1
|
Xia Q, Gu M, Xu Y, Sang H, Lin W, Wang Y, Liu K. Unmasking the invisible enemy: A case report of metagenomics-guided diagnosis and treatment of neonatal septic meningitis caused by Corynebacterium aurimucosum in a preterm infant with neonatal lupus erythematosus. Medicine (Baltimore) 2024; 103:e35968. [PMID: 38363904 PMCID: PMC10869058 DOI: 10.1097/md.0000000000035968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 10/16/2023] [Indexed: 02/18/2024] Open
Abstract
RATIONALE Neonatal septic meningitis is a serious condition that can be caused by various pathogens, including Corynebacterium aurimucosum, a rare and opportunistic bacterium. We reports a case of infectious meningitis in a premature infant with neonatal lupus erythematosus caused by C aurimucosum. The purpose of this study is to explore the occurrence of meningitis caused by C aurimucosum in preterm infants with neonatal lupus erythematosus. We found that early diagnosis and treatment are crucial for this type of meningitis, especially for infants with impaired immunity or mothers receiving immunosuppressive therapy. This bacterium is rare in clinical practice, but it needs to be taken seriously. PATIENT CONCERNS The infant was born to a mother with systemic lupus erythematosus who had a history of long-term immunosuppressive therapy. The infant presented with preterm birth, purplish-red skin, fever, and widespread scarlet dermatitis. He also had positive anti-Ro/SSA and anti-La/SSB antibodies. DIAGNOSIS The infant was diagnosed with neonatal lupus erythematosus based on clinical and serological features. A lumbar puncture revealed septic meningitis with high levels of total nucleated cells, protein, and Pan's test in the CSF. The macrogenic examination identified C aurimucosum as the causative agent. The culture of the mother's vaginal secretion also revealed the same bacterium. INTERVENTIONS The infant was treated with anti-infective therapy with ceftriaxone, ampicillin, vancomycin, and meropenem. He also received prednisone and gammaglobulin infusion for neonatal lupus erythematosus. OUTCOMES The infant's temperature returned to normal, and his general condition and responsiveness improved. The CSF cytology and biochemistry normalized, and the culture was negative. The cranial MRI examination showed no abnormalities. The red rash disappeared, and the follow-ups after discharge revealed no complications. LESSONS This case highlights the importance of early diagnosis and treatment of neonatal septic meningitis caused by C aurimucosum, especially in infants with immunocompromised conditions or maternal history of immunosuppressive therapy. C aurimucosum should not be overlooked as a potential pathogen in neonatal septic meningitis.
Collapse
Affiliation(s)
- Qing Xia
- Kunming Children’s Hospital, Pulmonary and Critical Care Medicine, Kunming, China
- The Affiliated Hospital of Kunming University of Science and Technology, The First People’s Hospital of Yunnan Province, Kunming, PR China
| | - Meiqun Gu
- The Affiliated Hospital of Kunming University of Science and Technology, The First People’s Hospital of Yunnan Province, Kunming, PR China
| | - Yu Xu
- The Affiliated Hospital of Kunming University of Science and Technology, The First People’s Hospital of Yunnan Province, Kunming, PR China
| | - Haoke Sang
- The Affiliated Hospital of Kunming University of Science and Technology, The First People’s Hospital of Yunnan Province, Kunming, PR China
| | - Wenhua Lin
- Chinese People’s Liberation Army Logistic Support Army No. 920 Hospital, Kunming, China
| | - Yajun Wang
- The Affiliated Hospital of Kunming University of Science and Technology, The First People’s Hospital of Yunnan Province, Kunming, PR China
| | - Kai Liu
- Kunming Children’s Hospital, Pulmonary and Critical Care Medicine, Kunming, China
| |
Collapse
|
2
|
He Y, Geng S, Mei Q, Zhang L, Yang T, Zhu C, Fan X, Wang Y, Tong F, Gao Y, Fang X, Bao R, Sheng X, Pan A. Diagnostic Value and Clinical Application of Metagenomic Next-Generation Sequencing for Infections in Critically Ill Patients. Infect Drug Resist 2023; 16:6309-6322. [PMID: 37780531 PMCID: PMC10541086 DOI: 10.2147/idr.s424802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 09/14/2023] [Indexed: 10/03/2023] Open
Abstract
Objective To evaluate the diagnostic value and clinical application of metagenomic next-generation sequencing (mNGS) for infections in critically ill patients. Methods Comparison of diagnostic performance of mNGS and conventional microbiological testing for pathogens was analyzed in 234 patients. The differences between immunocompetent and immunocompromised individuals in mNGS-guided anti-infective treatment adjustment were also analyzed. Results The sensitivity and specificity of mNGS for bacterial and fungal detection were 96.6% (95% confidence interval [CI], 93.5%-99.6%) and 83.1% (95% CI, 75.2%-91.1%), and 85.7% (95% CI, 71.9%-99.5%) and 93.2% (95% CI, 89.7%-96.7%), respectively. Overall, 152 viruses were detected by mNGS, but in which 28 viruses were considered causative agents. The proportion of mNGS-guided beneficial anti-infective therapy adjustments in the immunocompromised group was greater than in the immunocompetent group (48.5% vs 30.1%; P=0.008). In addition, mNGS-guided anti-infective regimens with peripheral blood and BALF specimens had the highest proportion (39.0%; 40.0%), but the proportion of patients not helpful due to peripheral blood mNGS was also as high as 22.0%. Conclusion mNGS might be a promising technology to provide precision medicine for critically ill patients with infection.
Collapse
Affiliation(s)
- Yuxi He
- Department of Intensive Care Unit, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, People’s Republic of China
| | - Shike Geng
- Department of Intensive Care Unit, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, People’s Republic of China
| | - Qing Mei
- Department of Intensive Care Unit, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, People’s Republic of China
| | - Lei Zhang
- Department of Intensive Care Unit, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, People’s Republic of China
| | - Tianjun Yang
- Department of Intensive Care Unit, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, People’s Republic of China
| | - Chunyan Zhu
- Department of Intensive Care Unit, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, People’s Republic of China
| | - Xiaoqin Fan
- Department of Intensive Care Unit, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, People’s Republic of China
| | - Yinzhong Wang
- Department of Intensive Care Unit, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, People’s Republic of China
| | - Fei Tong
- Department of Intensive Care Unit, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, People’s Republic of China
| | - Yu Gao
- Department of Intensive Care Unit, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, People’s Republic of China
| | - Xiaowei Fang
- Department of Intensive Care Unit, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, People’s Republic of China
| | - Renren Bao
- Department of Intensive Care Unit, the Affiliated Provincial Hospital of Anhui Medical University, Hefei, Anhui, People’s Republic of China
| | - Ximei Sheng
- Department of Intensive Care Unit, the Training Center of Anhui Provincial Hospital, Wannan Medical College, Wuhu, Anhui, People’s Republic of China
| | - Aijun Pan
- Department of Intensive Care Unit, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, People’s Republic of China
- Department of Intensive Care Unit, the Affiliated Provincial Hospital of Anhui Medical University, Hefei, Anhui, People’s Republic of China
- Department of Intensive Care Unit, the Training Center of Anhui Provincial Hospital, Wannan Medical College, Wuhu, Anhui, People’s Republic of China
| |
Collapse
|
3
|
Li Y, Rong J, Gao C. Phylogenetic analyses of antimicrobial resistant Corynebacterium striatum strains isolated from a nosocomial outbreak in a tertiary hospital in China. Antonie Van Leeuwenhoek 2023:10.1007/s10482-023-01855-8. [PMID: 37368178 PMCID: PMC10371919 DOI: 10.1007/s10482-023-01855-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 06/19/2023] [Indexed: 06/28/2023]
Abstract
Corynebacterium striatum is an emerging, multidrug-resistant pathogen that frequently causes nosocomial infections worldwide. This study aimed to investigate phylogenetic relationship and presence of genes responsible for antimicrobial resistance among C. striatum strains associated with an outbreak at the Shanxi Bethune Hospital, China, in 2021. Fecal samples were collected from 65 patients with C. striatum infection at Shanxi Bethune Hospital between February 12, 2021 and April 12, 2021. C. striatum isolates were identified by 16S rRNA and rpoB gene sequencing. E-test strips were used to examine the antimicrobial susceptibility of the isolates. Whole-genome sequencing and bioinformatics analysis were employed to assess the genomic features and identify antimicrobial resistance genes of the isolates. Crystal violet staining was conducted to determine the ability of biofilm formation of each isolate. A total of 64 C. striatum isolates were identified and categorized into 4 clades based on single nucleotide polymorphisms. All isolates were resistant to penicillin, meropenem, ceftriaxone, and ciprofloxacin but susceptible to vancomycin and linezolid. Most isolates were also resistant to tetracycline, clindamycin, and erythromycin, with susceptibility rates of 10.77, 4.62, and 7.69%, respectively. Genomic analysis revealed 14 antimicrobial resistance genes in the isolates, including tetW, ermX, and sul1. Crystal violet staining showed that all isolates formed biofilms on the abiotic surface. Four clades of multidrug-resistant C. striatum spread in our hospitals possibly due to the acquisition of antimicrobial resistance genes.
Collapse
Affiliation(s)
- Yuchuan Li
- Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030032, China.
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
| | - Jianrong Rong
- Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030032, China
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Chunyan Gao
- Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030032, China
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| |
Collapse
|
4
|
Kang Y, Chen S, Zheng B, Du X, Li Z, Tan Z, Zhou H, Huang J, Tian L, Zhong J, Ma X, Li F, Yao J, Wang Y, Zheng M, Li Z. Epidemiological Investigation of Hospital Transmission of Corynebacterium striatum Infection by Core Genome Multilocus Sequence Typing Approach. Microbiol Spectr 2023; 11:e0149022. [PMID: 36537812 PMCID: PMC9927548 DOI: 10.1128/spectrum.01490-22] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 11/17/2022] [Indexed: 12/24/2022] Open
Abstract
Corynebacterium striatum has recently received increasing attention due to its multiple antimicrobial resistances and its role as an invasive infection/outbreak agent. Recently, whole-genome sequencing (WGS)-based core genome multilocus sequence typing (cgMLST) has been used in epidemiological studies of specific human pathogens. However, this method has not been reported in studies of C. striatum. In this work, we aim to propose a cgMLST scheme for C. striatum. All publicly available C. striatum genomes, 30 C. striatum strains isolated from the same hospital, and 1 epidemiologically unrelated outgroup C. striatum strain were used to establish a cgMLST scheme targeting 1,795 genes (hereinafter referred to as 1,795-cgMLST). The genotyping results of cgMLST showed good congruence with core genome-based single-nucleotide polymorphism typing in terms of tree topology. In addition, the cgMLST provided a greater discrimination than the MLST method based on 6 housekeeping genes (gyrA, gyrB, hsp65, rpoB, secA1, and sodA). We established a clonal group (CG) threshold based on 104 allelic differences; a total of 56 CGs were identified from among 263 C. striatum strains. We also defined an outbreak threshold based on seven allelic differences that is capable of identifying closely related isolates that could give clues on hospital transmission. According to the results of analysis of drug-resistant genes and virulence genes, we identified CG4, CG5, CG26, CG28, and CG55 as potentially hypervirulent and multidrug-resistant CGs of C. striatum. This study provides valuable genomic epidemiological data on the diversity, resistance, and virulence profiles of this potentially pathogenic microorganism. IMPORTANCE Recently, WGS of many human and animal pathogens has been successfully used to investigate microbial outbreaks. The cgMLST schema are powerful genotyping tools that can be used to investigate potential epidemics and provide classification of the strains precise and reliable. In this study, we proposed the development of a cgMLST typing scheme for C. striatum, and then we evaluated this scheme for its applicability to hospital transmission investigations. This report describes the first cgMLST schema for C. striatum. The analysis of hospital transmission of C. striatum based on cgMLST methods has important clinical epidemiological significance for improving nosocomial infection monitoring of C. striatum and in-depth understanding of its nosocomial transmission routes.
