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Kitamura N, Hoan TT, Do HM, Dao TA, Le LT, Le TTT, Doan TTT, Chau TN, Dinh HT, Iwaki M, Senoh M, Efstraciou A, Ho NM, Pham DM, Dang DA, Toizumi M, Fine P, Do HT, Yoshida LM. Seroepidemiology and Carriage of Diphtheria in Epidemic-Prone Area and Implications for Vaccination Policy, Vietnam. Emerg Infect Dis 2023; 29:70-80. [PMID: 36573549 PMCID: PMC9796191 DOI: 10.3201/eid2901.220975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
In 2019, a community-based, cross-sectional carriage survey and a seroprevalence survey of 1,216 persons 1-55 years of age were conducted in rural Vietnam to investigate the mechanism of diphtheria outbreaks. Seroprevalence was further compared with that of an urban area that had no cases reported for the past decade. Carriage prevalence was 1.4%. The highest prevalence, 4.5%, was observed for children 1-5 years of age. Twenty-seven asymptomatic Coerynebacterium diphtheriae carriers were identified; 9 carriers had tox gene-bearing strains, and 3 had nontoxigenic tox gene-bearing strains. Child malnutrition was associated with low levels of diphtheria toxoid IgG, which might have subsequently increased child carriage prevalence. Different immunity patterns in the 2 populations suggested that the low immunity among children caused by low vaccination coverage increased transmission, resulting in symptomatic infections at school-going age, when vaccine-induced immunity waned most. A school-entry booster dose and improved infant vaccination coverage are recommended to control transmissions.
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Abe M, Kimura M, Maruyama H, Watari T, Ogura S, Takagi S, Uchida N, Otsuka Y, Taniguchi S, Araoka H. Clinical characteristics and drug susceptibility patterns of Corynebacterium species in bacteremic patients with hematological disorders. Eur J Clin Microbiol Infect Dis 2021; 40:2095-2104. [PMID: 33895886 DOI: 10.1007/s10096-021-04257-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 04/15/2021] [Indexed: 01/13/2023]
Abstract
The aim of this study was to clarify the clinical and microbiological characteristics of Corynebacterium bacteremia in hematological patients. We retrospectively reviewed the medical records of patients with Corynebacterium bacteremia from April 2013 to June 2018. The causative Corynebacterium species were identified using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Drug susceptibility tests were performed using the broth microdilution method recommended by the Clinical and Laboratory Standards Institute. In total, 147 cases of Corynebacterium bacteremia were identified during the study period. Corynebacterium striatum was the most frequent pathogen. Catheter-related bloodstream infection was diagnosed in 19.7% of all patients, and moderate/severe oral or severe gastrointestinal mucosal impairment was detected in 19.7%. Polymicrobial infection was found in about 20% of cases, with Enterococcus faecium being the most frequent isolate. The overall 30-day mortality was 34.7% (51/147). Multivariate analysis showed that E. faecium co-infection (odds ratio (OR) 9.3; 95% confidence interval (CI) 2.1-40), systemic corticosteroids (OR 3.6; 95% CI 1.4-8.9), other immunosuppressive drugs (OR 0.32; 95% CI 0.13-0.76), and a Pitt bacteremia score ≥4 (OR 12; 95% CI 3.9-40) were significant risk factors for overall 30-day mortality. The drug susceptibility rates for beta-lactam antimicrobial agents were quite low. All isolates were susceptible to glycopeptides and linezolid. However, some C. striatum isolates were resistant to daptomycin. Corynebacterium bacteremia can occur in the presence of several types of mucosal impairment. Our drug susceptibility data indicate that Corynebacterium bacteremia in hematological patients could be treated by glycopeptides or linezolid.
