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Yamazaki R, Nishiyama O, Yosikawa K, Gose K, Oomori T, Nishikawa Y, Sano A, Matsumoto H. Incidence, etiology, and outcome of hospital-acquired pneumonia in patients with acute exacerbation of fibrotic idiopathic interstitial pneumonia. Respir Investig 2024; 62:488-493. [PMID: 38579411 DOI: 10.1016/j.resinv.2024.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 03/07/2024] [Accepted: 03/15/2024] [Indexed: 04/07/2024]
Abstract
BACKGROUND Acute exacerbations (AEs) of fibrotic idiopathic interstitial pneumonia (fIIP) that require hospitalization occur in some patients. During hospitalization, these patients can develop hospital-acquired pneumonia (HAP), a common hospital-acquired infection with a high mortality rate. However, the characteristics of HAP in AE-fIIP remain unknown. The purpose of this study was to determine the incidence, causative pathogens, and outcomes of HAP in patients with AE-fIIP. METHODS The medical records of consecutive patients who were hospitalized with AE-fIIP from January 2008 to December 2019 were analyzed for the incidence, causative pathogen, and survival of HAP. The records of patients with an obvious infection-triggered AE were excluded from analysis. RESULTS There were 128 patients with AE-fIIP (89 with idiopathic pulmonary fibrosis [IPF] and 39 with non-IPF fIIP) who were hospitalized a total of 155 times (111 with IPF and 44 with non-IPF fIIP). HAP occurred in 49 patients (40 with IPF and 9 with non-IPF fIIP). The incidence and the in-hospital mortality rates of HAP in patients with AE-fIIP were high, at 32.2% and 48.9%, respectively. Corynebacterium spp. was the most common causative pathogen, which was followed by human cytomegalovirus (HCMV). CONCLUSIONS The incidence and the in-hospital mortality rates of HAP in patients with AE-fIIP are high. To improve their survival, patients with fIIP who had AEs and HAP should receive prompt empirical treatment for possible infections with Corynebacterium spp. and testing for HCMV.
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Affiliation(s)
- Ryo Yamazaki
- Department of Respiratory Medicine and Allergology, Kindai University Faculty of Medicine, Osakasayama, Osaka, 589-8511, Japan
| | - Osamu Nishiyama
- Department of Respiratory Medicine and Allergology, Kindai University Faculty of Medicine, Osakasayama, Osaka, 589-8511, Japan.
| | - Kazuya Yosikawa
- Department of Respiratory Medicine and Allergology, Kindai University Faculty of Medicine, Osakasayama, Osaka, 589-8511, Japan
| | - Kyuya Gose
- Department of Respiratory Medicine and Allergology, Kindai University Faculty of Medicine, Osakasayama, Osaka, 589-8511, Japan
| | - Takashi Oomori
- Department of Respiratory Medicine and Allergology, Kindai University Faculty of Medicine, Osakasayama, Osaka, 589-8511, Japan
| | - Yusaku Nishikawa
- Department of Respiratory Medicine and Allergology, Kindai University Faculty of Medicine, Osakasayama, Osaka, 589-8511, Japan
| | - Akiko Sano
- Department of Respiratory Medicine and Allergology, Kindai University Faculty of Medicine, Osakasayama, Osaka, 589-8511, Japan
| | - Hisako Matsumoto
- Department of Respiratory Medicine and Allergology, Kindai University Faculty of Medicine, Osakasayama, Osaka, 589-8511, Japan
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Mangutov EO, Alieva AA, Kharseeva GG, Voronina NA, Alekseeva LP, Evdokimova VV, Yakusheva OA, Popivnenko MD. Corynebacterium spp.: relationship of pathogenic properties and antimicrobial resistance. Klin Lab Diagn 2022; 67:519-524. [PMID: 36099461 DOI: 10.51620/0869-2084-2022-67-9-519-524] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Corynebacterium spp. are part of the human microbiome, but can cause the development of inflammatory diseases of various localization. Purpose - to evaluate the relationship between pathogenic properties and resistance to antimicrobial drugs (AMD) of Corynebacterium spp. from patients with inflammatory diseases of the respiratory tract. Strains of Corynebacterium spp. isolated from patients with inflammatory diseases of the respiratory tract (99 pcs.) and practically healthy individuals (33 pcs.). Isolates were identified by mass spectrometric method (MALDI-ToFMS), their adhesive and invasive activity on Hep-2 cells, cytopathic effect (CPE) in CHO-K1 cell culture, and resistance to antimicrobial drugs (AMD) were determined. Indicators of adhesion (3.65±0.679(CFU±m)x102/ml), invasion (1.72±0.230 (CFU±m)x102/ml), cytotoxicity (69.1±3.8% of dead CHO-K1 cells ) Corynebasterium spp. strains isolated from patients are higher (p≤0.05) than similar indicators in practically healthy people. 90.9% of isolates from patients had resistance to AMD, in most cases (57.6±4.9%) resistance to only one AMP was noted, less often to two (25.2±4.3%), three or more (8.08±2.7%). According to the results of correlation-regression analysis, pathogenic properties (adhesiveness, invasiveness, cytotoxicity) of Corynebacterium spp. strains isolated from patients are in close direct relationship with resistance to AMD. This indicates the importance of identifying strains of non-diphtheria corynebacteria resistant to AMDs, which, under the influence of developing resistance to AMDs, can increase their pathogenic potential, moving from commensalism to parasitism.