Collapse
Affiliation(s)
- Yutong Kang
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Shenglin Chen
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
- School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Beijia Zheng
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Department of Clinical Laboratory, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, Zhejiang, China
| | - Xiaoli Du
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhenpeng Li
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhizhou Tan
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Haijian Zhou
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jia Huang
- Institute for the Prevention and Control of Infectious Diseases, Xinjiang Center for Disease Control and Prevention, Urumqi, Xinjiang, China
| | - Leihao Tian
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
- National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | - Jiaxin Zhong
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xueli Ma
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
- National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | - Fang Li
- Department of Medicine, Tibet University, Lhasa, Tibet, China
| | - Jiang Yao
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yu Wang
- Department of Clinical Laboratory Medicine, Shanxi Bethune Hospital & Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Meiqin Zheng
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
- National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | - Zhenjun Li
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| |
Collapse
|
5
|
Zhang H, Tan X, Zhang Z, Yang X, Wang L, Li M, Shi D, Li Y, Li J, Li Z, Liao X. Targeted Antibiotics for Lower Respiratory Tract Infection with Corynebacterium striatum. Infect Drug Resist 2023; 16:2019-2028. [PMID: 37038476 PMCID: PMC10082571 DOI: 10.2147/idr.s404855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 03/29/2023] [Indexed: 04/12/2023] Open
Abstract
Purpose To assess the impact of targeted antibiotic therapy on clinical outcomes of patients with lower respiratory tract (LRT) infection with Corynebacterium striatum (C. striatum). Methods A new propensity score-inverse probability of treatment weighting (IPTW) cohort study was conducted by using 10-year data. The study included LRT infection patients with respiratory secretions cultured positive for C. striatum simultaneously. The primary outcome was all-cause hospital mortality; the secondary outcomes included hospital stay, ICU stay and ventilation time. The safety outcomes were drug-related serum creatinine (Cr) increase and thrombocytopenia. Results A total of 339 patients were included in the cohort, and 84 (24.78%) initiated vancomycin or linezolid therapy. In the new IPTW cohort, targeted antibiotic therapy did not improve all-cause hospital mortality (P=0.632), and the OR (95% CI) was 0.879 (0.519-1.488). Moreover, targeted antibiotic therapy was not associated with hospital stay (P=0.415), ICU stay (P=0.945) or ventilation time (P=0.885). The side effects of drug-related higher serum Cr (P=0.044) and thrombocytopenic levels (P=0.038) cannot be ignored. Conclusion Clinical benefits by vancomycin or linezolid targeted against LRT infection with C. striatum were limited and with drug-related side effects. A prospectively designed study is needed to further confirm the results.
Collapse
Affiliation(s)
- Huan Zhang
- Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
- Department of Critical Care Medicine, The Third People’s Hospital of Chengdu, Chengdu, People’s Republic of China
| | - Xiaojiao Tan
- Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Zhen Zhang
- Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Xuewei Yang
- Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Lijie Wang
- Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Meiqian Li
- Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Dan Shi
- Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Yao Li
- Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Jianbo Li
- Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Zhen Li
- Clinical Research Unit, First Maternity and Infant Hospital of Shanghai, Shanghai, People’s Republic of China
| | - Xuelian Liao
- Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
- Department of Critical Care Medicine, West China Tianfu Hospital of Sichuan University, Chengdu, People’s Republic of China
- Correspondence: Xuelian Liao, Department of Critical Care Medicine, West China Hospital, Sichuan University, No. 37, Guoxue Lane, Wuhou district, Chengdu, People’s Republic of China, Tel +8613541023033, Email
| |
Collapse
|
6
|
Jesus HNR, Ramos JN, Rocha DJPG, Alves DA, Silva CS, Cruz JVO, Vieira VV, Souza C, Santos LS, Navas J, Ramos RTJ, Azevedo V, Aguiar ERGR, Mattos-Guaraldi AL, Pacheco LGC. The pan-genome of the emerging multidrug-resistant pathogen Corynebacterium striatum. Funct Integr Genomics 2022; 23:5. [PMID: 36534203 DOI: 10.1007/s10142-022-00932-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 10/06/2022] [Accepted: 11/24/2022] [Indexed: 12/23/2022]
Abstract
Corynebacterium striatum, a common constituent of the human skin microbiome, is now considered an emerging multidrug-resistant pathogen of immunocompromised and chronically ill patients. However, little is known about the molecular mechanisms in the transition from colonization to the multidrug-resistant (MDR) invasive phenotype in clinical isolates. This study performed a comprehensive pan-genomic analysis of C. striatum, including isolates from "normal skin microbiome" and from MDR infections, to gain insights into genetic factors contributing to pathogenicity and multidrug resistance in this species. For this, three novel genome sequences were obtained from clinical isolates of C. striatum of patients from Brazil, and other 24 complete or draft C. striatum genomes were retrieved from GenBank, including the ATCC6940 isolate from the Human Microbiome Project. Analysis of C. striatum strains demonstrated the presence of an open pan-genome (α = 0.852803) containing 3816 gene families, including 15 antimicrobial resistance (AMR) genes and 32 putative virulence factors. The core and accessory genomes included 1297 and 1307 genes, respectively. The identified AMR genes are primarily associated with resistance to aminoglycosides and tetracyclines. Of these, 66.6% are present in genomic islands, and four AMR genes, including aac(6')-ib7, are located in a class 1-integron. In conclusion, our data indicated that C. striatum possesses genomic characteristics favorable to the invasive phenotype, with high genomic plasticity, a robust genetic arsenal for iron acquisition, and important virulence determinants and AMR genes present in mobile genetic elements.
Collapse
Affiliation(s)
- Hendor N R Jesus
- Multicenter Post-Graduate Program in Biochemistry and Molecular Biology (PMBqBM), Institute of Health Sciences, Federal University of Bahia, Salvador, BA, Brazil
| | - Juliana N Ramos
- Laboratory of Diphtheria and Corinebacteria of Clinical Relevance, School of Medical Sciences, Rio de Janeiro State University - LDCIC/FCM/UERJ, Rio de Janeiro, RJ, Brazil
| | - Danilo J P G Rocha
- Institute of Health Sciences, Federal University of Bahia, Salvador, BA, Brazil
| | - Daniele A Alves
- Institute of Health Sciences, Federal University of Bahia, Salvador, BA, Brazil.,Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Carolina S Silva
- Institute of Health Sciences, Federal University of Bahia, Salvador, BA, Brazil
| | - João V O Cruz
- Institute of Health Sciences, Federal University of Bahia, Salvador, BA, Brazil
| | - Verônica V Vieira
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório Interdisciplinar de Pesquisas Médicas, Rio de Janeiro, RJ, Brazil
| | - Cassius Souza
- Laboratory of Diphtheria and Corinebacteria of Clinical Relevance, School of Medical Sciences, Rio de Janeiro State University - LDCIC/FCM/UERJ, Rio de Janeiro, RJ, Brazil
| | - Louisy S Santos
- Laboratory of Diphtheria and Corinebacteria of Clinical Relevance, School of Medical Sciences, Rio de Janeiro State University - LDCIC/FCM/UERJ, Rio de Janeiro, RJ, Brazil
| | - Jesus Navas
- Cantabria University, Instituto de Investigación Valdecilla (IDIVAL), Santander, Spain
| | - Rommel T J Ramos
- Institute of Biological Sciences, Federal University of Para, Belem, PA, Brazil.,Biological Engineering Laboratory, Science and Technology Park Guama, Belem, PA, Brazil
| | - Vasco Azevedo
- Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Eric R G R Aguiar
- Department of Biological Sciences, State University of Santa Cruz, Ilhéus, BA, Brazil
| | - Ana L Mattos-Guaraldi
- Laboratory of Diphtheria and Corinebacteria of Clinical Relevance, School of Medical Sciences, Rio de Janeiro State University - LDCIC/FCM/UERJ, Rio de Janeiro, RJ, Brazil
| | - Luis G C Pacheco
- Multicenter Post-Graduate Program in Biochemistry and Molecular Biology (PMBqBM), Institute of Health Sciences, Federal University of Bahia, Salvador, BA, Brazil. .,Institute of Health Sciences, Federal University of Bahia, Salvador, BA, Brazil.
| |
Collapse
|
7
|
Marino A, Campanella E, Stracquadanio S, Ceccarelli M, Zagami A, Nunnari G, Cacopardo B. Corynebacterium striatum Bacteremia during SARS-CoV2 Infection: Case Report, Literature Review, and Clinical Considerations. Infect Dis Rep 2022; 14:383-390. [PMID: 35645221 PMCID: PMC9149851 DOI: 10.3390/idr14030042] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 05/10/2022] [Accepted: 05/11/2022] [Indexed: 02/01/2023] Open
Abstract
Bacterial infections, especially those in hospital settings, represent a major complication of COVID-19 patients, complicating management and worsening clinical outcomes. Corynebacterium striatum is a non-diphtheric actinobacterium that has been reported as being the causative agent of several different infections, affecting both immunocompetent and immunocompromised patients. Recently, C. striatum has been recognized as a nosocomial pathogen that is responsible for severe infection in critical patients, as well as in fragile and immunocompromised subjects. C. striatum has been described as the etiological agent of bacteremia, central line infections, and endocarditis. We report a case of a 91-year-old woman who was hospitalized due to SARS-CoV-2 infection, who developed C. striatum bacteremia and died despite antimicrobial therapy and clinical efforts. Furthermore, we discuss C. striatum diagnosis and treatment based on evidence from the scientific literature.
Collapse
Affiliation(s)
- Andrea Marino
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy;
- Department of Clinical and Experimental Medicine, Unit of Infectious Diseases, ARNAS Garibaldi Hospital, University of Catania, 95122 Catani, Italy; (M.C.); (A.Z.); (B.C.)
| | - Edoardo Campanella
- Department of Clinical and Experimental Medicine, Unit of Infectious Diseases, University of Messina, 98124 Messina, Italy; (E.C.); (G.N.)
| | - Stefano Stracquadanio
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy;
| | - Manuela Ceccarelli
- Department of Clinical and Experimental Medicine, Unit of Infectious Diseases, ARNAS Garibaldi Hospital, University of Catania, 95122 Catani, Italy; (M.C.); (A.Z.); (B.C.)
| | - Aldo Zagami
- Department of Clinical and Experimental Medicine, Unit of Infectious Diseases, ARNAS Garibaldi Hospital, University of Catania, 95122 Catani, Italy; (M.C.); (A.Z.); (B.C.)
| | - Giuseppe Nunnari
- Department of Clinical and Experimental Medicine, Unit of Infectious Diseases, University of Messina, 98124 Messina, Italy; (E.C.); (G.N.)
| | - Bruno Cacopardo
- Department of Clinical and Experimental Medicine, Unit of Infectious Diseases, ARNAS Garibaldi Hospital, University of Catania, 95122 Catani, Italy; (M.C.); (A.Z.); (B.C.)
| |
Collapse
|
8
|
Folliero V, Dell’Annunziata F, Roscetto E, Cammarota M, De Filippis A, Schiraldi C, Catania MR, Casolaro V, Perrella A, Galdiero M, Franci G. Niclosamide as a Repurposing Drug against Corynebacterium striatum Multidrug-Resistant Infections. Antibiotics (Basel) 2022; 11:antibiotics11050651. [PMID: 35625295 PMCID: PMC9137567 DOI: 10.3390/antibiotics11050651] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 05/09/2022] [Accepted: 05/11/2022] [Indexed: 02/06/2023] Open
Abstract
Corynebacterium striatum (C. striatum) is an emerging multidrug-resistant (MDR) pathogen associated with nosocomial infections. In this scenario, we screened the antimicrobial activity of the anthelmintic drugs doramectin, moxidectin, selamectin and niclosamide against 20 C. striatum MDR clinical isolates. Among these, niclosamide was the best performing drug against C. striatum. Niclosamide cytotoxicity was evaluated by a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay on immortalized human keratinocyte cells (HaCaT). After 20 h of treatment, the recorded 50% cytotoxic concentration (CC50) was 2.56 μg/mL. The antibacterial efficacy was determined via disc diffusion, broth microdilution method and time-killing. Against C. striatum, niclosamide induced a growth inhibitory area of 22 mm and the minimum inhibitory concentration that inhibits 90% of bacteria (MIC90) was 0.39 μg/mL, exhibiting bactericidal action. The biofilm biomass eradicating action was investigated through crystal violet (CV), MTT and confocal laser scanning microscopy (CLSM). Niclosamide affected the biofilm viability in a dose-dependent manner and degraded biomass by 55 and 49% at 0.39 μg/mL and 0.19 μg/mL. CLSM images confirmed the biofilm biomass degradation, showing a drastic reduction in cell viability. This study could promote the drug-repurposing of the anthelmintic FDA-approved niclosamide as a therapeutic agent to counteract the C. striatum MDR infections.