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Affiliation(s)
- Masahiro Abe
- Department of Infectious Diseases, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan.
| | - Muneyoshi Kimura
- Department of Infectious Diseases, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan
| | - Hideyuki Maruyama
- Department of Laboratory Medicine, Kameda Medical Center, Kamogawa, Chiba, Japan
| | - Tomohisa Watari
- Department of Laboratory Medicine, Kameda Medical Center, Kamogawa, Chiba, Japan
| | - Sho Ogura
- Department of Infectious Diseases, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan
| | | | - Naoyuki Uchida
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | - Yoshihito Otsuka
- Department of Laboratory Medicine, Kameda Medical Center, Kamogawa, Chiba, Japan
| | | | - Hideki Araoka
- Department of Infectious Diseases, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan.,Okinaka Memorial Institute for Medical Research, Tokyo, Japan
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Xu S, Qiu X, Hou X, Zhou H, Chen D, Wang X, Han L, Li D, Sun L, Ji X, Li M, Zhang J, Li M, Li Z. Direct detection of Corynebacterium striatum, Corynebacterium propinquum, and Corynebacterium simulans in sputum samples by high-resolution melt curve analysis. BMC Infect Dis 2021; 21:21. [PMID: 33413116 PMCID: PMC7788810 DOI: 10.1186/s12879-020-05633-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 11/19/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pulmonary infections caused by non-diphtheriae corynebacteria are increasing. However, rapid identification of Corynebacterium species poses a challenge due to the low genetic variation within the genus. METHODS Three reference strains and 99 clinical isolates were used in this study. A qPCR followed by high-resolution melting (HRM) targeting ssrA was performed to simultaneously identify C. striatum, C. propinquum and C. simulans. To further evaluate this assay's performance, 88 clinical sputum samples were tested by HRM and the detection results were compared with those of the traditional culture method and multiple cross-displacement amplification (MCDA) assay. RESULTS The melting curve produced by a pair of universal primers generated species-specific HRM curve profiles and could distinguish the three target species from other related bacteria. The limit of detection of HRM assay for DNA from the three purified Corynebacterium species was 100 fg. Compared with the culture method, HRM detected 22 additional positive specimens, representing a 23.9% relative increase in detection rate. The HRM assay had 98.4% (95% confidence interval [CI], 90.5-99.9%) sensitivity and 100% (95% CI, 82.8-100%) specificity. Additionally, 95.5% concordance between HRM and MCDA (κ = 0.89 [95% CI, 0.79-0.99]) was noted. CONCLUSIONS The HRM assay was a simple, rapid, sensitive, and specific diagnostic tool for detecting C. striatum, C. propinquum, and C. simulans, with the potential to contribute to early diagnosis, epidemiological surveillance, and rapid response to outbreak.
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Affiliation(s)
- Shuai Xu
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiaotong Qiu
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xuexin Hou
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Haijian Zhou
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Dongke Chen
- Department, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Xuebing Wang
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Lichao Han
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Dan Li
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Lina Sun
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xingzhao Ji
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Minghui Li
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jingshan Zhang
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Mengtong Li
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhenjun Li
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
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Neonakis IK, Stafylaki D, Spandidos DA. Reduction in the processing of possible blood culture contaminants by the application of a selection criterion. Exp Ther Med 2020; 20:2039-2042. [PMID: 32782514 PMCID: PMC7401217 DOI: 10.3892/etm.2020.8935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 06/23/2020] [Indexed: 11/18/2022] Open
Abstract
Possible blood culture (BC) contaminants are generally considered to be skin flora species including coagulase-negative Staphylococci (CNS), Corynebacterium species, Micrococcus species, Bacillus species and Propionibacterium acnes. Prior to October 1, 2016 all possible BC contaminants were fully processed (identification, susceptibility testing) in our laboratory. In order to reduce the laboratory workload from October 1, 2016 a possible contaminant was only processed if it was present in more than one BC pair drawn from the same patient within the same day. The two-year study period was divided in two periods namely period A from January 1, 2016 to September 30, 2016 (first 9 months) and period B from October 1, 2016 to December 31, 2017 (last 15 months). A series of indices (INs) were calculated including among others the Working Rate IN (WR) defined as the total isolates divided to the total number of BCs submitted per month and the CNS Rate (CNSR) defined as the total number of CNS processed divided to the total number of BCs submitted per month. A 23.08% reduction in the CNSR was noted (from 3.51% in period A to 2.70% in period B) whereas the overall WR was reduced from 7.19% in period A to 6.84% in period B. Furthermore, the total number of contaminants processed per month divided to the total number of isolates processed per month was reduced from 54.50% in period A to 42.41% in period B. The reduction in the INs recorded is of great value since it was achieved by the implementation of a simple criterion easily applicable and without any cost.
