Multidrug-Resistant<i>Corynebacterium striatum</i>Associated with Increased Use of Parenteral Antimicrobial Drugs

Hahn, William O.; Werth, Brian J.; Butler-Wu, Susan M.; Rakita, Robert M.

doi:10.3201/eid2211.160141

Cited by 60 publications

(52 citation statements)

References 30 publications

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“…Corynebacterium striatum , a bacterium associated with infection and multi-drug resistance(G.J. et al, 2010; Hahn et al, 2016; Patel et al, 2016), was the most prevalent Corynebacterium spp. classified in DFU, with C. jeikeium, C. amycolatum, C. pseudogenitalium, C. tuberculostearicum , and C. resistens in lesser abundances (Fig.…”

Section: Resultsmentioning

confidence: 99%

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The microbial basis of impaired wound healing: differential roles for pathogens, “bystanders”, and strain-level diversification in clinical outcomes

Kalan

Meisel

Loesche

et al. 2018

Preprint

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22Chronic, non-healing wounds are a major complication of diabetes associated with high morbidity 23 and health care expenditures estimated at $9-13 billion annually in the US. Though microbial 24 infection and critical colonization is hypothesized to impair healing and contribute to severe 25 outcomes such as amputation, antimicrobial therapy is inefficacious and the role of microbes in 26 tissue repair, regeneration, and healing remains unclear. Here, in a longitudinal prospective 27 cohort study of 100 subjects with non-infected neuropathic diabetic foot ulcer (DFU), we 28 performed metagenomic shotgun sequencing to elucidate microbial temporal dynamics at strain-29 level resolution, to investigate pathogenicity and virulence of the DFU microbiome with respect to 30 outcomes, and to determine the influence of therapeutic intervention on the DFU microbiota. Slow 31 healing DFUs were associated with signatures of biofilm formation, host invasion, and virulence. 32Though antibiotic resistance was widespread at the genetic level, debridement, rather than 33 antibiotic treatment, significantly shifted the DFU microbiome in patients with more favorable 34 outcomes. Primary clinical isolates of S. aureus, C. striatum, and A. faecalis induced differential 35 biological responses in keratinocytes and in a murine model of diabetic wound healing, with the 36 S. aureus strain associated with non-healing wounds eliciting the most severe phenotype. 37Together these findings implicate strain-level diversification of the wound pathogen S. aureus in 38 chronic wound outcomes, while revealing potential contributions from skin commensals and other 39 previously underappreciated constituents of the wound microbiota. 40 41 42 chronic wounds 43 44 MAIN TEXT: 45 INTRODUCTION 46 Chronic, non-healing wounds are common and costly complications of diabetes. Up to one in four 47 persons with diabetes will develop a diabetic foot ulcer (DFU)(Boyko et al., 2015; Martins-Mendes 48 et al., 2014), and approximately 25% of hospital stays for patients with diabetes are due to infected 49 or ischemic DFU(Ramsey et al., 1999). Complications from DFUs account for two-thirds of all 50 non-traumatic lower extremity amputations performed in the United States(Hoffstad et al., 2015; 51 Martins-Mendes et al., 2014) and 5-year mortality rates surpass those of prostate and breast 52 cancer, among others(Armstrong et al., 2007; Moulik et al., 2003). Improved therapeutic 53 approaches are desperately needed, as morbidity, mortality, and health care expenditures only 54 continue to increase as the prevalence of diabetes escalates worldwide. 55 56 Microbial colonization, biofilm formation, and infection are hypothesized to impair healing of DFUs 57 and contribute to severe complications such as osteomyelitis and amputation. Wound infection is 58 believed to underlie up to 90% of amputations(Boulton et al., 2005); yet quantitative cultures of 59 uninfected DFUs were not predictive of outcomes(Gardner et al., 2014). Systemic and topical 60 antimicrobials are of...

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Section: Resultsmentioning

confidence: 99%

“…in DFU, detected in 28% of our specimens. Considered an emerging multi-drug resistant microbe(Hahn et al, 2016), C. striatum is an underrecognized cause of diabetic foot osteomyelitis(G.J. et al, 2010; Patel et al, 2016) suggesting it should not be classified as merely contaminating skin flora in the clinic.…”

Section: Discussionmentioning

confidence: 99%

The microbial basis of impaired wound healing: differential roles for pathogens, “bystanders”, and strain-level diversification in clinical outcomes

Kalan

Meisel

Loesche

et al. 2018

Preprint

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“…However, there are more and more articles that report hard to treat infections due to nontoxigenic strains of Corynebacterium spp. with resistance to antibiotics [6,19,22].…”

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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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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“…Usually C. striatum shows excellent susceptibility to vancomycin. Hahn WO et al reported a total of 71% (n=121) of isolates resistant to penicillin, tetracycline, clindamycin, erythromycin and ciprofloxacin [15,16]. In the first case C. striatum that we isolated was susceptible to vancomycin and linezolid.…”

Section: Discussionmentioning

confidence: 72%

“…The bacteria is notorious for causing respiratory tract infections [14]. Multi drug resistant Cornyebacterium species are rapidly emerging [15,16]. Usually C. striatum shows excellent susceptibility to vancomycin.…”

Section: Discussionmentioning

confidence: 99%

Cornyebacterium striatum : an Emerging Bug

Lalani¹,

Khan²,

Tayyab³

et al. 2017

Clin Microbiol

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The increasing prevalence of chronic infections, with frequent exposure to broad-spectrum antibiotics for repeated and prolonged hospitalizations, favors the emergence of nosocomial infection by Gram-positive bacteria, such as outbreaks of Corynebacterium striatum. Cornyebacteria are gram-positive non spore forming rods. Many species are part of the normal skin and mucosal flora of humans. The clinical significance of C. striatum has recently been established. C. striatum has recently been reported to cause a variety of infections including pneumonia, endocarditis, septic arthritis, cerebrospinal fluid infection, surgical site infections and septicemia. In this study, describing three cases of Corynebacterium striatum that are attributed to health care associated infections and presented as post-surgical wound infection and hospital acquired pneumonia. The three cases include a case of a 68 years old lady who was readmitted with fever, pain and purulent discharge from surgical wound of the lower back, a 57 years old man who was readmitted 2 months after a road traffic accident with surgical wound infection of forearm and a 25 years old man on respiratory support after a head injury with ventilator associated pneumonia.

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Multidrug-ResistantCorynebacterium striatumAssociated with Increased Use of Parenteral Antimicrobial Drugs

Abstract: Device-related infections with this pathogen frequently require prolonged parenteral therapy.

Cited by 60 publications

References 30 publications

The microbial basis of impaired wound healing: differential roles for pathogens, “bystanders”, and strain-level diversification in clinical outcomes

The microbial basis of impaired wound healing: differential roles for pathogens, “bystanders”, and strain-level diversification in clinical outcomes

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

Cornyebacterium striatum : an Emerging Bug

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