Collapse
Affiliation(s)
- Veronica Folliero
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (V.F.); (F.D.); (M.C.); (A.D.F.); (C.S.)
| | - Federica Dell’Annunziata
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (V.F.); (F.D.); (M.C.); (A.D.F.); (C.S.)
| | - Emanuela Roscetto
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, 80131 Naples, Italy; (E.R.); (M.R.C.)
| | - Marcella Cammarota
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (V.F.); (F.D.); (M.C.); (A.D.F.); (C.S.)
| | - Anna De Filippis
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (V.F.); (F.D.); (M.C.); (A.D.F.); (C.S.)
| | - Chiara Schiraldi
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (V.F.); (F.D.); (M.C.); (A.D.F.); (C.S.)
| | - Maria Rosaria Catania
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, 80131 Naples, Italy; (E.R.); (M.R.C.)
| | - Vincenzo Casolaro
- Department of Medicine Surgery and Dentistry, University of Salerno, Baronissi, 84081 Salerno, Italy;
| | - Alessandro Perrella
- Division Emerging Infectious Disease and High Contagiousness, Hospital D Cotugno, 80131 Naples, Italy;
| | - Massimiliano Galdiero
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (V.F.); (F.D.); (M.C.); (A.D.F.); (C.S.)
- Correspondence: (M.G.); (G.F.)
| | - Gianluigi Franci
- Department of Medicine Surgery and Dentistry, University of Salerno, Baronissi, 84081 Salerno, Italy;
- Clinical Pathology and Microbiology Unit, San Giovanni di Dio e Ruggi D’Aragona University Hospital, 84126 Salerno, Italy
- Correspondence: (M.G.); (G.F.)
| |
Collapse
|
9
|
Chen H, Bai X, Gao Y, Liu W, Yao X, Wang J. Profile of Bacteria with ARGs Among Real-World Samples from ICU Admission Patients with Pulmonary Infection Revealed by Metagenomic NGS. Infect Drug Resist 2021; 14:4993-5004. [PMID: 34866919 PMCID: PMC8636693 DOI: 10.2147/idr.s335864] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 11/16/2021] [Indexed: 12/27/2022] Open
Abstract
Background Treatment of pulmonary infections in the intensive care unit (ICU) represents a great challenge, especially infections caused by antibiotic resistance pathogens. A thorough and up-to-date knowledge of the local spectrum of antibiotic resistant bacteria can improve the antibiotic treatment efficiency. In this study, we aimed to reveal the profile of bacteria with antibiotic resistance genes (ARGs) in real-world samples from ICU admission patients with pulmonary infection in Mainland, China, by metagenomic next-generation sequencing (mNGS). Methods A total of 504 different types of clinical samples from 452 ICU admission patients with pulmonary infection were detected by mNGS analysis. Results A total of 485 samples from 434 patients got successful mNGS results. Among 434 patients, one or more bacteria with ARGs were detected in 192 patients (44.24%, 192/434), and ≥2 bacteria with ARGs were detected in 85 (19.59%, 85/434) patients. The predominant detected bacteria were Corynebacterium striatum (C. striatum) (11.76%, 51/434), Acinetobacter baumannii (A. baumannii) (11.52%, 50/434) and Enterococcus faecium (E. faecium) (8.99%, 39/434). ermX conferred resistance to MSLB and cmx to phenicol were the only two ARGs detected in C. striatum; in A. baumannii, most of ARGs were resistance-nodulation-division (RND)-type efflux pumps genes, which conferred resistance to multi-drug; ermB conferred resistance to MSLB and efmA to multi-drug were the predominant ARGs in E. faecium. Bacteria with ARGs were detected in 50% (140/280) bronchoalveolar lavage fluid (BALF) and 50.5% (48/95) sputum samples, which were significantly higher than in blood and cerebrospinal fluid (CSF) samples. Conclusion High level of bacteria with ARGs was observed in clinical samples, especially BALF and sputum samples from ICU admission patients with pulmonary infection in Mainland, China. And C. striatum resistant to MSLB and/or phenicol, multi-drug resistance A. baumannii and E. faecium were the lead bacteria.
Collapse
Affiliation(s)
- Huijuan Chen
- Department of Biomedical Engineering, College of Life Science and Bioengineering, Beijing University of Technology, Beijing, People's Republic of China
| | - Xinhua Bai
- Department of Clinical Laboratory, Beijing Capitalbio Medlab, Beijing, People's Republic of China
| | - Yang Gao
- Department of Clinical Laboratory, Beijing Capitalbio Medlab, Beijing, People's Republic of China
| | - Wenxuan Liu
- Department of Clinical Laboratory, Beijing Capitalbio Medlab, Beijing, People's Republic of China
| | - Xuena Yao
- Department of Clinical Laboratory, Beijing Capitalbio Medlab, Beijing, People's Republic of China
| | - Jing Wang
- Department of Clinical Laboratory, Beijing Capitalbio Medlab, Beijing, People's Republic of China
| |
Collapse
|
10
|
Charalampous T, Alcolea-Medina A, Snell LB, Williams TGS, Batra R, Alder C, Telatin A, Camporota L, Meadows CIS, Wyncoll D, Barrett NA, Hemsley CJ, Bryan L, Newsholme W, Boyd SE, Green A, Mahadeva U, Patel A, Cliff PR, Page AJ, O'Grady J, Edgeworth JD. Evaluating the potential for respiratory metagenomics to improve treatment of secondary infection and detection of nosocomial transmission on expanded COVID-19 intensive care units. Genome Med 2021; 13:182. [PMID: 34784976 PMCID: PMC8594956 DOI: 10.1186/s13073-021-00991-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 10/14/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Clinical metagenomics (CMg) has the potential to be translated from a research tool into routine service to improve antimicrobial treatment and infection control decisions. The SARS-CoV-2 pandemic provides added impetus to realise these benefits, given the increased risk of secondary infection and nosocomial transmission of multi-drug-resistant (MDR) pathogens linked with the expansion of critical care capacity. METHODS CMg using nanopore sequencing was evaluated in a proof-of-concept study on 43 respiratory samples from 34 intubated patients across seven intensive care units (ICUs) over a 9-week period during the first COVID-19 pandemic wave. RESULTS An 8-h CMg workflow was 92% sensitive (95% CI, 75-99%) and 82% specific (95% CI, 57-96%) for bacterial identification based on culture-positive and culture-negative samples, respectively. CMg sequencing reported the presence or absence of β-lactam-resistant genes carried by Enterobacterales that would modify the initial guideline-recommended antibiotics in every case. CMg was also 100% concordant with quantitative PCR for detecting Aspergillus fumigatus from 4 positive and 39 negative samples. Molecular typing using 24-h sequencing data identified an MDR-K. pneumoniae ST307 outbreak involving 4 patients and an MDR-C. striatum outbreak involving 14 patients across three ICUs. CONCLUSION CMg testing provides accurate pathogen detection and antibiotic resistance prediction in a same-day laboratory workflow, with assembled genomes available the next day for genomic surveillance. The provision of this technology in a service setting could fundamentally change the multi-disciplinary team approach to managing ICU infections. The potential to improve the initial targeted treatment and rapidly detect unsuspected outbreaks of MDR-pathogens justifies further expedited clinical assessment of CMg.
Collapse
Affiliation(s)
- Themoula Charalampous
- Centre for Clinical Infection and Diagnostics Research, Department of Infectious Diseases, School of Immunology and Microbial Sciences, Kings College London, London, UK
| | - Adela Alcolea-Medina
- Centre for Clinical Infection and Diagnostics Research, Department of Infectious Diseases, School of Immunology and Microbial Sciences, Kings College London, London, UK
- Infection Sciences, Viapath, St Thomas' Hospital, London, UK
| | - Luke B Snell
- Centre for Clinical Infection and Diagnostics Research, Department of Infectious Diseases, School of Immunology and Microbial Sciences, Kings College London, London, UK
- Department of Infectious Diseases, Guy's and St Thomas' Hospital NHS Foundation Trust, London, UK
| | - Tom G S Williams
- Department of Infectious Diseases, Guy's and St Thomas' Hospital NHS Foundation Trust, London, UK
| | - Rahul Batra
- Centre for Clinical Infection and Diagnostics Research, Department of Infectious Diseases, School of Immunology and Microbial Sciences, Kings College London, London, UK
- Department of Infectious Diseases, Guy's and St Thomas' Hospital NHS Foundation Trust, London, UK
| | - Christopher Alder
- Centre for Clinical Infection and Diagnostics Research, Department of Infectious Diseases, School of Immunology and Microbial Sciences, Kings College London, London, UK
- Department of Infectious Diseases, Guy's and St Thomas' Hospital NHS Foundation Trust, London, UK
| | - Andrea Telatin
- Quadram Institute Bioscience, Norwich Research Park, Norwich, UK
| | - Luigi Camporota
- Critical Care Directorate, Guy's and St Thomas' Hospital NHS Foundation Trust, London, UK
| | | | - Duncan Wyncoll
- Critical Care Directorate, Guy's and St Thomas' Hospital NHS Foundation Trust, London, UK
| | - Nicholas A Barrett
- Critical Care Directorate, Guy's and St Thomas' Hospital NHS Foundation Trust, London, UK
| | - Carolyn J Hemsley
- Department of Infectious Diseases, Guy's and St Thomas' Hospital NHS Foundation Trust, London, UK
| | - Lisa Bryan
- Infection Sciences, Viapath, St Thomas' Hospital, London, UK
| | - William Newsholme
- Department of Infectious Diseases, Guy's and St Thomas' Hospital NHS Foundation Trust, London, UK
| | - Sara E Boyd
- Department of Infectious Diseases, Guy's and St Thomas' Hospital NHS Foundation Trust, London, UK
| | - Anna Green
- Department of Cellular Pathology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Ula Mahadeva
- Department of Cellular Pathology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Amita Patel
- Centre for Clinical Infection and Diagnostics Research, Department of Infectious Diseases, School of Immunology and Microbial Sciences, Kings College London, London, UK
- Department of Infectious Diseases, Guy's and St Thomas' Hospital NHS Foundation Trust, London, UK
| | | | - Andrew J Page
- Quadram Institute Bioscience, Norwich Research Park, Norwich, UK
| | - Justin O'Grady
- Quadram Institute Bioscience, Norwich Research Park, Norwich, UK.
| | - Jonathan D Edgeworth
- Centre for Clinical Infection and Diagnostics Research, Department of Infectious Diseases, School of Immunology and Microbial Sciences, Kings College London, London, UK.
- Infection Sciences, Viapath, St Thomas' Hospital, London, UK.
- Department of Infectious Diseases, Guy's and St Thomas' Hospital NHS Foundation Trust, London, UK.
| |
Collapse
|
11
|
Milosavljevic MN, Milosavljevic JZ, Kocovic AG, Stefanovic SM, Jankovic SM, Djesevic M, Milentijevic MN. Antimicrobial treatment of Corynebacterium striatum invasive infections: a systematic review. Rev Inst Med Trop Sao Paulo 2021; 63:e49. [PMID: 34161555 PMCID: PMC8216692 DOI: 10.1590/s1678-9946202163049] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 05/07/2021] [Indexed: 01/03/2023] Open
Abstract
The aim of this study was to establish an evidence-based guideline for the
antibiotic treatment of Corynebacterium striatum infections.
Several electronic databases were systematically searched for clinical trials,
observational studies or individual cases on patients of any age and gender with
systemic inflammatory response syndrome, harboring C. striatum
isolated from body fluids or tissues in which it is not normally present.
C. striatum had to be identified as the only causative
agent of the invasive infection, and its isolation from blood, body fluids or
tissues had to be confirmed by one of the more advanced diagnostic methods
(biochemical methods, mass spectrometry and/or gene sequencing). This systematic
review included 42 studies that analyzed 85 individual cases with various
invasive infections caused by C. striatum. More than one
isolate of C. striatum exhibited 100% susceptibility to
vancomycin, linezolid, teicoplanin, piperacillin-tazobactam,
amoxicillin-clavulanate and cefuroxime. On the other hand, some strains of this
bacterium showed a high degree of resistance to fluoroquinolones, to the
majority majority of β-lactams, aminoglycosides, macrolides, lincosamides and
cotrimoxazole. Despite the antibiotic treatment, fatal outcomes were reported in
almost 20% of the patients included in this study. Gene sequencing methods
should be the gold standard for the identification of C.
striatum, while MALDI-TOF and the Vitek system can be used as
alternative methods. Vancomycin should be used as the antibiotic of choice for
the treatment of C. striatum infections, in monotherapy or in
combination with piperacillin-tazobactam. Alternatively, linezolid, teicoplanin
or daptomycin may be used in severe infections, while amoxicillin-clavulanate
may be used to treat mild infections caused by C. striatum.