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Affiliation(s)
- Ioannis K Neonakis
- Department of Clinical Microbiology and Microbial Pathogenesis, University Hospital of Heraklion, 71201 Heraklion, Greece
| | - Dimitra Stafylaki
- Department of Clinical Microbiology and Microbial Pathogenesis, University Hospital of Heraklion, 71201 Heraklion, Greece
| | - Demetrios A Spandidos
- Laboratory of Clinical Virology, School of Medicine, University of Crete, 71003 Heraklion, Greece
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Valdoleiros SR, Sousa Neves C, Abranches Carvalho J, Gonçalves C, Pereira P, Vasconcelos O, Castro AP, Ramos MH. Infection and colonization by Corynebacterium pseudodiphtheriticum: a 9-year observational study in a university central hospital. Eur J Clin Microbiol Infect Dis 2020; 39:1745-52. [PMID: 32367215 DOI: 10.1007/s10096-020-03891-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 04/01/2020] [Indexed: 10/24/2022]
Abstract
Despite constituting part of the human commensal flora, Corynebacterium pseudodiphtheriticum has been recognized as a potentially infectious agent, most frequently in immunocompromised patients or individuals with other morbidity factors, but significant association to comorbid states remains unproven. This study's purpose was to assess clinical significance, risk factors for infection and antimicrobial susceptibility of C. pseudodiphtheriticum isolates. A retrospective observational study was conducted. Relevance of isolation was determined by clinical, laboratory, and imaging criteria. Forty-nine isolates occurred in 47 episodes. Colonization was assumed in 12% and infection in 78%, of which 51% were nosocomial. Patients with infection were older, with male predominance; both age and gender were statistically significant (p < 0.05) between infection and colonization groups. Although dyslipidemia (58%), arterial hypertension (58%), invasive procedures (56%), and chronic lung disease (50%) were prevalent in the infection group, no comorbidity was a significant risk factor for infection compared with colonization. Charlson comorbidity index showed no statistically difference between groups. Mortality rate was 14% in infection. Respiratory samples were the main isolation product; all tested strains were susceptible to amoxicillin/clavulanate and vancomycin. Resistant strains were observed for clindamycin (77%) and erythromycin (48%). C. pseudodiphtheriticum isolation was associated with infection in most cases. Despite the high prevalence of comorbidities and invasive procedures, no factors other than age and gender were significantly associated with infection. Although C. pseudodiphtheriticum may constitute a contaminant or colonizer in clinical samples, positive cultures in patients with signs and symptoms consistent with infection should not be neglected.
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Yanai M, Ogasawasa M, Hayashi Y, Suzuki K, Takahashi H, Satomura A. Retrospective evaluation of the clinical characteristics associated with Corynebacterium species bacteremia. Braz J Infect Dis 2018; 22:24-29. [PMID: 29360429 PMCID: PMC9425686 DOI: 10.1016/j.bjid.2017.12.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 12/20/2017] [Accepted: 12/21/2017] [Indexed: 12/01/2022] Open
Abstract
Objectives Corynebacterium spp. are becoming recognized as pathogens that potentially cause various infections. We aimed to evaluate the clinical characteristics associated with Corynebacterium spp. bacteremia. Patients and methods We retrospectively reviewed the medical records of all adult patients who had positive blood cultures for Corynebacterium spp. in a single university hospital between January 2014 and December 2016. Patients were divided into a bacteremia group and a contamination group based on microbiological test results and clinical characteristics. Patients’ characteristics, antimicrobial susceptibility of isolated species, antimicrobials administered, and patient outcomes were evaluated. Results Corynebacterium spp. were isolated from blood samples of 63 patients; Corynebacterium striatum was the predominant isolate. Twenty-eight patients were determined to have bacteremia. Younger age (p = 0.023), shorter time to positivity (p = 0.006), longer hospital stay (p = 0.009), and presence of an indwelling vascular catheter (p = 0.002) were observed more often in the bacteremia group compared to the contamination group. The source of infection in most patients with bacteremia was an intravenous catheter. All tested strains were susceptible to vancomycin. Four of the 27 patients with bacteremia died, despite administration of appropriate antimicrobial therapy. Conclusions We found that younger age, shorter time to positivity, and presence of an indwelling catheter were related to bacteremia caused by Corynebacterium spp. Appropriate antimicrobials should be administered once Corynebacterium spp. are isolated from the blood and bacteremia is suspected.
