Molecular evidence of person-to-person transmission of a pigmented strain of Corynebacterium striatum in intensive care units

Leonard, Rebecca; Nowowiejski, D J; Warren, Jeffrey J.; Finn, Dennis; Coyle, Marie B.

doi:10.1128/jcm.32.1.164-169.1994

Cited by 69 publications

(48 citation statements)

References 26 publications

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“…Until recently, C. striatum rarely has been reported as a cause of human disease. The organism has been described as causing respiratory disease (4,6,8,11,19,23,25), but it has also been isolated in cases of endocarditis, septicemia, osteomyelitis, infections of central lines, ulcers and wounds, and eye infections (11,21,31). In our hospital, C. striatum was the coryneform bacterium most frequently isolated from clinical samples during the period from 1990 to 1993 (21a).…”

Section: Discussionmentioning

confidence: 90%

“…In a separate study (22), we found that C. striatum was the causative agent in a case of fatal pulmonary disease in a young, previously healthy man who was hospitalized in the intensive care unit at HUS. Leonard et al had also reported (19) person-toperson transmission of a pigmented strain of C. striatum in intensive care units.…”

Section: Discussionmentioning

confidence: 97%

“…Previously, there have been several case reports (4,6,8,11,19,21,23), and two series (25,31) have been described, whereby three and six cases, respectively, of C. striatum infections were reported. Personto-person transmission of C. striatum in intensive care units has also been described, but limited information on the clinical charts of these patients was presented (19). In this report, we describe the microbiological identification and susceptibility testing of 31 C. striatum strains isolated from clinical samples of 24 patients.…”

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confidence: 99%

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Phenotypic characteristics of 31 strains of Corynebacterium striatum isolated from clinical samples

et al. 1995

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31 Corynebacterium striatum strains recovered from clinical samples from 24 patients were characterized. Twenty (64%) strains were isolated from wound exudates, 5 (16%) were isolated from bronchial aspirates, 2 (7%) were isolated from urine, 2 (7%) were isolated from endotracheal tubes, 1 (3%) was isolated from a catheter, and 1 (3%) was isolated from empyema. The organisms were identified by conventional culture and phenotypic characterization, the API CORYNE system, and cellular fatty acid composition analyses. The colonies of C. striatum could be confused with those of coagulase-negative staphylococci upon primary isolation from clinical material. A consistent phenotypic pattern was observed: all strains reduced nitrate, hydrolyzed tyrosine, and produced acid from glucose, fructose, and sucrose but not from maltose. API CORYNE profile numbers were 3100105 (28 strains) and 3000105 (3 strains). Susceptibility testing of C. striatum was performed by disk diffusion. All strains were susceptible to both imipenem and vancomycin and resistant to fosfomycin; most strains were susceptible to ampicillin and cephalosporins and resistant to clindamycin, erythromycin, and tetracycline. Performing a Gram stain of fosfomycin-resistant ''Staphylococcus-like'' colonies was critical in order to identify C. striatum.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 97%

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confidence: 99%

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Phenotypic characteristics of 31 strains of Corynebacterium striatum isolated from clinical samples

et al. 1995

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“…following repeated exposure to broad-spectrum antibiotics, after the use of invasive medical procedures and in the presence of organic obstructive pathologies) [3][4][5]. Most reported C. striatum infections involved the respiratory tract and several outbreaks of nosocomial infections have been described [6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Epidemiological investigation of a nosocomial outbreak of multidrug-resistant Corynebacterium striatum at one Belgian university hospital

Verroken

Bauraing

Deplano

et al. 2014

Clinical Microbiology and Infection

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During an 8-month period, 24 Corynebacterium striatum isolates recovered from lower respiratory tract specimens of 10 hospitalized patients were characterized. The organisms were identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) and by 16S rRNA gene sequencing. The cluster of C. striatum exclusively affected patients who had been admitted to an intensive care unit and/or subsequently transferred to one medium-size respiratory care unit. Prolonged duration of hospitalization, advanced stage of chronic obstructive pulmonary disease, recent administration of antibiotics and exposure to an invasive diagnostic procedure were the most commonly found risk factors in these patients. Seven patients were colonized and three infected. All strains displayed a similar broad spectrum resistance to antimicrobial agents, remaining susceptible to vancomycin only. Typing analysis by MALDI-TOF MS and by semi-automated repetitive sequence-based PCR (DiversiLab typing) showed that all outbreak-associated C. striatum isolates clustered together in one single type while they differed markedly from epidemiologically unrelated C. striatum isolates. Pulsed-field gel electrophoresis (PFGE) profiles revealed three distinct PFGE types among the C. striatum isolates associated with the outbreak while all external strains except one belonged to a distinct type. We conclude that C. striatum is an opportunistic nosocomial pathogen in long-term hospitalized patients and can be at the origin of major outbreaks. The routine use of MALDI-TOF MS greatly facilitated the recognition/identification of this organism in clinical samples and this technique could also offer the potential to be used as an easy and rapid epidemiological typing tool for outbreak investigation.

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“…Transplant Infectious Disease 2003: 5: 53±58 and the clinical improvement coincided with the initiation of vancomycin/ rifampin therapy.It has been suggested(1,8) that the selective pressure exerted by prior antimicrobial treatment (particularly with b-lactams) might allow overgrowth of C. striatum as a ªsecondary colonizerº in immunosuppressed hosts. There are seven other well-documented reports of pneumonia or empyema in which C. striatum was isolated as a single organism (2, 9±13).…”

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Multidrug‐resistant Corynebacterium striatum pneumonia in a heart transplant recipient

Tarr

Stock

Cooke

et al. 2003

Transplant Infectious Dis

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Corynebacterium striatum is a rare, but likely underreported, cause of serious infections in immunocompromised hosts and generally is susceptible to multiple classes of antimicrobial agents. Here we report the first case of C. striatum infection in a solid organ transplant recipient. Three years after heart transplantation, a 58-year-old man developed bilateral pneumonia and pulmonary embolism. He did not improve with levofloxacin, piperacillin/tazobactam, and heparin treatment. A homogeneous population of abundant gram-positive rods was repeatedly demonstrated in sputum and bronchoalveolar lavage fluid, and C. striatum was grown in pure culture. The isolate was unusual for its multidrug-resistant (MDR) antimicrobial susceptibility pattern. The pneumonia resolved with 4 weeks of vancomycin therapy, in combination with rifampin given only during the first 2 weeks of treatment. The isolation of coryneforms ("diphtheroids") is often attributed to contamination. Their abundant presence on direct examination of specimens and/or their growth in pure culture suggest a pathogenic role, however, and indicate the need for accurate microbiological identification, particularly in immunocompromised hosts who have been hospitalized and previously treated with antibiotics. Combination therapy that includes vancomycin may be the most prudent treatment for MDR C. striatum infections.

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Molecular evidence of person-to-person transmission of a pigmented strain of Corynebacterium striatum in intensive care units

Cited by 69 publications

References 26 publications

Phenotypic characteristics of 31 strains of Corynebacterium striatum isolated from clinical samples

Phenotypic characteristics of 31 strains of Corynebacterium striatum isolated from clinical samples

Epidemiological investigation of a nosocomial outbreak of multidrug-resistant Corynebacterium striatum at one Belgian university hospital

Multidrug‐resistant Corynebacterium striatum pneumonia in a heart transplant recipient

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