAT General Hospital, Kifisia, 14561 Athens, Greece; (A.G.); (S.K.); (J.V.); (P.K.); (C.V.); (E.P.); (D.Z.); (E.S.); (I.V.); (C.P.)
| | - Eftychios Papagrigorakis
- 3rd Department of Orthopaedic Surgery, National & Kapodistrian University of Athens, KAT General Hospital, Kifisia, 14561 Athens, Greece; (A.G.); (S.K.); (J.V.); (P.K.); (C.V.); (E.P.); (D.Z.); (E.S.); (I.V.); (C.P.)
| | - Dimitrios Zachariou
- 3rd Department of Orthopaedic Surgery, National & Kapodistrian University of Athens, KAT General Hospital, Kifisia, 14561 Athens, Greece; (A.G.); (S.K.); (J.V.); (P.K.); (C.V.); (E.P.); (D.Z.); (E.S.); (I.V.); (C.P.)
| | - Evangelos Sakellariou
- 3rd Department of Orthopaedic Surgery, National & Kapodistrian University of Athens, KAT General Hospital, Kifisia, 14561 Athens, Greece; (A.G.); (S.K.); (J.V.); (P.K.); (C.V.); (E.P.); (D.Z.); (E.S.); (I.V.); (C.P.)
| | - Iordanis Varsamos
- 3rd Department of Orthopaedic Surgery, National & Kapodistrian University of Athens, KAT General Hospital, Kifisia, 14561 Athens, Greece; (A.G.); (S.K.); (J.V.); (P.K.); (C.V.); (E.P.); (D.Z.); (E.S.); (I.V.); (C.P.)
| | - Christos Patilas
- 3rd Department of Orthopaedic Surgery, National & Kapodistrian University of Athens, KAT General Hospital, Kifisia, 14561 Athens, Greece; (A.G.); (S.K.); (J.V.); (P.K.); (C.V.); (E.P.); (D.Z.); (E.S.); (I.V.); (C.P.)
| | - Sofia Tsiplakou
- Department of Microbiology, KAT General Hospital, Kifisia, 14561 Athens, Greece; (S.T.); (V.P.); (S.K.)
| | - Vasiliki Papaioannou
- Department of Microbiology, KAT General Hospital, Kifisia, 14561 Athens, Greece; (S.T.); (V.P.); (S.K.)
| | - Spyridon Kamariotis
- Department of Microbiology, KAT General Hospital, Kifisia, 14561 Athens, Greece; (S.T.); (V.P.); (S.K.)
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Mostafa MM, Kamel M, Mahdy A. Microbial colonization of sacral nerve stimulators pseudo-capsule: A single institution experience. Investig Clin Urol 2023; 64:495-500. [PMID: 37668206 PMCID: PMC10482663 DOI: 10.4111/icu.20230111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 05/27/2023] [Accepted: 07/13/2023] [Indexed: 09/06/2023] Open
Abstract
PURPOSE To evaluate the incidence and type of microbial colonization of the pseudo-capsule (PC) that forms around sacral nerve stimulators (SNS) and consequently the significance of surgical excision of this PC at time of SNS revision or removal. MATERIALS AND METHODS A cohort of 31 patients who underwent SNS revision or removal from January 2018 to June 2021 were retrospectively reviewed. The baseline demographics, rate and type of PC microbial colonization and development of SNS insertion site infection were reported. RESULTS A cohort of 31 patients who underwent "InterStim device (Medtronic)" revision or removal were included. The majority were females (93.5%). The most common indication for SNS insertion was refractory overactive bladder (67.7%). Nine patients (29.0%) underwent SNS revision due to malfunctional device, and 9 patients had SNS removal for the need of MRI procedures. Four patients (12.9%) had positive tissue culture growing Coryneform bacillus (50.0%), Cutibacterium acnes (25.0%) and Pseudomonas aeruginosa (25.0%). CONCLUSIONS PC colonization was uncommon at the time of SNS explant. However, more research is needed to better understand the role of PC-positive culture in increasing the risk of SNS device infections if strict adherence to sterile techniques is adopted.