Collapse
Affiliation(s)
- Milos N Milosavljevic
- University of Kragujevac, Faculty of Medical Sciences, Department of Pharmacology and toxicology, Kragujevac, Serbia
| | - Jovana Z Milosavljevic
- University of Kragujevac, Faculty of Medical Sciences, Department of Anatomy, Kragujevac, Serbia
| | - Aleksandar G Kocovic
- University of Kragujevac, Faculty of Medical Sciences, Department of Pharmacy, Kragujevac, Serbia
| | - Srdjan M Stefanovic
- University of Kragujevac, Faculty of Medical Sciences, Department of Pharmacy, Kragujevac, Serbia
| | - Slobodan M Jankovic
- University of Kragujevac, Faculty of Medical Sciences, Department of Pharmacology and toxicology, Kragujevac, Serbia
| | - Miralem Djesevic
- Private Policlinic Center Eurofar Sarajevo, Cardiology Department, Sarajevo, Bosnia and Herzegovina
| | - Milica N Milentijevic
- University of Priština, School of Medicine, Department of Infectious Diseases, Pristina, Serbia
| |
Collapse
|
12
|
Virulence of clinically relevant multidrug resistant Corynebacterium striatum strains and their ability to adhere to human epithelial cells and inert surfaces. Microb Pathog 2021; 155:104887. [PMID: 33894290 DOI: 10.1016/j.micpath.2021.104887] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 04/07/2021] [Accepted: 04/08/2021] [Indexed: 01/13/2023]
Abstract
Corynebacterium striatum is a nosocomial pathogen which is increasingly associated with serious infections in both immunocompetent and immunocompromised patients. However, little is known about virulence factors and mechanisms that may enhance the establishment and long-term survival of Corynebacterium striatum. in the hospital environment. In this study, we investigated the ability of 22 multidrug-resistant C. striatum clinical isolates to adhere to human epithelial cells and to produce biofilm on polystyrene plates, glass and various tracheostomy tubes. We also tested the virulence of these strains on the nematode Caenorhabditis elegans. They showed good adhesion to epithelial human cells after 180 min of infection. The 22 C. striatum were able to produce biofilms on positively and negatively charged abiotic surfaces at 37 °C. They were also able to infect and to kill Caenorhabditis elegans after 5 days of infection. The virulence condition was associated with the presence of SpaDEF operon encoding pili in all strains. This study provides new insights on virulence mechanisms that may contribute to the persistence of C. striatum in the hospital environment, increasing the probability of causing nosocomial infections.
Collapse
|
13
|
Silva-Santana G, Silva CMF, Olivella JGB, Silva IF, Fernandes LMO, Sued-Karam BR, Santos CS, Souza C, Mattos-Guaraldi AL. Worldwide survey of Corynebacterium striatum increasingly associated with human invasive infections, nosocomial outbreak, and antimicrobial multidrug-resistance, 1976-2020. Arch Microbiol 2021; 203:1863-1880. [PMID: 33625540 PMCID: PMC7903872 DOI: 10.1007/s00203-021-02246-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 01/08/2021] [Accepted: 02/14/2021] [Indexed: 01/01/2023]
Abstract
Corynebacterium striatum is part of microbiota of skin and nasal mucosa of humans and has been increasingly reported as the etiologic agent of community-acquired and nosocomial diseases. Antimicrobial multidrug-resistant (MDR) C. striatum strains have been increasingly related to various nosocomial diseases and/or outbreaks worldwide, including fatal invasive infections in immunosuppressed and immunocompetent patients. Although cases of infections by C. striatum still neglected in some countries, the improvement of microbiological techniques and studies led to the increase of survival of patients with C. striatum nosocomial infections at different levels of magnitude. Biofilm formation on abiotic surfaces contributes for the persistence of virulent C. striatum and dissemination of antimicrobial resistance in hospital environment. Besides that, empirical antibiotic therapy can select multi-resistant strains and transfer intra and interspecies genes horizontally. In this study, a worldwide survey of C. striatum human infections and nosocomial outbreaks was accomplished by the analysis of clinical–epidemiological and microbiological features of reported cases from varied countries, during a 44-year period (1976–2020).
Collapse
Affiliation(s)
- Giorgio Silva-Santana
- Laboratory of Diphtheria and Corynebacteria of Clinical Relevance, Faculty of Medical Sciences, University of the State of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
- The Collaborating Centre for Reference and Research on Diphtheria/National Health Foundation/Ministry of Health, Rio de Janeiro, Brazil.
- Health Sciences Center, Institute of Microbiology Paulo de Góes, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
- Centro de Ciências da Saúde (CCS), Universidade Federal do Rio de Janeiro, Instituto de Microbiologia Professor Paulo de Góes, Cidade Universitária, Ilha do Fundão, Rio de Janeiro, Brazil.
| | - Cecília Maria Ferreira Silva
- Laboratory of Diphtheria and Corynebacteria of Clinical Relevance, Faculty of Medical Sciences, University of the State of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
- The Collaborating Centre for Reference and Research on Diphtheria/National Health Foundation/Ministry of Health, Rio de Janeiro, Brazil
| | - Julianna Giordano Botelho Olivella
- Laboratory of Diphtheria and Corynebacteria of Clinical Relevance, Faculty of Medical Sciences, University of the State of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
- The Collaborating Centre for Reference and Research on Diphtheria/National Health Foundation/Ministry of Health, Rio de Janeiro, Brazil
| | - Igor Ferreira Silva
- Laboratory of Diphtheria and Corynebacteria of Clinical Relevance, Faculty of Medical Sciences, University of the State of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
- The Collaborating Centre for Reference and Research on Diphtheria/National Health Foundation/Ministry of Health, Rio de Janeiro, Brazil
| | - Laís Menegoi Oliveira Fernandes
- Laboratory of Diphtheria and Corynebacteria of Clinical Relevance, Faculty of Medical Sciences, University of the State of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
- The Collaborating Centre for Reference and Research on Diphtheria/National Health Foundation/Ministry of Health, Rio de Janeiro, Brazil
| | - Bruna Ribeiro Sued-Karam
- Laboratory of Diphtheria and Corynebacteria of Clinical Relevance, Faculty of Medical Sciences, University of the State of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
- The Collaborating Centre for Reference and Research on Diphtheria/National Health Foundation/Ministry of Health, Rio de Janeiro, Brazil
| | - Cíntia Silva Santos
- Laboratory of Diphtheria and Corynebacteria of Clinical Relevance, Faculty of Medical Sciences, University of the State of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
- The Collaborating Centre for Reference and Research on Diphtheria/National Health Foundation/Ministry of Health, Rio de Janeiro, Brazil
| | - Cassius Souza
- Laboratory of Diphtheria and Corynebacteria of Clinical Relevance, Faculty of Medical Sciences, University of the State of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
- The Collaborating Centre for Reference and Research on Diphtheria/National Health Foundation/Ministry of Health, Rio de Janeiro, Brazil
| | - Ana Luíza Mattos-Guaraldi
- Laboratory of Diphtheria and Corynebacteria of Clinical Relevance, Faculty of Medical Sciences, University of the State of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
- The Collaborating Centre for Reference and Research on Diphtheria/National Health Foundation/Ministry of Health, Rio de Janeiro, Brazil
- Health Sciences Center, Institute of Microbiology Paulo de Góes, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
- Centro de Ciências da Saúde (CCS), Universidade Federal do Rio de Janeiro, Instituto de Microbiologia Professor Paulo de Góes, Cidade Universitária, Ilha do Fundão, Rio de Janeiro, Brazil
| |
Collapse
|
14
|
Xu S, Qiu X, Hou X, Zhou H, Chen D, Wang X, Han L, Li D, Sun L, Ji X, Li M, Zhang J, Li M, Li Z. Direct detection of Corynebacterium striatum, Corynebacterium propinquum, and Corynebacterium simulans in sputum samples by high-resolution melt curve analysis. BMC Infect Dis 2021; 21:21. [PMID: 33413116 PMCID: PMC7788810 DOI: 10.1186/s12879-020-05633-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 11/19/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pulmonary infections caused by non-diphtheriae corynebacteria are increasing. However, rapid identification of Corynebacterium species poses a challenge due to the low genetic variation within the genus. METHODS Three reference strains and 99 clinical isolates were used in this study. A qPCR followed by high-resolution melting (HRM) targeting ssrA was performed to simultaneously identify C. striatum, C. propinquum and C. simulans. To further evaluate this assay's performance, 88 clinical sputum samples were tested by HRM and the detection results were compared with those of the traditional culture method and multiple cross-displacement amplification (MCDA) assay. RESULTS The melting curve produced by a pair of universal primers generated species-specific HRM curve profiles and could distinguish the three target species from other related bacteria. The limit of detection of HRM assay for DNA from the three purified Corynebacterium species was 100 fg. Compared with the culture method, HRM detected 22 additional positive specimens, representing a 23.9% relative increase in detection rate. The HRM assay had 98.4% (95% confidence interval [CI], 90.5-99.9%) sensitivity and 100% (95% CI, 82.8-100%) specificity. Additionally, 95.5% concordance between HRM and MCDA (κ = 0.89 [95% CI, 0.79-0.99]) was noted. CONCLUSIONS The HRM assay was a simple, rapid, sensitive, and specific diagnostic tool for detecting C. striatum, C. propinquum, and C. simulans, with the potential to contribute to early diagnosis, epidemiological surveillance, and rapid response to outbreak.
Collapse
Affiliation(s)
- Shuai Xu
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiaotong Qiu
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xuexin Hou
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Haijian Zhou
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Dongke Chen
- Department, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Xuebing Wang
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Lichao Han
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Dan Li
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Lina Sun
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xingzhao Ji
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Minghui Li
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jingshan Zhang
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Mengtong Li
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhenjun Li
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
| |
Collapse
|
15
|
Wang X, Zhou H, Du P, Lan R, Chen D, Dong A, Lin X, Qiu X, Xu S, Ji X, Li M, Hou X, Sun L, Li D, Han L, Li Z. Genomic epidemiology of Corynebacterium striatum from three regions of China: an emerging national nosocomial epidemic. J Hosp Infect 2020; 110:67-75. [PMID: 33166588 DOI: 10.1016/j.jhin.2020.10.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 09/27/2020] [Accepted: 10/03/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Corynebacteritum straitum has been considered as an emerging multi-drug-resistant (MDR) pathogen. Isolation of MDR C. striatum as the only organism from respiratory samples from hospitalized patients is increasing in China. AIM To elucidate the genomic epidemiology and evolution of C. striatum in China. METHODS A total of 260 isolates from 2016 to 2018 were collected from three hospitals in three regions of China. Antibiotic sensitivity testing was performed on all isolates. Whole-genome sequencing was applied to all isolates to assess their genomic diversity and relationships and detect the presence of antimicrobial resistance genes (ARG) and ARG cassettes. FINDINGS Almost all isolates (96.2%, 250/260) showed multi-drug-resistance. Genome sequencing revealed four major lineages with lineage IV emerging as the epidemic lineage. Most of the diversity was developed in the last 6 years. Each hospital has its own predominant clones with potential spread between Hebei and Guangdong hospitals. Genomic analysis further revealed multiple antimicrobial resistance genes. CONCLUSIONS Our results suggested that four lineages of C. striatum have spread in parallel across China, causing persistent and extensive transmissions within hospitals. MDR C. striatum infection has become a national epidemic. Antibiotic-driven selection pressure may have played significant roles in forming persistent and predominant clones. Our data provide the basis for surveillance and prevention strategies to control the epidemic caused by MDR C. striatum.