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Affiliation(s)
- Mitsuru Yanai
- Nihon University School of Medicine, Department of Internal Medicine, Division of General Medicine, Tokyo, Japan.
| | - Maiko Ogasawasa
- Nihon University School of Medicine, Department of Internal Medicine, Division of General Medicine, Tokyo, Japan
| | - Yuta Hayashi
- Nihon University School of Medicine, Department of Internal Medicine, Division of General Medicine, Tokyo, Japan
| | - Kiyozumi Suzuki
- Nihon University School of Medicine, Department of Internal Medicine, Division of General Medicine, Tokyo, Japan
| | - Hiromichi Takahashi
- Nihon University School of Medicine, Department of Pathology and Mircobiology, Division of Laboratory Medicine, Tokyo, Japan
| | - Atsushi Satomura
- Nihon University School of Medicine, Department of Pathology and Mircobiology, Division of Laboratory Medicine, Tokyo, Japan
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Teutsch B, Berger A, Marosevic D, Schönberger K, Lâm TT, Hubert K, Beer S, Wienert P, Ackermann N, Claus H, Drayß M, Thiel K, van der Linden M, Vogel U, Sing A. Corynebacterium species nasopharyngeal carriage in asymptomatic individuals aged ≥ 65 years in Germany. Infection 2017; 45:607-611. [PMID: 28429151 DOI: 10.1007/s15010-017-1017-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 04/07/2017] [Indexed: 01/23/2023]
Abstract
PURPOSE The prevalence of protective anti-diphtheria toxin antibodies decreases with age. Therefore, the elderly might serve as reservoir for potentially toxigenic Corynebacterium (C.) species (C. diphtheriae, C. ulcerans, and C. pseudotuberculosis). This study aimed to examine the colonization rate of the nasopharynx with corynebacteria of individuals aged 65 years and older. METHODS In the period from October 2012 to June 2013, nasal and throat swabs were taken from 714 asymptomatic subjects aged 65-106 years (average age 77.2) at three regions in Germany and investigated for Corynebacterium species. RESULTS A total of 402 strains of Corynebacterium species were isolated from 388 out of 714 asymptomatic subjects (carriage rate 54.3%). The carriage rate was significantly higher in study participants living in retirement homes (68.4%) compared to those living autonomously at home (51.1%). Strains were isolated mostly from the nose (99%). Corynebacterium accolens was the most often isolated species (39.8%), followed by C. propinquum (24.1%), C. pseudodiphtheriticum (19.4%), and C. tuberculostearicum (10.2%). No C. diphtheriae, C. ulcerans, and C. pseudotuberculosis strains were isolated. A subsample of 74 subjects was tested serologically for anti-diphtheria antibodies. Protective anti-diphtheria toxin antibodies were found in 29.7% of the subjects; 70.3% showed no protective immunity. CONCLUSIONS These results suggest that carriage of potentially toxigenic corynebacteria is very rare among people aged 65 and older in Germany. However, the low prevalence of protective anti-diphtheria toxin antibodies might pose a risk for acquiring diphtheria especially for the elderly.