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Affiliation(s)
- E O Mangutov
- Federal State Educational Institution of Higher Education «Rostov State Medical University» Ministry of Health of Russia
| | - A A Alieva
- Federal State Educational Institution of Higher Education «Rostov State Medical University» Ministry of Health of Russia
| | - Galina Georgievna Kharseeva
- Federal State Educational Institution of Higher Education «Rostov State Medical University» Ministry of Health of Russia
| | - N A Voronina
- Federal State Educational Institution of Higher Education «Rostov State Medical University» Ministry of Health of Russia
| | | | | | | | - M D Popivnenko
- Federal State Educational Institution of Higher Education «Rostov State Medical University» Ministry of Health of Russia
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Kharseeva GG, Mangutov EO, Alutina EL, But OM, Pakhomova AE. Etiological significance of Corynebacterium spp. in the development of diseases of the respiratory tract. Klin Lab Diagn 2021; 66:673-677. [PMID: 34882352 DOI: 10.51620/0869-2084-2021-66-11-673-677] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Corynebacterium spp. It is associated with inflammatory diseases of the respiratory tract (tracheitis, pharyngitis, rhinosinusitis, bronchitis, pneumonia, etc.). C. pseudodiphtheriticum can be the causative agent of bacterial coinfection in patients with a new coronavirus infection (COVID-19). The aim is to determine the pathogenic properties and resistance to antimicrobial drugs of Corynebacterium spp. strains to establish their etiological significance in the development of inflammatory diseases of the respiratory tract. Strains of Corynebacterium spp. isolated from patients with inflammatory diseases of the respiratory tract (43 pcs.) and practically healthy individuals (29 pcs.). Isolates were identified by mass spectrometric method (MALDI-TOF MS), their cytopathic effect in CHO-K1 cell culture, hemolytic, urease activity, antimicrobial drug resistance were determined. Strains of Corynebacterium spp. isolated from patients in the amount of 105 CFU/ml or more, practically healthy - 104 CFU/ml or less. Isolates of Corynebacterium spp. patients had a more pronounced cytopathic effect (83.7±11.1%) and were more often resistant to antimicrobial drugs than those isolated from practically healthy. To establish the etiological significance of Corynebacterium spp. isolates. in the development of inflammatory diseases of the respiratory tract, it is advisable to determine their amount in biological material (105 CFU/ml or more), the cytopathic effect on CHO-K1 cell culture, as well as the presence of multiple resistance to antimicrobial drugs. Differences in the characteristics of Corynebacterium spp. isolates. from patients with respiratory tract pathology and practically healthy individuals are associated with the strain, not the species, of corynebacteria.
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Affiliation(s)
- Galina G Kharseeva
- Federal State Educational Institution of Higher Education «Rostov State Medical University» Ministry of Health of Russia
| | - E O Mangutov
- Federal State Educational Institution of Higher Education «Rostov State Medical University» Ministry of Health of Russia
| | - E L Alutina
- Federal State Educational Institution of Higher Education «Rostov State Medical University» Ministry of Health of Russia
| | - O M But
- Municipal budgetary health care institution, «City hospital № 20 of Rostov-on-Don»
| | - A E Pakhomova
- Federal State Educational Institution of Higher Education «Rostov State Medical University» Ministry of Health of Russia
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Ogawa Y, Ote H, Arai T, Kazama R, Kimura K, Nagata T, Kumasawa J, Kohno M, Kohata H, Nishida K, Gohma I, Kasahara K. Corynebacterium pseudodiphtheriticum as a pathogen in bacterial co-infection in COVID-19 patients with mechanical ventilation. Jpn J Infect Dis 2021; 75:202-204. [PMID: 34470958 DOI: 10.7883/yoken.jjid.2021.481] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Many studies have been conducted on ventilator-associated complications (VACs) in COVID-19 patients. However, in these studies, the causative organisms were similar, and there are no reports on VAC corresponding with Corynebacteria. Coryneforms are frequently cultured in polymicrobial infections and are usually considered contaminants in respiratory specimens. However today, Corynebacterium pseudodiphtheriticum or striatum is known to be a pathogen in lower respiratory tract infection. We report three cases of VAC probably due to Corynebacterium pseudodiphtheriticum in COVID-19 patients. If purulent lower respiratory specimens showed coryneform predominantly via Gram staining, empirical therapy should be started. Furthermore, species identification and drug susceptibility testing should be performed.