Collapse
Affiliation(s)
- X Wang
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Changping, Beijing, 102206, China
| | - H Zhou
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Changping, Beijing, 102206, China
| | - P Du
- Beijing Key Laboratory of Emerging Infectious Diseases, Institute of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, China
| | - R Lan
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, NSW, 2052, Australia
| | - D Chen
- Department of Laboratory Medicine, Beijing Hospital, National Center of Gerontology, Beijing, 100730, China
| | - A Dong
- University of Science and Technology Affiliated Hospital, Tangshan, 063000, China
| | - X Lin
- Guangzhou Panyu Central Hospital, Guangzhou, 510000, China
| | - X Qiu
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Changping, Beijing, 102206, China
| | - S Xu
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Changping, Beijing, 102206, China
| | - X Ji
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Changping, Beijing, 102206, China
| | - M Li
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Changping, Beijing, 102206, China
| | - X Hou
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Changping, Beijing, 102206, China
| | - L Sun
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Changping, Beijing, 102206, China
| | - D Li
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Changping, Beijing, 102206, China
| | - L Han
- Department of Medicine, Tibet University, Lhasa, 850000, China
| | - Z Li
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Changping, Beijing, 102206, China.
| |
Collapse
|
16
|
Souza CD, Mota HF, Faria YV, Cabral FDO, Oliveira DRD, Sant'Anna LDO, Nagao PE, Santos CDS, Moreira LO, Mattos-Guaraldi AL. Resistance to Antiseptics and Disinfectants of Planktonic and Biofilm-Associated Forms of Corynebacterium striatum. Microb Drug Resist 2020; 26:1546-1558. [PMID: 32429830 DOI: 10.1089/mdr.2019.0124] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Disinfection and antisepsis are of primary importance in controlling nosocomial infections and outbreaks by pathogens expressing multiple resistance to antimicrobial agents (multidrug-resistant [MDR]) used in therapy. Nowadays, infections related to health services (HAIs) due to MDR and multidrug-susceptible (MDS) Corynebacterium striatum should not be underestimated, including patients using invasive medical devices. The virulence potential of C. striatum needs further investigation. Currently, susceptibility profiles of planktonic and/or sessile forms of four C. striatum strains of different pulsed-field gel electrophoresis types were examined as biocides based on the manufacturer's recommendations: 2% glutaraldehyde (GA), 2% peracetic acid (PA), 1% potassium monopersulfate (Virkon®; VK), 1% sodium hypochlorite (SH), and 70% ethyl alcohol (ET). Time-kill assays using 2% bovine serum albumin (BSA) were performed for evaluation of influence of organic matter on biocides effects. Planktonic forms expressed GA resistance at different levels. C. striatum viability was observed until 2, 4, 20, and 30 min for MDR 2369/II, MDS 1954/IV, MDR 1987/I, and MDS 1961/III strains, respectively. In contrast to GA, the biocides PA, VK24h, SH, and ET had higher effective bacterial mortality. However, storage of VK (48 hr) reduced their biocide activities. Moreover, mature biofilms were produced on abiotic substrates, including steel surfaces. Post-treatment with GA (30 min), survival of sessile forms was ≥100% than planktonic forms of all C. striatum tested strains. Independent of biocides tested, BSA increased the survival of planktonic and sessile forms (p ≤ 0.005). Present data indicated that hospital staff should be aware of dissemination and eradication of HAIs by C. striatum presenting resistance to biocides, including high-level disinfectants, such as GA.
Collapse
Affiliation(s)
- Cassius de Souza
- Laboratory of Diphtheria and Corynebacteria of Clinical Relevance (LDCIC), Faculdade de Ciências Médicas (FCM), Universidade do Estado do Rio de Janeiro (UERJ), The Collaborating Centre for Reference and Research on Diphtheria/National Health Foundation/Ministry of Health-FNS/MS, Rio de Janeiro, Brazil
| | - Higor Franceschi Mota
- Laboratory of Diphtheria and Corynebacteria of Clinical Relevance (LDCIC), Faculdade de Ciências Médicas (FCM), Universidade do Estado do Rio de Janeiro (UERJ), The Collaborating Centre for Reference and Research on Diphtheria/National Health Foundation/Ministry of Health-FNS/MS, Rio de Janeiro, Brazil
| | - Yuri Vieira Faria
- Laboratory of Diphtheria and Corynebacteria of Clinical Relevance (LDCIC), Faculdade de Ciências Médicas (FCM), Universidade do Estado do Rio de Janeiro (UERJ), The Collaborating Centre for Reference and Research on Diphtheria/National Health Foundation/Ministry of Health-FNS/MS, Rio de Janeiro, Brazil
| | - Fellipe de Oliveira Cabral
- Laboratory of Diphtheria and Corynebacteria of Clinical Relevance (LDCIC), Faculdade de Ciências Médicas (FCM), Universidade do Estado do Rio de Janeiro (UERJ), The Collaborating Centre for Reference and Research on Diphtheria/National Health Foundation/Ministry of Health-FNS/MS, Rio de Janeiro, Brazil
| | - Dryelle Rodrigues de Oliveira
- Laboratory of Diphtheria and Corynebacteria of Clinical Relevance (LDCIC), Faculdade de Ciências Médicas (FCM), Universidade do Estado do Rio de Janeiro (UERJ), The Collaborating Centre for Reference and Research on Diphtheria/National Health Foundation/Ministry of Health-FNS/MS, Rio de Janeiro, Brazil
| | - Lincoln de Oliveira Sant'Anna
- Laboratory of Diphtheria and Corynebacteria of Clinical Relevance (LDCIC), Faculdade de Ciências Médicas (FCM), Universidade do Estado do Rio de Janeiro (UERJ), The Collaborating Centre for Reference and Research on Diphtheria/National Health Foundation/Ministry of Health-FNS/MS, Rio de Janeiro, Brazil
| | - Prescilla Emy Nagao
- Departamento de Biologia Celular, Instituto de Biologia Roberto Alcântara Gomes, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Cintia da Silva Santos
- Laboratory of Diphtheria and Corynebacteria of Clinical Relevance (LDCIC), Faculdade de Ciências Médicas (FCM), Universidade do Estado do Rio de Janeiro (UERJ), The Collaborating Centre for Reference and Research on Diphtheria/National Health Foundation/Ministry of Health-FNS/MS, Rio de Janeiro, Brazil
| | - Lílian Oliveira Moreira
- Faculdade de Farmácia, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Ana Luíza Mattos-Guaraldi
- Laboratory of Diphtheria and Corynebacteria of Clinical Relevance (LDCIC), Faculdade de Ciências Médicas (FCM), Universidade do Estado do Rio de Janeiro (UERJ), The Collaborating Centre for Reference and Research on Diphtheria/National Health Foundation/Ministry of Health-FNS/MS, Rio de Janeiro, Brazil
| |
Collapse
|
17
|
Asgin N, Otlu B. Antimicrobial Resistance and Molecular Epidemiology of Corynebacterium striatum Isolated in a Tertiary Hospital in Turkey. Pathogens 2020; 9:pathogens9020136. [PMID: 32093060 PMCID: PMC7168331 DOI: 10.3390/pathogens9020136] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 02/15/2020] [Accepted: 02/18/2020] [Indexed: 01/14/2023] Open
Abstract
Although Corynebacterium striatum is part of the human flora, it has recently drawn attention both for its multidrug resistance and its role as an invasive infection/outbreak agent. This cross-sectional study aimed to determine the antimicrobial resistance and clonal relationships among C. striatum strains. In total, 81 C. striatum strains were identified using Phoenix-100TM (BD, Sparks, MD, USA). The antimicrobial resistance of the strains was determined using the Kirby–Bauer disk diffusion method. Clonal relatedness among the strains was performed via arbitrarily primed polymerase chain reaction (AP-PCR). All 81 C. striatum strains were resistant to penicillin, cefotaxime, ciprofloxacin, and tetracycline, but susceptible to vancomycin and linezolid. The resistance rates to gentamicin, erythromycin, and clindamycin were 34.6%, 79%, and 87.7% respectively. AP-PCR results showed no predominant clone among the C. striatum strains. Corynebacterium striatum is reportedly the cause of an increasing number of invasive infections/outbreaks. Moreover, treatment options are limited. The study showed that vancomycin, linezolid, and gentamicin can be selected for the empirical treatment of C. striatum infections. Although no single-clone outbreak was observed in our hospital, small clonal circulations were observed within some units, indicating cross-contamination. Therefore, a comprehensive infection control program is warranted in future.
Collapse
Affiliation(s)
- Nergis Asgin
- Department of Medical Microbiology, Faculty of Medicine, Karabuk University, 78100 Karabuk, Turkey
- Correspondence: ; Tel.: +90-370-4189446
| | - Baris Otlu
- Department of Medical Microbiology, Faculty of Medicine, Inonu University, 44280 Malatya, Turkey;
| |
Collapse
|
18
|
Angeletti S, Ciccozzi M. Matrix-assisted laser desorption ionization time-of-flight mass spectrometry in clinical microbiology: An updating review. INFECTION GENETICS AND EVOLUTION 2019; 76:104063. [DOI: 10.1016/j.meegid.2019.104063] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 09/29/2019] [Accepted: 10/05/2019] [Indexed: 12/17/2022]
|
19
|
Casanova C, Lo Priore E, Egli A, Seth-Smith HMB, Räber L, Ott D, Pflüger V, Droz S, Marschall J, Sommerstein R. Agrobacterium spp. nosocomial outbreak assessment using rapid MALDI-TOF MS based typing, confirmed by whole genome sequencing. Antimicrob Resist Infect Control 2019; 8:171. [PMID: 31700617 PMCID: PMC6829841 DOI: 10.1186/s13756-019-0619-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 10/01/2019] [Indexed: 11/10/2022] Open
Abstract
Background A number of episodes of nosocomial Agrobacterium spp. bacteremia (two cases per year) were observed at Bern University Hospital, Switzerland, from 2015 to 2017. This triggered an outbreak investigation. Methods Cases of Agrobacterium spp. bacteremias that occurred between August 2011 and February 2017 were investigated employing line lists, environmental sampling, rapid protein- (MALDI-TOF MS), and genome-based typing (pulsed field gel electrophoresis and whole genome sequencing) of the clinical isolates. Results We describe a total of eight bacteremia episodes due to A. radiobacter (n = 2), Agrobacterium genomovar G3 (n = 5) and A. pusense (n = 1). Two tight clusters were observed by WGS typing, representing the two A. radiobacter isolates (cluster I, isolated in 2015) and four of the Agrobacterium genomovar G3 isolates (cluster II, isolated in 2016 and 2017), suggesting two different point sources. The epidemiological investigations revealed two computer tomography (CT) rooms as common patient locations, which correlated with the two outbreak clusters. MALDI-TOF MS permitted faster evaluation of strain relatedness than DNA-based methods. High resolution WGS-based typing confirmed the MALDI-TOF MS clustering. Conclusions We report clinical and epidemiological characteristics of two outbreak clusters with Agrobacterium. spp. bacteremia likely acquired during CT contrast medium injection and highlight the use of MALDI-TOF MS as a rapid tool to assess relatedness of rare gram-negative pathogens in an outbreak investigation.
Collapse
Affiliation(s)
- Carlo Casanova
- 1Institute for Infectious Diseases, University of Bern, Friedbühlstrasse 51, 3001 Bern, Switzerland
| | - Elia Lo Priore
- Department of Infectious Diseases, Bern University Hospital, University of Bern, Freiburgstrasse, 3001 Bern, Switzerland
| | - Adrian Egli
- 3Division of Clinical Microbiology, University Hospital Basel, Basel, Switzerland.,4Applied Microbiology Research, Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Helena M B Seth-Smith
- 3Division of Clinical Microbiology, University Hospital Basel, Basel, Switzerland.,4Applied Microbiology Research, Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Lorenz Räber
- Department of Cardiology, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Daniel Ott
- Department of Radiology, Bern University Hospital, University of Bern, Bern, Switzerland
| | | | - Sara Droz
- 1Institute for Infectious Diseases, University of Bern, Friedbühlstrasse 51, 3001 Bern, Switzerland
| | - Jonas Marschall
- Department of Infectious Diseases, Bern University Hospital, University of Bern, Freiburgstrasse, 3001 Bern, Switzerland
| | - Rami Sommerstein
- Department of Infectious Diseases, Bern University Hospital, University of Bern, Freiburgstrasse, 3001 Bern, Switzerland
| |
Collapse
|
20
|
Wang X, Zhou H, Chen D, Du P, Lan R, Qiu X, Hou X, Liu Z, Sun L, Xu S, Ji X, Li H, Li D, Zhang J, Zeng H, Li Z. Whole-Genome Sequencing Reveals a Prolonged and Persistent Intrahospital Transmission of Corynebacterium striatum, an Emerging Multidrug-Resistant Pathogen. J Clin Microbiol 2019; 57:e00683-19. [PMID: 31315959 PMCID: PMC6711910 DOI: 10.1128/jcm.00683-19] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 06/27/2019] [Indexed: 12/31/2022] Open
Abstract
Corynebacterium striatum is an emerging multidrug-resistant (MDR) pathogen that occurs primarily among immunocompromised and chronically ill patients. However, little is known about the genomic diversity of C. striatum, which contributes to its long-term persistence and transmission in hospitals. In this study, a total of 192 C. striatum isolates obtained from 14 September 2017 to 29 March 2018 in a hospital in Beijing, China, were analyzed by antimicrobial susceptibility testing and pulsed-field gel electrophoresis (PFGE). Whole-genome sequencing was conducted on 91 isolates. Nearly all isolates (96.3%, 183/190) were MDR. The highest resistance rate was observed for ciprofloxacin (99.0%, 190/192), followed by cefotaxime (90.6%, 174/192) and erythromycin (89.1%, 171/192). PFGE separated the 192 isolates into 79 pulsotypes, and differences in core genome single-nucleotide polymorphisms (SNPs) partitioned the 91 isolates sequenced into four clades. Isolates of the same pulsotype were identical or nearly identical at the genome level, with some exceptions. Two dominant subclones, clade 3a, and clade 4a, were responsible for the hospital-wide dissemination. Genomic analysis further revealed nine resistance genes mobilized by eight unique cassettes. PFGE and whole-genome sequencing revealed that the C. striatum isolates studied were the result mainly of predominant clones spreading in the hospital. C. striatum isolates in the hospital progressively acquired resistance to antimicrobial agents, demonstrating that isolates of C. striatum may adapt rapidly through the acquisition and accumulation of resistance genes and thus evolve into dominant and persistent clones. These insights will be useful for the prevention of C. striatum infection in hospitals.
