Disseminated Corynebacterium jeikeium Infection in Cancer Patients

Abstract

Corynebacterium jeikeium is a multidrug-resistant gram-positive bacterium of the human skin flora and one of the most clinically important nondiphtherial corynebacteria in the acute care setting. C. jeikeium can cause different forms of infections, especially in immunocompromised patients with underlying risk factors and comorbidities. C. jeikeium was initially described in 1976 as a highly resistant coryneform bacteria causing severe sepsis in patients with hematologic malignancies and profound neutropenia. C. jeikeium infection has also been reported in the setting of endocarditis, septicemia, meningitis, pneumonia, and soft tissue infections. Management of disseminated C. jeikeium infection in immunocompromised cancer patients can be challenging due to its high virulence and rapid skin colonization. We present two cases of disseminated C. jeikeium infection in patients with acute myelogenous leukemia (AML) and underlying comorbidities. Both patients presented with neutropenic fever resistant to initial standard empiric antibiotic therapy.

Frog Skin-Derived Peptides Against Corynebacterium jeikeium: Correlation between Antibacterial and Cytotoxic Activities

“…Similar data were previously collected for viability assays performed with Esc(1-21) at the same concentrations, except for the greater cytotoxicity against macrophages at 64 µM (i.e., about 50% cell viability) [41]. Lacking the harmful effect of esculentin peptides, particularly for Esc (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18) at the antimicrobial concentrations (MIC and MBC values), suggested they are safe compounds, also for long-term treatment.…”

“…However, no studies have been conducted so far for these peptides, as well as for other AMPs, against C. jeikeium. Here, for the first time, we analyzed the effect of some frog skin AMPs against this bacterium and selected the esculentin peptides as the most active molecules with an MIC of 0.125 and 4 µM for Esc and Esc (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18), respectively. This outcome is in sharp contrast with the weaker activity of Esc(1-21) previously recorded against other Gram-positive bacteria (e.g., Staphylococcus aureus, S. epidermidis), where MICs ranging from 1 to 64 µM were found [37].…”

“…In comparison, MICs ranging from 8 to 16 µM were obtained for the other selected AMPs. Unlike temporins and bombinin H2, esculentin peptides are lysine-rich Interestingly, when the most active esculentin peptides were tested for their bactericidal activity, they were found to cause almost the complete killing of the bacterial population with an MBC (i.e., the lowest peptide concentration able to cause a ≥3 log reduction in the number of bacterial cells) 2-fold higher than the corresponding MIC, i.e., 8 µM and 0.25 µM for Esc (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18) and Esc(1-21), respectively.…”

“…Esc (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18), Esc , temporin A, temporin B, temporin G, and bombinin H 2 were purchased from Biomatik (USA/Canada). Each peptide was assembled by stepwise solid-phase synthesis and purified via reverse-phase high-performance liquid chromatography to a purity of 98% using a gradient of acetonitrile in 0.1% aqueous trifluoroacetic acid (from 28% to 100% in 30 min) at a flow rate of 1.0 mL/min.…”

“…Indeed, in these latter, due to the impaired immune system, "helpful" microorganisms belonging to the commensal flora and regularly living within the host can turn into opportunistic pathogens leading to the appearance of infections with an illness state [9][10][11][12][13]. Considering the rising enhancement of people recovering from chemotherapy treatments or with a compromised defense mechanism, the number of these nosocomial infections (encompassing endocarditis, pneumoniae, peritonitis, and enteritis) is actually extremely alarming [14,15]. The first line therapies to combat C. jeikeium-associated infections include glycopeptides vancomycin or teicoplanin.…”