Clinical relevance and impact of Corynebacterium isolation in lower respiratory tract of critically ill patients requiring mechanical ventilation

Abstract

Purpose Corynebacterium spp. (C. spp.) is commonly considered as a contaminant in respiratory specimens. No study has ever focused on its clinical relevance in the lower respiratory tract of patients admitted to the intensive care unit (ICU) and requiring mechanical ventilation. The aims were to describe the characteristics of ICU patients with a C. spp. positive deep respiratory specimen, to investigate the impact of C. spp. on the occurrence of pneumonia, and to evaluate the outcomes of these pneumonia. Methods We retrospectively included all adult patients admitted to ICU in a 1000-bed University Hospital (2007-2017) who had a C. spp. positive lower respiratory tract specimen at a significant quantitative level. We used clinical, radiological, and microbiological criteria to classify the likelihood of such pneumonia. Results Among the 31 patients included, acute respiratory failure and postoperative care after major surgery were the main reasons of admission. SAPS II was 47 [34-60]. C. spp. pneumonia was considered as probable, possible and unlikely in 10, 14, and 7 patients, respectively. Fifty-two and 94% of C. spp. strains were sensitive to amoxicillin, and vancomycin/linezolid, respectively. Seventeen patients had a complete course of antibiotic against C. spp. The overall ICU mortality was 58%. Conclusion Corynebacterium spp seems to be responsible for authentic pneumonia in mechanically ventilated patients. It should be considered as clinically relevant when predominantly present in respiratory specimen from patients suspected with pneumonia in ICU, and empirically treated.

Respiratory microbiome profiles differ by recent hospitalization and nursing home residence in patients on mechanical ventilation

“…Based on such studies, Clariot et al suggested that Corynebacterium spp. may be responsible for pneumonia in mechanically ventilated patients, similar to our results [ 33 ], while Yasuda et al reported that C. ulcerans produces diphtheria toxin and causes severe pneumonia complicated by diffuse pseudomembrane formation in the central airways [ 36 ]. Corynebacterium spp.…”

“…are among the commensal flora of the nasopharynx [32], a causative role in pneumonia was recently described [33][34][35][36]. The identification of Corynebacteria subspecies is now possible using new diagnostic technologies, such as matrix-assisted laser desorption ionization time of flight mass spectrometry and 16S rRNA gene sequencing [13,[33][34][35]37]. Based on such studies, Clariot et al suggested that Corynebacterium spp.…”

Multiresistance and endemic status of Corynebacterium striatum associated with nosocomial infections: a critical situation in Intensive Care Units and varied wards of a tertiary care hospital, Rio de Janeiro metropolitan area, Brazil

“…Impaired airway protection, decreased lung clearance, damaged lung structure, antibiotic exposure, primary immunocompromised conditions or acquired im-munodeficiency after a prolonged stay in ICU were all conditions that can be encountered in ICU, and that may promote the onset of pneumonia caused by Corynebacterium spp. 33 Nowadays, the risk of pneumonia is increased in the intubated patients receiving mechanical ventilation and the ventilator associated pneumonia nosocomial pneumonia due to mechanical ventilation procedures in mechanically ventilated patients is a matter of concern world wild, including Brazil. 34 Remarkably, current findings also indicated ventilator support as a risk factor for acquiring C. striatum infection.…”

Respiratory Microbiome Profiles Differ by Recent Hospitalization and Nursing Home Residence in Patients on Mechanical Ventilation

“…are among the commensal ora of the nasopharynx [32], a causative role in pneumonia was recently described [33][34][35][36]. The identi cation of Corynebacteria subspecies is now possible using new diagnostic technologies, such as matrix-assisted laser desorption ionization time of ight mass spectrometry and 16S rRNA gene sequencing [13,[33][34][35]37]. Based on such studies, Clariot et al suggested that Corynebacterium spp.…”