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Affiliation(s)
- Yoshihiko Ogawa
- Department of Infectious Disease, Sakai City Medical Center, Japan.,COVID-19 treatment team, Sakai City Medical Center, Japan
| | - Hiroyuki Ote
- COVID-19 treatment team, Sakai City Medical Center, Japan
| | - Tatsuya Arai
- COVID-19 treatment team, Sakai City Medical Center, Japan
| | - Ryo Kazama
- COVID-19 treatment team, Sakai City Medical Center, Japan
| | - Kazuhide Kimura
- Department of Critical Care Medicine, Sakai City Medical Center, Japan
| | - Toshihiko Nagata
- Department of Critical Care Medicine, Sakai City Medical Center, Japan
| | - Junji Kumasawa
- Department of Critical Care Medicine, Sakai City Medical Center, Japan
| | - Michihiko Kohno
- Department of Critical Care Medicine, Sakai City Medical Center, Japan
| | - Hisakazu Kohata
- Department of Critical Care Medicine, Sakai City Medical Center, Japan
| | - Koji Nishida
- COVID-19 treatment team, Sakai City Medical Center, Japan
| | - Iwao Gohma
- COVID-19 treatment team, Sakai City Medical Center, Japan
| | - Kei Kasahara
- Department of Infectious Diseases, Nara Medical University, Japan
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Mangutov EO, Kharseeva GG, Alutina EL. Corynebacterium spp. - problematic pathogens of the human respiratory tract (review of literature). Klin Lab Diagn 2021; 66:502-508. [PMID: 34388322 DOI: 10.51620/0869-2084-2021-66-8-502-508] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Corynebacterium spp. - representatives of the normal microflora of the human body, but their role in the development of diseases in both immunocompromised and immunocompetent patients is known. Corynebacterim spp. (C. pseudodiphtheriticum, C. striatum, C. amycolatum, C. accolens, C. argentoratense, etc.) is associated with diseases of the respiratory tract: tracheitis, pharyngitis, rhinosinusitis, bronchitis, etc. They can be transmitted by airborne droplets, household contact, and possibly by hematogenic pathways. Corynebacterim spp. toxins do not produce, but are capable of adhesion and invasion, biofilm formation, production of neuraminidase, hyaluronidase, and hemolysin. It is necessary to take into account not so much the species, but the strain affiliation of isolates of Corynebacterium spp., since among the representatives of one species of non-diphtheria corynebacteria (for example, C. pseudodiphtheriticum), colonizing the respiratory tract, there may be strains that can exhibit not only pathogenic properties, but also probiotic activity. Microbiological diagnostics is based on their quantitative determination in biological material, phenotypic (culture study, test systems for biochemical identification, Vitek 2 automated systems) and genotypic (16SpRNA gene sequencing and rpoB) methods. It is possible to use mass spectrometric analysis (MALDI-ToF-MS). The greatest activity against Corynebacterium spp. in vitro studies preserve vancomycin, teicoplanin, and linezolid. Successful therapy with at least two of the following antimicrobial agents (AMP) has been reported: vancomycin, rifampicin, linezolid, and daptomycin. The sensitivity of isolates of Corynebacterium spp. to AMP is not related to the species, but is due to strain differences, and therefore it is necessary to test each isolated strain. Continuous monitoring of the sensitivity of Corynebacterium spp. strains to AMP is necessary due to the observed variability of these traits. Of particular importance is the identification of multidrug-resistant isolates that are currently considered highly pathogenic. When compiling the review, the databases Scopus, Web of Science, The Cochrane Library, CyberLeninka, RSCI were used.