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Affiliation(s)
- Mostafa M Mostafa
- Division of Urology, Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Department of Urology, Assiut University Hospitals, Assiut, Egypt.
| | - Mohamed Kamel
- Division of Urology, Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Ayman Mahdy
- Division of Urology, Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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Jabri H, Krings S, Fall PA, Baurain D, Daube G, Taminiau B. Microbiota Profiling on Veterinary Faculty Restroom Surfaces and Source Tracking. Microorganisms 2023; 11:2053. [PMID: 37630613 PMCID: PMC10459056 DOI: 10.3390/microorganisms11082053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 08/02/2023] [Accepted: 08/07/2023] [Indexed: 08/27/2023] Open
Abstract
In this study, we aimed to develop a comprehensive microbial source amplicon database tailored for source tracking in veterinary settings. We rigorously tested our locally curated source tracking database by selecting a frequently accessed environment by veterinary students and veterinarians. By exploring the composition of resident microbiota and identifying potential sources of contamination, including animals, the environment, and human beings, we aimed to provide valuable insights into the dynamics of microbial transmission within veterinary facilities. The 16S rDNA amplicon sequencing was used to determine the bacterial taxonomic profiles of restroom surfaces. Bacterial sources were identified by linking our metadata-enriched local database to the microbiota profiling analysis using high-quality sequences. Microbiota profiling shows the dominance of four phyla: Actinobacteria, Bacteroidetes, Proteobacteria, and Firmicutes. If the restroom cleaning process did not appear to impact microbiota composition, significant differences regarding bacterial distribution were observed between male and female users in different sampling campaigns. Combining 16S rDNA profiling to our specific sources labeling pipeline, we found aquatic and human sources were the primary environment keywords in our campaigns. The probable presence of known animal sources (bovids, insects, equids, suids…) associated with bacterial genera such as Chryseobacterium, Bergeyella, Fibrobacter, and Syntrophococcus was also involved in restroom surfaces, emphasizing the proximity between these restrooms and the exchange of bacteria between people involved in animals handling. To summarize, we have demonstrated that DNA sequence-based source tracking may be integrated with high-throughput bacterial community analysis to enrich microbial investigation of potential bacterial contamination sources, especially for little known or poorly identified taxa. However, more research is needed to determine the tool's utility in other applications.
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Affiliation(s)
- Hiba Jabri
- Laboratory of Food Microbiology, Fundamental and Applied Research for Animals and Health Center (FARAH), Department of Food Sciences, Faculty of Veterinary Medicine, University of Liege, Quartier Vallée 2, B42, Avenue de Cureghem 10, 4000 Liège, Belgium; (H.J.); (G.D.)
| | - Simone Krings
- Department of Microbial Sciences, School of Biosciences, Faculty of Health and Medical Sciences, Univesity of Surrey, Guildford GU2 7XH, UK;
| | - Papa Abdoulaye Fall
- FoodChainID GENOMICS, Laboratory Manager NGS, Rue Hayeneux, 62, 4040 Herstal, Belgium;
| | - Denis Baurain
- Eukaryotic Phylogenomics, InBioS-PhytoSYSTEMS, University of Liège, 4000 Liège, Belgium;
| | - Georges Daube
- Laboratory of Food Microbiology, Fundamental and Applied Research for Animals and Health Center (FARAH), Department of Food Sciences, Faculty of Veterinary Medicine, University of Liege, Quartier Vallée 2, B42, Avenue de Cureghem 10, 4000 Liège, Belgium; (H.J.); (G.D.)
| | - Bernard Taminiau
- Laboratory of Food Microbiology, Fundamental and Applied Research for Animals and Health Center (FARAH), Department of Food Sciences, Faculty of Veterinary Medicine, University of Liege, Quartier Vallée 2, B42, Avenue de Cureghem 10, 4000 Liège, Belgium; (H.J.); (G.D.)