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Affiliation(s)
- Barbara Teutsch
- Bavarian Health and Food Safety Authority, Veterinärstraße 2, 85764, Oberschleißheim, Germany
| | - Anja Berger
- Bavarian Health and Food Safety Authority, Veterinärstraße 2, 85764, Oberschleißheim, Germany.,National Consiliary Laboratory for Diphtheria, Oberschleißheim, Germany
| | - Durdica Marosevic
- Bavarian Health and Food Safety Authority, Veterinärstraße 2, 85764, Oberschleißheim, Germany.,European Programme for Public Health Microbiology Training, European Centre of Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Katharina Schönberger
- Bavarian Health and Food Safety Authority, Veterinärstraße 2, 85764, Oberschleißheim, Germany
| | - Thiên-Trí Lâm
- National Reference Center for Meningococci and Haemophilus Influenzae, Institute for Hygiene and Microbiology, University of Würzburg, Würzburg, Germany
| | - Kerstin Hubert
- National Reference Center for Meningococci and Haemophilus Influenzae, Institute for Hygiene and Microbiology, University of Würzburg, Würzburg, Germany
| | - Steffi Beer
- Sanitätsdienst der Bundeswehr, Koblenz, Germany
| | | | - Nikolaus Ackermann
- Bavarian Health and Food Safety Authority, Veterinärstraße 2, 85764, Oberschleißheim, Germany
| | - Heike Claus
- National Reference Center for Meningococci and Haemophilus Influenzae, Institute for Hygiene and Microbiology, University of Würzburg, Würzburg, Germany
| | - Maria Drayß
- National Reference Center for Meningococci and Haemophilus Influenzae, Institute for Hygiene and Microbiology, University of Würzburg, Würzburg, Germany
| | - Kathrin Thiel
- National Reference Center for Meningococci and Haemophilus Influenzae, Institute for Hygiene and Microbiology, University of Würzburg, Würzburg, Germany
| | - Mark van der Linden
- National Reference Center for Streptococci, Institut für Medizinische Mikrobiologie des UKA, RWTH Aachen, Aachen, Germany
| | - Ulrich Vogel
- National Reference Center for Meningococci and Haemophilus Influenzae, Institute for Hygiene and Microbiology, University of Würzburg, Würzburg, Germany
| | - Andreas Sing
- Bavarian Health and Food Safety Authority, Veterinärstraße 2, 85764, Oberschleißheim, Germany. .,National Consiliary Laboratory for Diphtheria, Oberschleißheim, Germany.
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Abstract
BACKGROUND Corynebacterium pseudodiphtheriticum may be present as commensal flora of the respiratory tract and therefore it may be difficult to assess clinical relevance when it is cultured from lower respiratory tract specimens. Our objective was to determine the clinical relevance of C. pseudodiphtheriticum as a lower respiratory tract pathogen and to define patients at risk of developing lower respiratory tract infections caused by C. pseudodiphtheriticum. METHODS We retrospectively identified all lower respiratory tract cultures positive for C. pseudodiphtheriticum over a 10-year period and assessed clinical relevance by predefined criteria. RESULTS Clinical relevance was likely or possible in 86% of patients. Pre-existent comorbidity was present in 86% of patients, mostly underlying cardiac or pulmonary disease. All isolates were susceptible to amoxicillin. CONCLUSION C. pseudodiphtheriticum should be considered a clinically relevant pathogen when cultured from the lower respiratory tract in symptomatic patients.
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Affiliation(s)
- Sonja E Van Roeden
- a From the Department of Internal Medicine , Diakonessenhuis Utrecht , The Netherlands
| | - Steven F Thijsen
- b Department of Medical Microbiology and Immunology , Diakonessenhuis Utrecht , The Netherlands
| | - Sanjay U C Sankatsing
- a From the Department of Internal Medicine , Diakonessenhuis Utrecht , The Netherlands
| | - Gijs J M Limonard
- c Department of Pulmonary Diseases , Diakonessenhuis Utrecht , The Netherlands
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