Collapse
Affiliation(s)
- Xuebing Wang
- State Key Laboratory of Infectious Disease Prevention and Control, Chinese Center for Disease Control and Prevention, National Institute for Communicable Disease Control and Prevention, Changping, Beijing, China
| | - Haijian Zhou
- State Key Laboratory of Infectious Disease Prevention and Control, Chinese Center for Disease Control and Prevention, National Institute for Communicable Disease Control and Prevention, Changping, Beijing, China
| | - Dongke Chen
- Department of Laboratory Medicine, Beijing Hospital, National Center of Gerontology, Beijing, China
| | - Pengcheng Du
- Beijing Key Laboratory of Emerging Infectious Diseases, Institute of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Ruiting Lan
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, Australia
| | - Xiaotong Qiu
- State Key Laboratory of Infectious Disease Prevention and Control, Chinese Center for Disease Control and Prevention, National Institute for Communicable Disease Control and Prevention, Changping, Beijing, China
| | - Xuexin Hou
- State Key Laboratory of Infectious Disease Prevention and Control, Chinese Center for Disease Control and Prevention, National Institute for Communicable Disease Control and Prevention, Changping, Beijing, China
| | - Zhiguo Liu
- State Key Laboratory of Infectious Disease Prevention and Control, Chinese Center for Disease Control and Prevention, National Institute for Communicable Disease Control and Prevention, Changping, Beijing, China
| | - Lina Sun
- State Key Laboratory of Infectious Disease Prevention and Control, Chinese Center for Disease Control and Prevention, National Institute for Communicable Disease Control and Prevention, Changping, Beijing, China
| | - Shuai Xu
- State Key Laboratory of Infectious Disease Prevention and Control, Chinese Center for Disease Control and Prevention, National Institute for Communicable Disease Control and Prevention, Changping, Beijing, China
| | - Xingzhao Ji
- State Key Laboratory of Infectious Disease Prevention and Control, Chinese Center for Disease Control and Prevention, National Institute for Communicable Disease Control and Prevention, Changping, Beijing, China
| | - Heqiao Li
- School of Laboratory Medicine and Life Sciences, Wenzhou Medical University, Wenzhou, China
| | - Dan Li
- State Key Laboratory of Infectious Disease Prevention and Control, Chinese Center for Disease Control and Prevention, National Institute for Communicable Disease Control and Prevention, Changping, Beijing, China
| | - Jingshan Zhang
- State Key Laboratory of Infectious Disease Prevention and Control, Chinese Center for Disease Control and Prevention, National Institute for Communicable Disease Control and Prevention, Changping, Beijing, China
| | - Hui Zeng
- Beijing Key Laboratory of Emerging Infectious Diseases, Institute of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Zhenjun Li
- State Key Laboratory of Infectious Disease Prevention and Control, Chinese Center for Disease Control and Prevention, National Institute for Communicable Disease Control and Prevention, Changping, Beijing, China
| |
Collapse
|
21
|
Ramos JN, Souza C, Faria YV, da Silva EC, Veras JFC, Baio PVP, Seabra SH, de Oliveira Moreira L, Hirata Júnior R, Mattos-Guaraldi AL, Vieira VV. Bloodstream and catheter-related infections due to different clones of multidrug-resistant and biofilm producer Corynebacterium striatum. BMC Infect Dis 2019; 19:672. [PMID: 31357945 PMCID: PMC6664767 DOI: 10.1186/s12879-019-4294-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 07/17/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Corynebacterium striatum is an emerging multidrug-resistant (MDR) pathogen associated with immunocompromised and chronically ill patients, as well as nosocomial outbreaks. In this study, we characterized 23 MDR C. striatum isolated of bloodstream and catheter-related infections from a hospital of Rio de Janeiro. METHODS C. striatum isolates were identified by 16S rRNA and rpoB genes sequencing. The dissemination of these isolates was accomplished by pulsed-field gel electrophoresis (PFGE). All isolates were submitted to antimicrobial susceptibility testing by disk diffusion and by minimum inhibitory concentration using E-test strips methods. Antimicrobial resistance genes were detected by polymerase chain reaction. Quantitative tests were performed on four different abiotic surfaces and the ability to produce biofilm on the surface of polyurethane and silicone catheter was also demonstrated by scanning electron microscopy. RESULTS Eleven PFGE profiles were found. The PFGE profile I was the most frequently observed among isolates. Five different MDR profiles were found and all PFGE profile I isolates presented susceptibility only to tetracycline, vancomycin, linezolid and daptomycin. Only the multidrug-susceptible isolate did not show mutations in the quinolone-resistance determinant region (QRDR) of the gyrA gene and was negative in the search of genes encoding antibiotic resistance. The other 22 isolates were positive to resistance genes to aminoglycoside, macrolides/lincosamides and chloramphenicol and showed mutations in the QRDR of the gyrA gene. Scanning electron microscopy illustrated the ability of MDR blood isolate partaker of the epidemic clone (PFGE profile I) to produce mature biofilm on the surface of polyurethane and silicone catheter. CONCLUSIONS Genotyping analysis by PFGE revealed the permanence of the MDR PFGE profile I in the nosocomial environment. Other new PFGE profiles emerged as etiologic agents of invasive infections. However, the MDR PFGE profile I was also found predominant among patients with hematogenic infections. The high level of multidrug resistance associated with biofilm formation capacity observed in MDR C. striatum is a case of concern.
Collapse
Affiliation(s)
- Juliana Nunes Ramos
- Laboratório de Difteria e Corinebactérias de Importância Clínica, Faculdade de Ciências Médicas, Centro Colaborador e Referência para pesquisa de Difteria/Ministério da Saúde, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
- Instituto Nacional de Controle de Qualidade em Saúde, Fundação Oswaldo Cruz, INCQS/FIOCRUZ, Rio de Janeiro, Brazil
- Laboratório Interdisciplinar de Pesquisas Médicas (LIPMED), Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Av. Brasil, 4365, Pavilhão Cardoso Fontes, 10 andar, sala 17, Manguinhos, Rio de Janeiro, 21040-900 Brazil
| | - Cassius Souza
- Laboratório de Difteria e Corinebactérias de Importância Clínica, Faculdade de Ciências Médicas, Centro Colaborador e Referência para pesquisa de Difteria/Ministério da Saúde, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Yuri Vieira Faria
- Laboratório de Difteria e Corinebactérias de Importância Clínica, Faculdade de Ciências Médicas, Centro Colaborador e Referência para pesquisa de Difteria/Ministério da Saúde, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
- Laboratório de Tecnologia em Bioquímica e Microscopia, Centro Universitário Estadual da Zona Oeste, Rio de Janeiro, Brazil
| | - Eliane Cristine da Silva
- Laboratório de Difteria e Corinebactérias de Importância Clínica, Faculdade de Ciências Médicas, Centro Colaborador e Referência para pesquisa de Difteria/Ministério da Saúde, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - João Flávio Carneiro Veras
- Instituto Nacional de Controle de Qualidade em Saúde, Fundação Oswaldo Cruz, INCQS/FIOCRUZ, Rio de Janeiro, Brazil
| | - Paulo Victor Pereira Baio
- Laboratório de Difteria e Corinebactérias de Importância Clínica, Faculdade de Ciências Médicas, Centro Colaborador e Referência para pesquisa de Difteria/Ministério da Saúde, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
- Laboratório Interdisciplinar de Pesquisas Médicas (LIPMED), Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Av. Brasil, 4365, Pavilhão Cardoso Fontes, 10 andar, sala 17, Manguinhos, Rio de Janeiro, 21040-900 Brazil
| | - Sérgio Henrique Seabra
- Laboratório de Tecnologia em Bioquímica e Microscopia, Centro Universitário Estadual da Zona Oeste, Rio de Janeiro, Brazil
| | - Lilian de Oliveira Moreira
- Laboratório de Bacteriologia e Imunologia Clínica, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Raphael Hirata Júnior
- Laboratório de Difteria e Corinebactérias de Importância Clínica, Faculdade de Ciências Médicas, Centro Colaborador e Referência para pesquisa de Difteria/Ministério da Saúde, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Ana Luíza Mattos-Guaraldi
- Laboratório de Difteria e Corinebactérias de Importância Clínica, Faculdade de Ciências Médicas, Centro Colaborador e Referência para pesquisa de Difteria/Ministério da Saúde, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Verônica Viana Vieira
- Laboratório Interdisciplinar de Pesquisas Médicas (LIPMED), Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Av. Brasil, 4365, Pavilhão Cardoso Fontes, 10 andar, sala 17, Manguinhos, Rio de Janeiro, 21040-900 Brazil
| |
Collapse
|
22
|
Qiu X, Chen D, Wang X, Zhou H, Hou X, Zhang J, Li M, Li Z. A novel isothermal amplification-based method for detection of Corynebacterium striatum. J Microbiol Methods 2019; 164:105675. [PMID: 31351107 DOI: 10.1016/j.mimet.2019.105675] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 07/23/2019] [Accepted: 07/23/2019] [Indexed: 11/16/2022]
Abstract
Corynebacterium striatum is an emerging multidrug-resistant pathogen causing increasing numbers of infections and nosocomial outbreaks worldwide. Thus, a simple, rapid and accurate method for C. striatum is urgently required for improving diagnosis efficiency. In this study, a C. striatum-multiple cross displacement amplification (MCDA) with visual detection reagent (VR) assay (C. striatum-MCDA-VR), which was a novel isothermal amplification-based method, was established to detect the species-specific ftr1 gene of C. striatum. Amplification was performed at a constant temperature (68 °C) for only 40 min, and the reaction results could be easily elucidated by observation of reaction mixture color when employing the VR. The limit of detection of this method was 10 fg of pure C. striatum DNA. No cross-reaction was observed with non-C. striatum strains. In testing of clinical sputum samples, the C. striatum-MCDA-VR assay showed excellent sensitivity and specificity when compared with sputum smear tests and PCR. The C. striatum-MCDA-VR assay is a simple, rapid and cost-effective approach for identifying C. striatum in microbiological laboratories, especially in resource-limited settings.
Collapse
Affiliation(s)
- Xiaotong Qiu
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Changping, Beijing, China
| | - Dongke Chen
- Department of Laboratory Medicine, Beijing Hospital, National Center of Gerontology, Beijing, China
| | - Xuebing Wang
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Changping, Beijing, China
| | - Haijian Zhou
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Changping, Beijing, China
| | - Xuexin Hou
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Changping, Beijing, China
| | - Jingshan Zhang
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Changping, Beijing, China
| | - Mengtong Li
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Changping, Beijing, China
| | - Zhenjun Li
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Changping, Beijing, China.
| |
Collapse
|
23
|
Suh JW, Ju Y, Lee CK, Sohn JW, Kim MJ, Yoon YK. Molecular epidemiology and clinical significance of Corynebacterium striatum isolated from clinical specimens. Infect Drug Resist 2019; 12:161-171. [PMID: 30655682 PMCID: PMC6324608 DOI: 10.2147/idr.s184518] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Purpose This study investigated the clinical epidemiology, antimicrobial susceptibility, and molecular epidemiology of Corynebacterium striatum isolates. Patients and methods An observational study was conducted at a university hospital in the Republic of Korea from August to December 2016. All subjects were patients who tested positive for C. striatum clinically. Clinical data were analyzed to evaluate the microbiological and genotypic characteristics of C. striatum strains. Results Sixty-seven C. striatum isolates recovered from non-duplicated patients were characterized. Patients were classified into three groups according to the infection type: nosocomial infection (71.6%), health care-associated infection (8.7%), and community-acquired infection (18.8%). The most common clinical specimens were urine (35.8%) and skin abscesses (32.8%). Fifty-two (77.6%) isolates showed multidrug resistance, defined as resistance to ≥3 different antibiotic families. All strains were susceptible to vancomycin and linezolid. Resistance to other antibiotics varied: penicillin (n=65; 97.0%), ampicillin (n=63; 94.0%), cefotaxime (n=64; 95.5%), and levofloxacin (n=61; 91.0%). Phylogenetic analysis identified all 16 S rRNA gene sequences of the 67 isolates as those of C. striatum, where 98%–99% were homologous to C. striatum ATCC 6940. In multilocus sequence typing for internal transcribed spacer region, gyrA, and rpoB sequencing, the most predominant sequence types (STs) were ST2, ST3, ST6, and ST5. Conclusion C. striatum isolates may cause opportunistic infections associated with nosocomial infections through horizontal transmission. The presence of multidrug resistance and intra-hospital dissemination implicate C. striatum isolates as a potential target pathogen for infection control and antimicrobial stewardship programs.