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Milosavljevic MN, Milosavljevic JZ, Kocovic AG, Stefanovic SM, Jankovic SM, Djesevic M, Milentijevic MN. Antimicrobial treatment of Corynebacterium striatum invasive infections: a systematic review. Rev Inst Med Trop Sao Paulo 2021; 63:e49. [PMID: 34161555 PMCID: PMC8216692 DOI: 10.1590/s1678-9946202163049] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 05/07/2021] [Indexed: 01/03/2023] Open
Abstract
The aim of this study was to establish an evidence-based guideline for the
antibiotic treatment of Corynebacterium striatum infections.
Several electronic databases were systematically searched for clinical trials,
observational studies or individual cases on patients of any age and gender with
systemic inflammatory response syndrome, harboring C. striatum
isolated from body fluids or tissues in which it is not normally present.
C. striatum had to be identified as the only causative
agent of the invasive infection, and its isolation from blood, body fluids or
tissues had to be confirmed by one of the more advanced diagnostic methods
(biochemical methods, mass spectrometry and/or gene sequencing). This systematic
review included 42 studies that analyzed 85 individual cases with various
invasive infections caused by C. striatum. More than one
isolate of C. striatum exhibited 100% susceptibility to
vancomycin, linezolid, teicoplanin, piperacillin-tazobactam,
amoxicillin-clavulanate and cefuroxime. On the other hand, some strains of this
bacterium showed a high degree of resistance to fluoroquinolones, to the
majority majority of β-lactams, aminoglycosides, macrolides, lincosamides and
cotrimoxazole. Despite the antibiotic treatment, fatal outcomes were reported in
almost 20% of the patients included in this study. Gene sequencing methods
should be the gold standard for the identification of C.
striatum, while MALDI-TOF and the Vitek system can be used as
alternative methods. Vancomycin should be used as the antibiotic of choice for
the treatment of C. striatum infections, in monotherapy or in
combination with piperacillin-tazobactam. Alternatively, linezolid, teicoplanin
or daptomycin may be used in severe infections, while amoxicillin-clavulanate
may be used to treat mild infections caused by C. striatum.
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Affiliation(s)
- Milos N Milosavljevic
- University of Kragujevac, Faculty of Medical Sciences, Department of Pharmacology and toxicology, Kragujevac, Serbia
| | - Jovana Z Milosavljevic
- University of Kragujevac, Faculty of Medical Sciences, Department of Anatomy, Kragujevac, Serbia
| | - Aleksandar G Kocovic
- University of Kragujevac, Faculty of Medical Sciences, Department of Pharmacy, Kragujevac, Serbia
| | - Srdjan M Stefanovic
- University of Kragujevac, Faculty of Medical Sciences, Department of Pharmacy, Kragujevac, Serbia
| | - Slobodan M Jankovic
- University of Kragujevac, Faculty of Medical Sciences, Department of Pharmacology and toxicology, Kragujevac, Serbia
| | - Miralem Djesevic
- Private Policlinic Center Eurofar Sarajevo, Cardiology Department, Sarajevo, Bosnia and Herzegovina
| | - Milica N Milentijevic
- University of Priština, School of Medicine, Department of Infectious Diseases, Pristina, Serbia
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Hollnagel K, Willen J, Ellis M, Soleimanifard Y, Booth R, Nandi S. Chronic Corynebacterium striatum Septic Arthritis in a Patient Referred for Total Knee Arthroplasty. Case Rep Orthop 2020; 2020:1392182. [PMID: 32206362 PMCID: PMC7077040 DOI: 10.1155/2020/1392182] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 02/25/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND While Corynebacterium striatum and other Corynebacterium species were historically considered contaminants, they are recently being identified as pathogens with increasing frequency. Case Summary. We report the case of a 78-year-old gentleman with a three-year history of knee pain and established diagnosis of osteoarthritis referred for consideration for total knee arthroplasty. He had no knee pain with passive range-of-motion. Plain films demonstrated bony erosions atypical for osteoarthritis. Joint aspiration white blood cell count was 30,548/mm3, but multiple cultures were positive for C. striatum. The infection was successfully treated with open irrigation and debridement, complete synovectomy, and six weeks of intravenous daptomycin. CONCLUSION To our knowledge, this is the first report of chronic C. striatum septic arthritis of a native joint and only the third case of C. striatum septic arthritis of the knee.C. striatum. The infection was successfully treated with open irrigation and debridement, complete synovectomy, and six weeks of intravenous daptomycin. C. striatum. The infection was successfully treated with open irrigation and debridement, complete synovectomy, and six weeks of intravenous daptomycin.