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Affiliation(s)
- E O Mangutov
- Federal State Educational Institution of Higher Education «Rostov State Medical University» Ministry of Health of Russia
| | - Galina Georgievna Kharseeva
- Federal State Educational Institution of Higher Education «Rostov State Medical University» Ministry of Health of Russia
| | - E L Alutina
- Federal State Educational Institution of Higher Education «Rostov State Medical University» Ministry of Health of Russia
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Baek MG, Woo SJ, Kim NE, Baek C, Won S, Kim Y, Lee JJ, Yi H, Hong JY. Respiratory microbiome profiles differ by recent hospitalization and nursing home residence in patients on mechanical ventilation. J Transl Med 2020; 18:464. [PMID: 33287847 PMCID: PMC7720271 DOI: 10.1186/s12967-020-02642-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 11/27/2020] [Indexed: 02/08/2023] Open
Abstract
Background Healthcare-associated pneumonia (HCAP) is a heterogeneous disease. We redefined nursing-home- and hospital-associated infections (NHAI) group by revising existing HCAP risk factors. The NHAI group comprised nursing home residents with a poor functional status, or recent (past 90 days) hospitalization or recent (past 180 days) antibiotic therapy. Our aim was to determine whether respiratory microbiota profiles are related to newly defined NHAI group in critically ill patients on mechanical ventilation. Methods The 180 endotracheal aspirates (ETAs) from 60 mechanically ventilated ICU patients (NHAI group, n = 24; non-NHAI group, n = 36) were prospectively collected on days 1, 3 and 7 in a university hospital. The bacterial community profiles of the ETAs were explored by 16S rRNA gene sequencing. A phylogenetic-tree-based microbiome association test (TMAT), generalized linear mixed models (GLMMs), the Wilcoxon test and the reference frame method were used to analyze the association between microbiome abundance and disease phenotype. Results The relative abundance of the genus Corynebacterium was significantly higher in the pneumonia than in the non-pneumonia group. The microbiome analysis revealed significantly lower α-diversity in the NHAI group than in the non-NHAI group. In the analysis of β-diversity, the structure of the microbiome also differed significantly between the two groups (weighted UniFrac distance, Adonis, p < 0.001). The abundance of Corynebacterium was significantly higher, and the relative abundances of Granulicatella, Staphylococcus, Streptococcus and Veillonella were significantly lower, in the NHAI group than in the non-NHAI group. Conclusions The microbiota signature of the ETAs distinguished between patients with and without risk factors for NHAI. The lung microbiome may serve as a therapeutic target for NHAI group.
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Affiliation(s)
- Min-Gyung Baek
- Department of Public Health, Korea University, Seoul, Republic of Korea
| | - Seong Ji Woo
- Institute of New Frontier Research, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Nam Eun Kim
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Chaeyun Baek
- Department of Public Health, Korea University, Seoul, Republic of Korea
| | - Sungho Won
- Institute of Health and Environment, Seoul National University, Seoul, Republic of Korea.,Interdisciplinary Program of Bioinformatics, Seoul National University, Seoul, Republic of Korea
| | - Youngmi Kim
- Institute of New Frontier Research, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Jae Jun Lee
- Institute of New Frontier Research, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Hana Yi
- School of Biosystems and Biomedical Sciences, College of Health Science, Korea University, Seoul, Republic of Korea.
| | - Ji Young Hong
- Institute of New Frontier Research, Hallym University College of Medicine, Chuncheon, Republic of Korea. .,Division of Pulmonary and Critical Care Medicine, Department of Medicine, Chuncheon Sacred Heart Hospital, Hallym University Medical Center, 77, Sakju-ro, Chuncheon-si, Gangwon-do, 200-704, Republic of Korea.
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7
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Nagasawa R, Hara Y, Miyazaki T, Murohashi K, Watanabe H, Kaneko T. An autopsy case of ventilator-associated tracheobronchitis caused by Corynebacterium species complicated with diffuse alveolar damage. Respir Med Case Rep 2020; 31:101208. [PMID: 32944501 PMCID: PMC7481557 DOI: 10.1016/j.rmcr.2020.101208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 08/25/2020] [Indexed: 11/30/2022] Open
Abstract
Ventilator-associated tracheobronchitis (VAT) has been reported to occur in 11% of intubated patients. Corynebacterium spp. can cause lower respiratory infections; however, to our knowledge, there have been no reported cases of VAT caused by Corynebacterium spp. A 55-year-old man was hospitalized with acute respiratory failure after autologous peripheral blood stem cell transplantation for Hodgkin lymphoma. Chest computed tomography showed diffuse ground-glass opacities in both lung fields. A few days after tracheal intubation, steroid pulse, and antibacterial drugs, the patient's pulmonary involvement temporarily improved. However, these opacities rapidly deteriorated, leading to death about 2 weeks after hospitalization. No significant bacteria other than Corynebacterium spp. were detected in sputum cultures during treatment and in blood culture at autopsy. Histological findings revealed tracheitis and diffuse alveolar damage. According to these findings, we diagnosed the patient as having VAT caused by Corynebacterium spp. This report suggests that Corynebacterium spp. might be an important causative pathogen of VAT in immunodeficient patients who undergo tracheal intubation. Additionally, optimal treatment for Corynebacterium spp. must be determined.
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Affiliation(s)
- Ryo Nagasawa
- Department of Pulmonology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Yu Hara
- Department of Pulmonology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Takuya Miyazaki
- Department of Hematology and Clinical Immunology, Yokohama City University School of Medicine, Yokohama, Japan
| | - Kota Murohashi
- Department of Pulmonology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Hiroki Watanabe
- Department of Pulmonology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Takeshi Kaneko
- Department of Pulmonology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
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