Bacteremia Caused by Multiply Resistant Corynebacterium urealyticum: Six Case Reports and Review

Fernández-Natal, Isabel; Guerra, Javier Miguel Martín; Alcoba, Manuel Luna; Cachón, F.; Soriano, Francisco

doi:10.1007/pl00011297

Cited by 26 publications

(22 citation statements)

References 8 publications

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“…In fact, nearly coincident with the first report of the genome sequence of C. glutamicum, the sequence of the very closely related Corynebacterium efficiens (Nishio et al 2003) as well as that from the well-known human pathogen Corynebacterium diphtheriae (Cerdeno-Tarraga et al 2003) were released. The genus also includes emergent pathogens, such as Corynebacterium jeikeium (Tauch et al 2005), Corynebacterium urealyticum (Fernandez-Natal et al 2001), and Corynebacterium amycolatum (Letek et al 2006a), which are frequently multi-drug resistant and cause nosocomial infections in immunosuppressed patients.…”

Section: Introductionmentioning

confidence: 99%

Cell growth and cell division in the rod-shaped actinomycete Corynebacterium glutamicum

Letek

Fiuza

Ordóñez

et al. 2008

Antonie van Leeuwenhoek

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Bacterial cell growth and cell division are highly complicated and diversified biological processes. In most rod-shaped bacteria, actin-like MreB homologues produce helicoidal structures along the cell that support elongation of the lateral cell wall. An exception to this rule is peptidoglycan synthesis in the rod-shaped actinomycete Corynebacterium glutamicum, which is MreB-independent. Instead, during cell elongation this bacterium synthesizes new cell-wall material at the cell poles whereas the lateral wall remains inert. Thus, the strategy employed by C. glutamicum to acquire a rod-shaped morphology is completely different from that of Escherichia coli or Bacillus subtilis. Cell division in C. glutamicum also differs profoundly by the apparent absence in its genome of homologues of spatial or temporal regulators of cell division, and its cell division apparatus seems to be simpler than those of other bacteria. Here we review recent advances in our knowledge of the C. glutamicum cell cycle in order to further understand this very different model of rod-shape acquisition.

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Section: Introductionmentioning

confidence: 99%

Cell growth and cell division in the rod-shaped actinomycete Corynebacterium glutamicum

Letek

Fiuza

Ordóñez

et al. 2008

Antonie van Leeuwenhoek

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“…Not only is the increase in case reports of corynebacteria involved in infections consistent with improved recognition of these bacteria, it also reflects the growing number of immunocompromised patients who are at risk for opportunistic infections. With respect to opportunistic infections associated with corynebacteria, lipophilic Corynebacterium jeikeium and Corynebacterium urealyticum are multidrug-resistant species frequently associated with bacteremia in patients with underlying hematological dyscrasia (6,7,13,18). When lipophilic multidrug-resistant corynebacteria are isolated from blood cultures, those that oxidize only glucose and are negative for urease are tentatively identified as C. jeikeium.…”

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confidence: 99%

Corynebacterium resistens sp. nov., a New Multidrug-Resistant Coryneform Bacterium Isolated from Human Infections

et al. 2005

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Five strains of an unknown, multidrug-resistant coryneform, gram-positive rod were isolated from blood, bronchial aspirate, and abscess specimens. Four of the five strains isolated were highly resistant to antimicrobial agents, including ␤-lactams, aminoglycosides, macrolides, quinolones, and tetracyclines, except for glycopeptides. In immunocompromised patients, bacteremia associated with this organism was rapidly fatal. This coryneform bacterium was nonmotile, lipophilic, and nonsaccharolytic. Lack of pyrazinamidase activity differentiated this organism from other lipophilic corynebacteria. Chemotaxonomic studies indicated that this multidrug-resistant coryneform bacterium belongs to the genus Corynebacterium. Comparative 16S rRNA gene sequencing and DNA-DNA hybridization analyses revealed that the five isolates were genetically identical and that they represent a new subline within the genus Corynebacterium, for which we propose the designation Corynebacterium resistens sp. nov. The type strain of Corynebacterium resistens is GTC 2026 T (SICGH 158 T , JCM 12819 T , CCUG 50093 T ).With the exception of Corynebacterium diphtheriae, the pathogenicity of corynebacteria has been underestimated and often underappreciated, despite an increasing number of reports associating corynebacteria with human disease (2, 7). Not only is the increase in case reports of corynebacteria involved in infections consistent with improved recognition of these bacteria, it also reflects the growing number of immunocompromised patients who are at risk for opportunistic infections. With respect to opportunistic infections associated with corynebacteria, lipophilic Corynebacterium jeikeium and Corynebacterium urealyticum are multidrug-resistant species frequently associated with bacteremia in patients with underlying hematological dyscrasia (6,7,13,18). When lipophilic multidrug-resistant corynebacteria are isolated from blood cultures, those that oxidize only glucose and are negative for urease are tentatively identified as C. jeikeium.During the management of two patients, one with acute myelocytic leukemia and one with myelodysplastic syndrome, we recovered two multidrug-resistant, lipophilic, asaccharolytic, urease-negative isolates from blood cultures. In addition, three other clinically significant, lipophilic, multidrug-resistant corynebacteria were recovered, bringing the total to five isolates resistant to antimicrobial agents at a level not previously observed. Because the isolates could not be assigned to any of the established taxa of coryneform bacteria, we studied these five strains further using a polyphasic taxonomic approach that included both phenotypic and molecular genetic methods. On the basis of the results of this investigation, we propose that our isolates represent a new Corynebacterium species, Corynebacterium resistens sp. nov. MATERIALS AND METHODSStrains and culture conditions. Strains SICGH 158 (Social Insurance Central General Hospital 158 ϭ GTC 2026) and SICGH 279 (GTC 2027) included in this study were reco...