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Affiliation(s)
- Katharine Hollnagel
- Department of Orthopaedic Surgery, The University of Toledo Medical Center, USA
| | - Jacob Willen
- Department of Orthopaedic Surgery, The University of Toledo Medical Center, USA
| | - Michael Ellis
- Department of Infectious Disease, The University of Toledo Medical Center, USA
| | | | - Robert Booth
- Department of Pathology, The University of Toledo Medical Center, USA
| | - Sumon Nandi
- Department of Orthopaedics, University of Maryland School of Medicine, USA
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Kawaguchi Y, Okamoto H, Endo K, Iwata H, Joyo Y, Nozaki M, Tamechika S, Waguri-Nagaya Y, Murakami H. Pyogenic tenosynovitis of the wrist due to Corynebacterium striatum in a patient with dermatomyositis: A case report. Medicine (Baltimore) 2020; 99:e18761. [PMID: 32011462 PMCID: PMC7220041 DOI: 10.1097/md.0000000000018761] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION Corynebacterium striatum is common contaminant in clinical specimens. Here, we report a rare case of pyogenic tenosynovitis of the wrist caused by C striatum in a dermatomyositis patient taking oral immunosuppressants. PATIENT CONCERNS A 67-year-old Japanese woman with dermatomyositis had a history of multiple intraarticular injections of corticosteroids to the right wrist joint for the treatment of osteoarthritis. She was admitted to our hospital with a painful lump on the right dorsal wrist lasting for three months. MRI revealed cellulitis of the dorsum of the right wrist and hand and fluid collection in the extensor tendon sheath. C striatum was detected in the cultures of three samples of synovial fluid taken from the dorsal hand. DIAGNOSIS Pyogenic tenosynovitis of the wrist due to C striatum. INTERVENTIONS The infection was successfully controlled with synovectomy and adjuvant antibiotic therapy. OUTCOMES There has been no sign of recurrence for 12-months after the surgical treatment. LESSONS This is the first reported case of pyogenic tenosynovitis due to C striatum in a patient with dermatomyositis. Clinicians should be aware that patients undergoing immunosuppressive therapy have a risk of C striatum infection.
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Affiliation(s)
- Yohei Kawaguchi
- Department of Orthopedic Surgery
- Department of Glial Cell Biology
| | | | | | | | | | | | - Shinya Tamechika
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, Mizuho-Ku, Nagoya, Japan
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Monomicrobial bone and joint infection due to Corynebacterium striatum: literature review and amoxicillin-rifampin combination as treatment perspective. Eur J Clin Microbiol Infect Dis 2019; 38:1269-1278. [PMID: 30903537 DOI: 10.1007/s10096-019-03542-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 03/14/2019] [Indexed: 12/18/2022]
Abstract
Corynebacterium striatum is a ubiquitous colonizer of human skin and mucous membranes. It is increasingly involved in infections, especially with prosthetic devices or in immunocompromised individuals. Microbiological diagnosis is challenging and bacterial resistance is a major concern. We performed a retrospective study of monomicrobial bone and joint infections (BJI) due to C. striatum in two referral centers from April 2012 to July 2017. We collected the patients' clinical and microbiological characteristics and outcomes. We also performed a literature review of BJI due to C. striatum. We identified 12 cases (nine prosthetic joint infections, one osteosynthetic device infection, one non-union, and one arthritis) in 11 patients, five of which were immunocompromised. Microbiological diagnosis was performed with prolonged culture media. Ten out of 12 strains were susceptible to aminopenicillin, a drug class not recommended for testing by the EUCAST/CASFM guidelines, and 8/12 patients were treated with amoxicillin-rifampicin. The cure rate was 8/12, after a median follow-up period of 487.5 days (IQR 140.3-1348.5). Twelve cases of BJI due to C. striatum were previously reported. Among them, 5/12 patients were immunocompromised, 3/12 cases were acute BJI, and 2/12 were device-related infections. The diagnosis was performed by PCR in one case, and 10/12 patients were treated with glycolipopeptides, with a cure rate of 11/12. We report the largest cohort of monomicrobial BJI with C. striatum. Determination of aminopenicillin susceptibility is essential since it is frequently active in our experience, even in BJI. The cure rate of this infection seems high.
