A case of recurrent Corynebacterium jeikeium endocarditis: Unanswered questions for the treatment of chronic endovascular infections

Clarke, John‐Ross D.; Rahman, Manal Abdur; Saul, Zane

doi:10.1016/j.idcr.2019.e00610

Cited by 10 publications

(7 citation statements)

References 12 publications

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“…Our study confirms specialized literature data [6,14,15,22,27]. The antibiotics that we tested belong to nine different classes and they are the most commonly used treatment options for Corynebacterium spp.…”

Section: Discussionsupporting

confidence: 89%

“…urealyticum has been associated with acute or chronic infections of the urinary tract, urolithiasis, kidney stones and ureteral stenosis [10,11]. Although considered a microorganism involved in the pathology of the urinary tract, C. urealyticum has been isolated from blood culture, endocarditis, pericarditis, osteomyelitis, wounds, and soft tissue infections [12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

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Antimicrobial Susceptibility Testing for Corynebacterium Species Isolated from Clinical Samples in Romania

Dragomirescu

Lixandru²,

Coldea³

et al. 2020

Antibiotics

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Antimicrobial resistance is one of the most important public health issues. Besides classical multidrug resistance species associated with medical care involved in superficial or invasive infections, there are strains less commonly associated with hospital or outpatient setting’s infections. Non-diphtheria Corynebacterium spp. could produce infections in patients with or without immune-compromised status. The aim of our study was to determine the susceptibility to antimicrobial agents to Corynebacterium spp. from clinical samples collected from Romanian hospitalized individuals and outpatients. Twenty Corynebacterium strains were isolated and identified as Corynebacterium striatum (n = 7), Corynebacterium amycolatum (n = 7), C. urealyticum (n = 3), Corynebacterium afermentans (n = 2), and Corynebacterium pseudodiphtheriticum (n = 1). All isolates have been tested for antibiotic susceptibility by standardized disc diffusion method and minimal inhibitory concentration (MIC) tests. Seventeen isolates demonstrated multidrug resistance phenotypes. The molecular support responsible for high resistance to quinolones for ten of these strains was determined by the detection of point mutation in the gene sequence gyrA.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Antimicrobial Susceptibility Testing for Corynebacterium Species Isolated from Clinical Samples in Romania

Dragomirescu

Lixandru²,

Coldea³

et al. 2020

Antibiotics

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“… 3 , 4 Persistence of C. jeikeium IE has been described and often requires multiple courses of vancomycin and recurrent heart valve replacements. 14 The patient in the case described had successful clearance of C. jeikeium following an aortic valve replacement combined with 6 weeks of antibiotic therapy with vancomycin.…”

Section: Discussionmentioning

confidence: 94%

Corynebacterium jeikeium native valve infective endocarditis case report: a confirmed microbiological and pathological diagnosis from heart valvular tissue

Dowling

Koen

2020

European Heart Journal - Case Reports

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Background The Modified Duke criteria is an important structured schematic for the diagnosis of infective endocarditis (IE). Corynebacterium jeikeium is a rare cause of IE that is often resistant to standard IE anti-microbials. We present a case of C. jeikeium IE, fulfilling the Modified Duke pathological criteria. Case summary A 50-year-old male presented with left leg peripheral vascular disease with septic changes requiring amputation. Routine echocardiography post-amputation demonstrated severe aortic valve regurgitation with vegetations that required valve replacement. Two initial blood cultures from a single venepuncture showed Streptococcus mitis which was treated with penicillin G prior to surgery. Subsequent aortic valve tissue cultured C. jeikeium with suggestive IE histological valvular changes and was successfully treated on a prolonged course of vancomycin. Discussion This is the first C. jeikeium IE case diagnosed on heart valvular tissue culture and highlights the importance for the fulfilment of the Modified Duke criteria in diagnosing left-sided IE. Mixed infection IE is rare, and this case possibly represents an unmasking of resistant C. jeikeium IE following initial treatment of penicillin G.

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“…However, the dormant forms of C. jeikeium used in the study that were produced as a result of the acidification of the environment proved to be resistant to both rifampicin and vancomycin (Figures 4B,C). Researchers previously demonstrated that, in some cases, vancomycin may be ineffective in the treatment of C. jeikeium bacteremia and endocarditis and disease recurrence occurred despite providing an extended course of antimicrobial therapy (Vanbosterhaut et al, 1989;Clarke et al, 2019). Wang et al (2001) "retrospectively reviewed 53 cases of C. jeikeium bacteremia in bone marrow transplant recipients who had a Hickman catheter without signs of local catheter site infection.…”

Section: Discussionmentioning

confidence: 99%

Corynebacterium jeikeium Dormant Cell Formation and Photodynamic Inactivation

2020

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Pathogenic non-spore forming bacteria enter a dormant state under stressful conditions, which likely allows them to acquire resistance to various antibiotics. This work revealed the efficient formation of dormant “non-culturable” (NC) Corynebacterium jeikeium cells in stationary phase upon gradual acidification of the growth medium. Such cells were unable to form colonies and existed in a prolonged stationary phase. At an early stage of dormancy (approximately 14 days post-inoculation), dormant cells are able for resuscitation in liquid medium. However, those stored for long time in dormant state needed addition of supernatant taking from active C. jeikeium cultures for successful resuscitation. NC cells possessed low RNA synthesis and significant tolerance to antibiotics (rifampicin and vancomycin). They also accumulated free porphyrins, and 5-aminolevulinic acid addition enhanced free porphyrin accumulation which makes them potentially sensitive to photodynamic inactivation (PDI). PDI of dormant bacteria was accomplished by exposing cells to a 565 nm wavelength of light using a SOLIS-4C light-emitting diode for 60 min. This revealed that increased porphyrin concentrations were correlated with elevated PDI sensitivity. Results shown here demonstrate the potential utility of employing PDI to minimize levels of dormant, persistent corynebacteria and the C. jeikeium dormancy model developed here may be useful for finding new drugs and techniques for combatting persistent corynebacteria.

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A case of recurrent Corynebacterium jeikeium endocarditis: Unanswered questions for the treatment of chronic endovascular infections

Cited by 10 publications

References 12 publications

Antimicrobial Susceptibility Testing for Corynebacterium Species Isolated from Clinical Samples in Romania

Antimicrobial Susceptibility Testing for Corynebacterium Species Isolated from Clinical Samples in Romania

Corynebacterium jeikeium native valve infective endocarditis case report: a confirmed microbiological and pathological diagnosis from heart valvular tissue

Corynebacterium jeikeium Dormant Cell Formation and Photodynamic Inactivation

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