Collapse
Affiliation(s)
- Jin Woong Suh
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea,
| | - Yongguk Ju
- Institute of Emerging Infectious Diseases, Korea University College of Medicine, Seoul, Republic of Korea,
| | - Chang Kyu Lee
- Department of Laboratory Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Jang Wook Sohn
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea, .,Institute of Emerging Infectious Diseases, Korea University College of Medicine, Seoul, Republic of Korea,
| | - Min Ja Kim
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea, .,Institute of Emerging Infectious Diseases, Korea University College of Medicine, Seoul, Republic of Korea,
| | - Young Kyung Yoon
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea, .,Institute of Emerging Infectious Diseases, Korea University College of Medicine, Seoul, Republic of Korea,
| |
Collapse
|
24
|
Los-Arcos I, Len O, Martín-Gómez MT, Baroja A, Berastegui C, Deu M, Sacanell J, Román A, Gavaldà J. Clinical Characteristics and Outcome of Lung Transplant Recipients with Respiratory Isolation of Corynebacterium spp. J Clin Microbiol 2018; 56:e00142-18. [PMID: 29793964 PMCID: PMC6062803 DOI: 10.1128/jcm.00142-18] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 05/12/2018] [Indexed: 01/28/2023] Open
Abstract
Although chronic respiratory disease and immunosuppression are risk factors for Corynebacterium species respiratory infection, data are scarce regarding this disease in lung transplantation. Our aim was to describe the clinical characteristics and outcomes of lung transplant recipients (LTR) with respiratory isolation of Corynebacterium spp. This was a retrospective observational study performed at a referral center in Barcelona, Spain (2014 to 2016). We included all LTR in whom Corynebacterium spp. were isolated in at least one good-quality lower respiratory tract specimen. Overall, 24 of 527 (4.6%) LTR at risk during the study period were included. The main epidemiological, clinical, and microbiological data were analyzed. The most frequently isolated species were C. striatum (11/24), C. pseudodiphtheriticum (3/24), and C. amycolatum (3/24). All 19 (76%) patients who underwent bronchoscopy showed abnormalities, mainly mucosal plaques at the bronchial suture and purulent secretions. Clinical cure was achieved in 8/12 (67%) patients who fulfilled the CDC definition of lower respiratory tract infection (LRTI). To assess the clinical relevance of Corynebacterium spp., only patients with monomicrobial isolation (n = 18) were evaluated. LRTI was diagnosed in 9, and a nonsignificant association was found with a significant number of Corynebacterium sp. CFU/ml (7/9 LRTI versus 2/9 non-LRTI, P = 0.057). Persistent infection was associated with metallic bronchial stent implantation (4/4 versus 2/14, P = 0.005). The isolation of Corynebacterium spp. in respiratory specimens of lung transplant recipients may herald a respiratory tract infection or bronchial suture damage. Bronchial stent implantation is a risk factor for the persistence of Corynebacterium species infection.
Collapse
Affiliation(s)
- Ibai Los-Arcos
- Infectious Diseases Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Oscar Len
- Infectious Diseases Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - María Teresa Martín-Gómez
- Microbiology Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Aída Baroja
- Internal Medicine Department, Complejo Hospitalario Universitario de Vigo, Vigo, Spain
| | - Cristina Berastegui
- Lung Transplant Unit, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - María Deu
- Thoracic Surgery Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Judith Sacanell
- Critical Care Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Antonio Román
- Lung Transplant Unit, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Joan Gavaldà
- Infectious Diseases Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| |
Collapse
|
25
|
Ramos JN, Rodrigues IDS, Baio PVP, Veras JFC, Ramos RTJ, Pacheco LG, Azevedo VA, Hirata Júnior R, Marín MA, Mattos-Guaraldi ALD, Vieira VV. Genome sequence of a multidrug-resistant Corynebacterium striatum isolated from bloodstream infection from a nosocomial outbreak in Rio de Janeiro, Brazil. Mem Inst Oswaldo Cruz 2018; 113:e180051. [PMID: 29995109 PMCID: PMC6037045 DOI: 10.1590/0074-02760180051] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 05/25/2018] [Indexed: 12/14/2022] Open
Abstract
Multidrug-resistant (MDR) Corynebacterium striatum has been cited with increased frequency as pathogen of nosocomial infections. In this study, we report the draft genome of a C. striatum isolated from a patient with bloodstream infection in a hospital of Rio de Janeiro, Brazil. The isolate presented susceptibility only to tetracycline, vancomycin and linezolid. The detection of various antibiotic resistance genes is fully consistent with previously observed multidrug-resistant pattern in Corynebacterium spp. A large part of the pTP10 plasmid of MDR C. striatum M82B is present in the genome of our isolate. A SpaDEF cluster and seven arrays of CRISPR-Cas were found.
Collapse
Affiliation(s)
- Juliana Nunes Ramos
- Fundação Oswaldo Cruz-Fiocruz, Instituto Nacional de Controle de Qualidade em Saúde, Rio de Janeiro, RJ, Brasil.,Universidade do Estado do Rio de Janeiro, Faculdade de Ciências Médicas, Laboratório de Difteria e Corinebactérias de Importância Clínica, Rio de Janeiro, RJ, Brasil
| | - Izabel Dos Santos Rodrigues
- Fundação Oswaldo Cruz-Fiocruz, Instituto Nacional de Controle de Qualidade em Saúde, Rio de Janeiro, RJ, Brasil.,Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório Interdisciplinar de Pesquisas Médicas, Rio de Janeiro, RJ, Brasil
| | - Paulo Victor Pereira Baio
- Universidade do Estado do Rio de Janeiro, Faculdade de Ciências Médicas, Laboratório de Difteria e Corinebactérias de Importância Clínica, Rio de Janeiro, RJ, Brasil
| | - João Flávio Carneiro Veras
- Fundação Oswaldo Cruz-Fiocruz, Instituto Nacional de Controle de Qualidade em Saúde, Rio de Janeiro, RJ, Brasil
| | | | - Luis Gc Pacheco
- Universidade Federal da Bahia, Instituto de Ciências da Saúde, Salvador, BA, Brasil
| | - Vasco Ariston Azevedo
- Universidade Federal de Minas Gerais, Instituto de Ciências Biológicas, Belo Horizonte, MG, Brasil
| | - Raphael Hirata Júnior
- Universidade do Estado do Rio de Janeiro, Faculdade de Ciências Médicas, Laboratório de Difteria e Corinebactérias de Importância Clínica, Rio de Janeiro, RJ, Brasil
| | - Michel Abanto Marín
- University of La Frontera, Scientific and Technological Bioresource Nucleus, Temuco, Chile
| | - Ana Luiza de Mattos-Guaraldi
- Universidade do Estado do Rio de Janeiro, Faculdade de Ciências Médicas, Laboratório de Difteria e Corinebactérias de Importância Clínica, Rio de Janeiro, RJ, Brasil
| | - Verônica Viana Vieira
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório Interdisciplinar de Pesquisas Médicas, Rio de Janeiro, RJ, Brasil
| |
Collapse
|
26
|
Kang SJ, Choi SM, Choi JA, Choi JU, Oh TH, Kim SE, Kim UJ, Won EJ, Jang HC, Park KH, Shin JH, Kweon SS, Jung SI. Factors affecting the clinical relevance of Corynebacterium striatum isolated from blood cultures. PLoS One 2018; 13:e0199454. [PMID: 29928059 PMCID: PMC6013186 DOI: 10.1371/journal.pone.0199454] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Accepted: 06/07/2018] [Indexed: 02/07/2023] Open
Abstract
This study aimed to identify clinical or microbiological factors affecting the clinical relevance of Corynebacterium striatum isolated from blood cultures. A total of 64 isolates from 51 patients identified as C. striatum by matrix assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) and 16S rRNA gene sequencing were assessed. More than two blood cultures were positive in 25 (48.1%) patients. Diabetes, solid tumor, and a history of previous exposure to antibiotics were more common in patients with multiple positive blood cultures. Charlson comorbidity scores were also higher, and more isolates were recovered after 48 hours of hospital stay in patients with multiple positive blood cultures. Strains recovered from patients with multiple positive blood cultures produced significantly more biofilm. Based on multilocus sequence typing (MLST), sequence type (ST) 20 (31.3%) was the most dominant, followed by ST2 (20.3%) and ST23 (10.9%). There was no relationship between the number of positive blood culture sets and sequence typing. In multivariate analyses, Carlson comorbidity score (odds ratio [OR], 1.91; 95% confidence interval [CI], 1.09–3.36; P = 0.03) and biofilm formation were associated with multiple positive blood cultures (OR, 17.43; 95% CI, 3.71–81.91; P = 0.03). This study provides evidence that the biofilm phenotype could contribute to determining the clinical significance of C. striatum in patients with severe underlying conditions. The predominance of certain STs suggests the relatedness of C. striatum infection and the nosocomial environment.
Collapse
Affiliation(s)
- Seung Ji Kang
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, South Korea
| | - Su-Mi Choi
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, South Korea
| | - Jin-A Choi
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, South Korea
| | - Jin Un Choi
- Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, South Korea
| | - Tae-Hoon Oh
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, South Korea
| | - Seong Eun Kim
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, South Korea
| | - Uh Jin Kim
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, South Korea
| | - Eun Jeong Won
- Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, South Korea
| | - Hee-Chang Jang
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, South Korea
| | - Kyung-Hwa Park
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, South Korea
| | - Jong Hee Shin
- Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, South Korea
| | - Sun-Seog Kweon
- Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, South Korea
| | - Sook-In Jung
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, South Korea
- * E-mail:
| |
Collapse
|
27
|
Comparison between disk diffusion and agar dilution methods to determine in vitro susceptibility of Corynebacterium spp. clinical isolates and update of their susceptibility. J Glob Antimicrob Resist 2018; 14:246-252. [PMID: 29782954 DOI: 10.1016/j.jgar.2018.05.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 05/11/2018] [Accepted: 05/11/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES Although Corynebacterium spp. are part of the microbiota of the skin and mucous membranes, human infections caused by Corynebacterium spp. have been reported and the multidrug resistance pattern of the recovered isolates was emphasised. Due to the usefulness of disk diffusion in daily practice, the purpose of this study was to compare disk diffusion with agar dilution to determine disk diffusion breakpoints and to review the antimicrobial susceptibility of the most frequent Corynebacterium spp. isolated in clinical samples. METHODS Susceptibility to 20 antimicrobial agents of 143 Corynebacterium spp. isolates recovered from relevant clinical samples was determined. Comparison between the disk diffusion and agar dilution methods for eight antimicrobial agents was performed to establish new breakpoints using simple linear regression analysis. RESULTS All of the isolates tested were susceptible to vancomycin, minocycline and linezolid. A typical susceptibility profile to β-lactam antibiotics among the different species included was not observed. Almost all isolates showed resistance to macrolides and lincosamides. Using a simple linear regression method, it was possible to establish breakpoints for penicillin, erythromycin, clindamycin, gentamicin and ciprofloxacin. However, the low correlation coefficient obtained for vancomycin, minocycline and trimethoprim/sulfamethoxazole did not allow establishment of breakpoints for the disk diffusion method. CONCLUSION The disk diffusion method could only be used to evaluate susceptibility to penicillin, erythromycin, clindamycin, gentamicin and ciprofloxacin. These data show that the presence of a Corynebacterium spp. isolate in a clinical sample demands the performance of antimicrobial susceptibility testing since the susceptibility profile is not predictable.