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Los-Arcos I, Len O, Martín-Gómez MT, Baroja A, Berastegui C, Deu M, Sacanell J, Román A, Gavaldà J. Clinical Characteristics and Outcome of Lung Transplant Recipients with Respiratory Isolation of Corynebacterium spp. J Clin Microbiol 2018; 56:e00142-18. [PMID: 29793964 PMCID: PMC6062803 DOI: 10.1128/jcm.00142-18] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 05/12/2018] [Indexed: 01/28/2023] Open
Abstract
Although chronic respiratory disease and immunosuppression are risk factors for Corynebacterium species respiratory infection, data are scarce regarding this disease in lung transplantation. Our aim was to describe the clinical characteristics and outcomes of lung transplant recipients (LTR) with respiratory isolation of Corynebacterium spp. This was a retrospective observational study performed at a referral center in Barcelona, Spain (2014 to 2016). We included all LTR in whom Corynebacterium spp. were isolated in at least one good-quality lower respiratory tract specimen. Overall, 24 of 527 (4.6%) LTR at risk during the study period were included. The main epidemiological, clinical, and microbiological data were analyzed. The most frequently isolated species were C. striatum (11/24), C. pseudodiphtheriticum (3/24), and C. amycolatum (3/24). All 19 (76%) patients who underwent bronchoscopy showed abnormalities, mainly mucosal plaques at the bronchial suture and purulent secretions. Clinical cure was achieved in 8/12 (67%) patients who fulfilled the CDC definition of lower respiratory tract infection (LRTI). To assess the clinical relevance of Corynebacterium spp., only patients with monomicrobial isolation (n = 18) were evaluated. LRTI was diagnosed in 9, and a nonsignificant association was found with a significant number of Corynebacterium sp. CFU/ml (7/9 LRTI versus 2/9 non-LRTI, P = 0.057). Persistent infection was associated with metallic bronchial stent implantation (4/4 versus 2/14, P = 0.005). The isolation of Corynebacterium spp. in respiratory specimens of lung transplant recipients may herald a respiratory tract infection or bronchial suture damage. Bronchial stent implantation is a risk factor for the persistence of Corynebacterium species infection.
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Affiliation(s)
- Ibai Los-Arcos
- Infectious Diseases Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Oscar Len
- Infectious Diseases Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - María Teresa Martín-Gómez
- Microbiology Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Aída Baroja
- Internal Medicine Department, Complejo Hospitalario Universitario de Vigo, Vigo, Spain
| | - Cristina Berastegui
- Lung Transplant Unit, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - María Deu
- Thoracic Surgery Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Judith Sacanell
- Critical Care Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Antonio Román
- Lung Transplant Unit, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Joan Gavaldà
- Infectious Diseases Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
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Corynebacterium striatum prosthetic joint infection. Enferm Infecc Microbiol Clin 2018; 37:480-481. [PMID: 29903503 DOI: 10.1016/j.eimc.2018.05.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 04/30/2018] [Accepted: 05/08/2018] [Indexed: 11/20/2022]
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