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Virgilio E, Solmone M, Scardigno A, Fradiani P, Ceci D, Teggi A, Enea Di Domenico G, Cavallo I, Ensoli F, Borro M, Simmaco M, Santino I, Cavallini M. Hard-to-heal peripheral wounds infected with Corynebacterium striatum: a prospective study. J Wound Care 2023; 32:811-820. [PMID: 38060419 DOI: 10.12968/jowc.2023.32.12.811] [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] [Indexed: 12/18/2023]
Abstract
OBJECTIVE To investigate Corynebacterium striatum as a nosocomial pathogen infecting hard-to-heal peripheral wounds, such as skin wounds, soft tissue abscesses and osteomyelitis. As of 2023, the medical community were alerted against the risk of emerging systemic and central infections; on the other hand literature on peripheral cutaneous regions is still scarce. METHOD In this study, two groups of patients with similar lesions which were infected were compared: one group with the presence of the coryneform rod, the other without. RESULTS In total, Corynebacterium striatum was cultured from 62 patients and 131 samples. Corynebacterium striatum infection correlated well with the presence of: foot ulcer; venous leg ulcer; altered ambulation and/or altered foot loading; peripheral vascular and arterial disease; hospitalisation; malignancy; spinal cord injury; and recent administration of antibiotics (p<0.05 for all associations). Patients with Corynebacterium striatum had a lower overall survival rate compared to patients in the non-Corynebacterium striatum group (28.6 versus 31.6 months, respectively; p=0.0285). Multivariate analysis revealed that Corynebacterium striatum infection was an independent factor for poor prognosis (p<0.0001). CONCLUSION In view of the findings of our study, Corynebacterium striatum appears to be an important opportunistic pathogen infecting peripheral tissues and complicating wound healing. Given its numerous and worrying virulence factors (such as multidrug resistance and biofilm production), particular attention should be given to this pathogen by professional wound care providers in nosocomial and outpatient environments.
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Affiliation(s)
- Edoardo Virgilio
- Department of Medicine and Surgery, University of Parma, Parma, Italy
- Department of General Surgery, Parma University Hospital, Parma, Italy
| | - Mariacarmela Solmone
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University Sapienza, Sant'Andrea Hospital, Rome, Italy
| | - Alessandro Scardigno
- Department of Neurosciences, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, University Sapienza, Sant'Andrea Hospital, Rome, Italy
| | - Piera Fradiani
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University Sapienza, Sant'Andrea Hospital, Rome, Italy
| | - Diego Ceci
- Department of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, University Sapienza, Sant'Andrea Hospital, Rome, Italy
| | - Antonella Teggi
- Department of Neurosciences, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, University Sapienza, Sant'Andrea Hospital, Rome, Italy
| | - Gino Enea Di Domenico
- Department of Clinical Pathology and Microbiology, St. Gallicano Institute, Istituti di Ricovero e Cura a Carattere Scientifico Rome, Italy
| | - Ilaria Cavallo
- Department of Clinical Pathology and Microbiology, St. Gallicano Institute, Istituti di Ricovero e Cura a Carattere Scientifico Rome, Italy
| | - Fabrizio Ensoli
- Department of Clinical Pathology and Microbiology, St. Gallicano Institute, Istituti di Ricovero e Cura a Carattere Scientifico Rome, Italy
| | - Marina Borro
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University Sapienza, Sant'Andrea Hospital, Rome, Italy
| | - Maurizio Simmaco
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University Sapienza, Sant'Andrea Hospital, Rome, Italy
| | - Iolanda Santino
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University Sapienza, Sant'Andrea Hospital, Rome, Italy
| | - Marco Cavallini
- Department of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, University Sapienza, Sant'Andrea Hospital, Rome, Italy
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Toll-Like Receptor 2 and Mincle Cooperatively Sense Corynebacterial Cell Wall Glycolipids. Infect Immun 2017; 85:IAI.00075-17. [PMID: 28483856 DOI: 10.1128/iai.00075-17] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 05/01/2017] [Indexed: 01/01/2023] Open
Abstract
Nontoxigenic Corynebacterium diphtheriae and Corynebacterium ulcerans cause invasive disease in humans and animals. Host sensing of corynebacteria is largely uncharacterized, albeit the recognition of lipoglycans by Toll-like receptor 2 (TLR2) appears to be important for macrophage activation by corynebacteria. The members of the order Corynebacterineae (e.g., mycobacteria, nocardia, and rhodococci) share a glycolipid-rich cell wall dominated by mycolic acids (termed corynomycolic acids in corynebacteria). The mycolic acid-containing cord factor of mycobacteria, trehalose dimycolate, activates the C-type lectin receptor (CLR) Mincle. Here, we show that glycolipid extracts from the cell walls of several pathogenic and nonpathogenic Corynebacterium strains directly bound to recombinant Mincle in vitro Macrophages deficient in Mincle or its adapter protein Fc receptor gamma chain (FcRγ) produced severely reduced amounts of granulocyte colony-stimulating factor (G-CSF) and of nitric oxide (NO) upon challenge with corynebacterial glycolipids. Consistently, cell wall extracts of a particular C. diphtheriae strain (DSM43989) lacking mycolic acid esters neither bound Mincle nor activated macrophages. Furthermore, TLR2 but not TLR4 was critical for sensing of cell wall extracts and whole corynebacteria. The upregulation of Mincle expression upon encountering corynebacteria required TLR2. Thus, macrophage activation by the corynebacterial cell wall relies on TLR2-driven robust Mincle expression and the cooperative action of both receptors.
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