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“…We believed that Corynebacterium species are known to be more adherent to urinary or intravascular lines than other bacteria [7] however in our case, even though C. urealyticum grew from three out of three samples of peripheral blood, cultures of the peripheral intravenous line remained sterile even after incubation was prolonged up to ten days as recommended to detect the presence of this organism [1]. Isolation of C. urealyticum from intravascular lines is a difficult task for several reasons, including its fastidious growth requirement with the need for a prolonged incubation in a selective culture medium.…”

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confidence: 74%

“…However, sepsis due to C. urealyticum is rare, with only few cases reported over the past three decades, but it remains a life-threatening condition with mortality rate up to 20% [1][2][3][4]. Very scarce information is available about infection caused by C. urealyticum acquired while in the hospital.…”

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confidence: 99%

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A case report and literature review of Corynebacterium urealyticum infection acquired in the hospital

et al. 2008

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Corynebacterium urealyticum is a Gram-positive, slowgrowing, and urea-splitting bacterium that frequently colonizes the skin and may occasionally cause a transient bacteremia [1][2][3][4]. However, sepsis due to C. urealyticum is rare, with only few cases reported over the past three decades, but it remains a life-threatening condition with mortality rate up to 20% [1][2][3][4]. Very scarce information is available about infection caused by C. urealyticum acquired while in the hospital. We analyzed the clinical features, management and outcome of one such patient.An 86-year-old man had a sudden onset of fever (40.3°C), dysuria, confusion and lethargy. He had hypertension and diabetes controlled with glyclazide and valsartan; there was no history of alcohol use or toxic habits nor was he taking other medications, including overthe-counter medications and herbal remedies. On admission, the patient appeared unwell and lethargic with a poor dental state, was dehydrated, with tachypnea (28 breaths/ min), blood pressure at 110/80 mmHg, and heart rate at 65 beats/min. Physical and neurological examination was normal except for motor function graded 3/5 throughout. A peripheral intravenous line, which was changed thereafter every fourth day, was inserted in the right arm.Laboratory analyses showed glucose 173 mg/dl (normal 60-110), creatinine 1.4 mg/dL (normal 0.4-1.2), urea 65 mg/dL (normal 10-50), leukocytes 7.4 9 10 9 cells/L (75% of which were neutrophils), and hematocrit 36.1%; amylase, lipase, electrolytes, coagulation, liver function tests, and arterial blood gas analysis were normal. Electrocardiogram revealed an atrial flutter with a 4:1 conduction and chest X-ray was normal. Urine analysis revealed trace proteins and glucose, pH was 5.5 and gravity 1017; microscopic examination showed 50 erythrocytes, 500 leukocytes, and 1074 bacteria per high-power field.After blood and urine samples were taken for culture, the patient was started on intravenous fluids, regular insulin, ciprofloxacin (200 mg i.v. twice daily), enoxaparin (50 IU/kg daily), and on the 5th day of hospital stay he was stable, alert and oriented but still pyrexial; at this time glucose, electrolytes, liver and renal function tests, and hematological variables were all within the normal range. On the 6th day, pyrexia settled and Pseudomonas aeruginosa, which was fully sensitive to amikacin and piperacillin and resistant to cephalosporins, quinolones, and carbapenems, grew from urine samples collected at admission; blood cultures remained sterile. Amikacin (15 mg/kg i.m. daily) and piperacillin/tazobactam (4.5 g i.v. three times daily) were administered in place of ciprofloxacin with a full clinical response; repeated urine and blood cultures grew no pathogens on the 13th day. Antibiotics were stopped while intravenous fluids were continued; an abdominal ultrasonography was unrevealing except for a moderate prostate enlargement, and a transthoracic echocardiography showed a mild left atrial enlargement with concentric left ventricular hypertrophy and...

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Bacteremia Caused by Multiply Resistant Corynebacterium urealyticum: Six Case Reports and Review

Cited by 26 publications

References 8 publications

Cell growth and cell division in the rod-shaped actinomycete Corynebacterium glutamicum

Cell growth and cell division in the rod-shaped actinomycete Corynebacterium glutamicum

Corynebacterium resistens sp. nov., a New Multidrug-Resistant Coryneform Bacterium Isolated from Human Infections

A case report and literature review of Corynebacterium urealyticum infection acquired in the hospital

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