Collapse
|
28
|
Salto IP, Torres Tejerizo G, Wibberg D, Pühler A, Schlüter A, Pistorio M. Comparative genomic analysis of Acinetobacter spp. plasmids originating from clinical settings and environmental habitats. Sci Rep 2018; 8:7783. [PMID: 29773850 PMCID: PMC5958079 DOI: 10.1038/s41598-018-26180-3] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 04/27/2018] [Indexed: 12/20/2022] Open
Abstract
Bacteria belonging to the genus Acinetobacter have become of clinical importance over the last decade due to the development of a multi-resistant phenotype and their ability to survive under multiple environmental conditions. The development of these traits among Acinetobacter strains occurs frequently as a result of plasmid-mediated horizontal gene transfer. In this work, plasmids from nosocomial and environmental Acinetobacter spp. collections were separately sequenced and characterized. Assembly of the sequenced data resulted in 19 complete replicons in the nosocomial collection and 77 plasmid contigs in the environmental collection. Comparative genomic analysis showed that many of them had conserved backbones. Plasmid coding sequences corresponding to plasmid specific functions were bioinformatically and functionally analyzed. Replication initiation protein analysis revealed the predominance of the Rep_3 superfamily. The phylogenetic tree constructed from all Acinetobacter Rep_3 superfamily plasmids showed 16 intermingled clades originating from nosocomial and environmental habitats. Phylogenetic analysis of relaxase proteins revealed the presence of a new sub-clade named MOBQAci, composed exclusively of Acinetobacter relaxases. Functional analysis of proteins belonging to this group showed that they behaved differently when mobilized using helper plasmids belonging to different incompatibility groups.
Collapse
Affiliation(s)
- Ileana P Salto
- IBBM (Instituto de Biotecnología y Biología Molecular), CCT-CONICET-La Plata, Departamento de Ciencias Biológicas, Facultad de Ciencias Exactas, Universidad Nacional de La Plata, Calles 47 y 115 (1900), La Plata, Argentina
| | - Gonzalo Torres Tejerizo
- IBBM (Instituto de Biotecnología y Biología Molecular), CCT-CONICET-La Plata, Departamento de Ciencias Biológicas, Facultad de Ciencias Exactas, Universidad Nacional de La Plata, Calles 47 y 115 (1900), La Plata, Argentina
- Center for Biotechnology (CeBiTec), Bielefeld University, Genome Research of Industrial Microorganisms, Universitätsstr. 27, D-33615, Bielefeld, Germany
| | - Daniel Wibberg
- Center for Biotechnology (CeBiTec), Bielefeld University, Genome Research of Industrial Microorganisms, Universitätsstr. 27, D-33615, Bielefeld, Germany
| | - Alfred Pühler
- Center for Biotechnology (CeBiTec), Bielefeld University, Genome Research of Industrial Microorganisms, Universitätsstr. 27, D-33615, Bielefeld, Germany
| | - Andreas Schlüter
- Center for Biotechnology (CeBiTec), Bielefeld University, Genome Research of Industrial Microorganisms, Universitätsstr. 27, D-33615, Bielefeld, Germany
| | - Mariano Pistorio
- IBBM (Instituto de Biotecnología y Biología Molecular), CCT-CONICET-La Plata, Departamento de Ciencias Biológicas, Facultad de Ciencias Exactas, Universidad Nacional de La Plata, Calles 47 y 115 (1900), La Plata, Argentina.
| |
Collapse
|
29
|
Benli AR, Adahan D. Applying local vancomycin with vacuum-assisted closure on decubitus isolated Corynebacterium striatum: a case report. FAMILY PRACTICE AND PALLIATIVE CARE 2018. [DOI: 10.22391/fppc.338928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
|
30
|
In Vitro Antibiotic Susceptibility Pattern of Non-diphtheriae Corynebacterium Isolates in Ontario, Canada, from 2011 to 2016. Antimicrob Agents Chemother 2018; 62:AAC.01776-17. [PMID: 29339389 DOI: 10.1128/aac.01776-17] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 01/04/2018] [Indexed: 12/15/2022] Open
Abstract
Non-diphtheriae Corynebacterium-associated disease has been increasingly observed and often presents a conundrum to the treating physician. Analysis of antibiotic susceptibility testing data for 1,970 clinical Corynebacterium isolates received between 2011 and 2016 revealed that empirical drug treatment options are limited to vancomycin and linezolid. Corynebacterium striatum was the most frequently observed species during this study period, along with C. amycolatum and C. pseudodiphtheriticum/C. propinquum Low levels of susceptibility to penicillin (14.5%), erythromycin (15.1%), and clindamycin (8.7%) were observed for non-diphtheriae Corynebacterium species, while 3.0% of isolates were not susceptible to daptomycin. Similarly, 26.9% and 38.1% of Corynebacterium isolates were susceptible to ciprofloxacin and trimethoprim-sulfamethoxazole, respectively. Our data show much lower susceptibility to penicillin than previously reported in the literature and an increasing number of isolates resistant to daptomycin, highlighting the need for continued antibiotic surveillance studies for appropriate patient management and treatment success.
Collapse
|
31
|
Hahn WO, Werth BJ, Butler-Wu SM, Rakita RM. Multidrug-Resistant Corynebacterium striatum Associated with Increased Use of Parenteral Antimicrobial Drugs. Emerg Infect Dis 2018; 22. [PMID: 27767926 PMCID: PMC5088002 DOI: 10.3201/eid2211.160141] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Device-related infections with this pathogen frequently require prolonged parenteral therapy. Corynebacterium striatum is an emerging multidrug-resistant bacteria. We retrospectively identified 179 isolates in a clinical database. Clinical relevance, in vitro susceptibility, and length of parenteral antimicrobial drug use were obtained from patient records. For patients with hardware- or device-associated infections, those with C. striatum infections were matched with patients infected with coagulase-negative staphylococci for case–control analysis. A total of 87 (71%) of 121 isolates were resistant to all oral antimicrobial drugs tested, including penicillin, tetracycline, clindamycin, erythromycin, and ciprofloxacin. When isolated from hardware or devices, C. striatum was pathogenic in 38 (87%) of 44 cases. Patients with hardware-associated C. striatum infections received parenteral antimicrobial drugs longer than patients with hardware-associated coagulase-negative staphylococci infections (mean ± SD 69 ± 5 days vs. 25 ± 4 days; p<0.001). C. striatum commonly shows resistance to antimicrobial drugs with oral bioavailability and is associated with increased use of parenteral antimicrobial drugs.
Collapse
|
32
|
Yanai M, Ogasawasa M, Hayashi Y, Suzuki K, Takahashi H, Satomura A. Retrospective evaluation of the clinical characteristics associated with Corynebacterium species bacteremia. Braz J Infect Dis 2018; 22:24-29. [PMID: 29360429 PMCID: PMC9425686 DOI: 10.1016/j.bjid.2017.12.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 12/20/2017] [Accepted: 12/21/2017] [Indexed: 12/01/2022] Open
Abstract
Objectives Corynebacterium spp. are becoming recognized as pathogens that potentially cause various infections. We aimed to evaluate the clinical characteristics associated with Corynebacterium spp. bacteremia. Patients and methods We retrospectively reviewed the medical records of all adult patients who had positive blood cultures for Corynebacterium spp. in a single university hospital between January 2014 and December 2016. Patients were divided into a bacteremia group and a contamination group based on microbiological test results and clinical characteristics. Patients’ characteristics, antimicrobial susceptibility of isolated species, antimicrobials administered, and patient outcomes were evaluated. Results Corynebacterium spp. were isolated from blood samples of 63 patients; Corynebacterium striatum was the predominant isolate. Twenty-eight patients were determined to have bacteremia. Younger age (p = 0.023), shorter time to positivity (p = 0.006), longer hospital stay (p = 0.009), and presence of an indwelling vascular catheter (p = 0.002) were observed more often in the bacteremia group compared to the contamination group. The source of infection in most patients with bacteremia was an intravenous catheter. All tested strains were susceptible to vancomycin. Four of the 27 patients with bacteremia died, despite administration of appropriate antimicrobial therapy. Conclusions We found that younger age, shorter time to positivity, and presence of an indwelling catheter were related to bacteremia caused by Corynebacterium spp. Appropriate antimicrobials should be administered once Corynebacterium spp. are isolated from the blood and bacteremia is suspected.
Collapse
Affiliation(s)
- Mitsuru Yanai
- Nihon University School of Medicine, Department of Internal Medicine, Division of General Medicine, Tokyo, Japan.
| | - Maiko Ogasawasa
- Nihon University School of Medicine, Department of Internal Medicine, Division of General Medicine, Tokyo, Japan
| | - Yuta Hayashi
- Nihon University School of Medicine, Department of Internal Medicine, Division of General Medicine, Tokyo, Japan
| | - Kiyozumi Suzuki
- Nihon University School of Medicine, Department of Internal Medicine, Division of General Medicine, Tokyo, Japan
| | - Hiromichi Takahashi
- Nihon University School of Medicine, Department of Pathology and Mircobiology, Division of Laboratory Medicine, Tokyo, Japan
| | - Atsushi Satomura
- Nihon University School of Medicine, Department of Pathology and Mircobiology, Division of Laboratory Medicine, Tokyo, Japan
| |
Collapse
|
33
|
Genomics of Corynebacterium striatum, an emerging multidrug-resistant pathogen of immunocompromised patients. Clin Microbiol Infect 2018; 24:1016.e7-1016.e13. [PMID: 29326010 DOI: 10.1016/j.cmi.2017.12.024] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 12/27/2017] [Accepted: 12/28/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Corynebacterium striatum is an emerging multidrug-resistant (MDR) pathogen of immunocompromised and chronically ill patients. The objective of these studies was to provide a detailed genomic analysis of disease-causing C. striatum and determine the genomic drivers of resistance and resistance-gene transmission. METHODS A multi-institutional and prospective pathogen genomics programme flagged seven MDR C. striatum infections occurring close in time, and specifically in immunocompromised patients with underlying respiratory diseases. Whole genome sequencing was used to identify clonal relationships among strains, genetic causes of antimicrobial resistance, and their mobilization capacity. Matrix-assisted linear desorption/ionization-time-of-flight analyses of sequenced isolates provided curated content to improve rapid clinical identification in subsequent cases. RESULTS Epidemiological and genomic analyses identified a related cluster of three out of seven C. striatum among lung transplant patients who had common procedures and exposures at an outlying institution. Genomic analyses further elucidated drivers of the MDR phenotypes, including resistance genes mobilized by IS3504 and ISCg9a-like insertion sequences. Seven mobilizable resistance genes were localized to a common chromosomal region bounded by unpaired insertion sequences, suggesting that a single recombination event could spread resistance to aminoglycosides, macrolides, lincosamides and tetracyclines to naive strains. CONCLUSION In-depth genomic studies of MDR C. striatum reveal its capacity for clonal spread within and across healthcare institutions and identify novel vectors that can mobilize multiple forms of drug resistance, further complicating efforts to treat infections in immunocompromised populations.
Collapse
|
34
|
Bao R, Gao X, Hu B, Zhou Z. Matrix-assisted laser desorption ionization time-of-flight mass spectrometry: a powerful tool for identification of Corynebacterium species. J Thorac Dis 2017; 9:3239-3245. [PMID: 29221301 DOI: 10.21037/jtd.2017.09.69] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) is a powerful tool that has initiated a revolution in the clinical microbiology laboratory for identification of nosocomial pathogens. The efficacy of MALDI-TOF MS produced by bioMerieux, Marcy l'Etoile, France (VITEK MS) for detecting Corynebacterium remains unknown. Methods Corynebacterium isolates were isolated from clinical specimen in a tertial teaching hospital from 2012 to 2013. All strains confirmed by rpoB sequencing were identified by API Coryne (bioMerieux), Phoenix (BD) and VITEK MS, respectively. The coincidence rate was used to evaluate the consistency and accuracy across three methods. Results In all, 75 Corynebacterium isolates were collected in this study. The dominant isolates were Corynebacterium striatum (58.7%), Corynebacterium jeikeium (16.0%), Corynebacterium amycolatum (5.3%), Corynebacterium urealyticum (5.3%), Corynebacterium glucuronolyticum (2.7%) and Corynebacterium minutissimum (2.7%). We found that there was no significant difference in the identification of corynebacterium to genus level by MS (100%, 75/75) or Phoenix (93.3%, 70/75) (P=0.058). However, 92.0% (69/75) strains were successfully identified to species by MS while which by Phoenix and API was 78.7% and 65.3% respectively. Compared with gene sequencing, the coincidence rate of identification by MS was significantly higher than Phoenix (P=0.036) and API (P<0.001). Compared with API Coryne (bioMerieux) and Phoenix, VITEK MS shown significant shorter detecting period and less cost. Conclusions VITEK MS was a powerful tool, which could be applied in clinical laboratory, improving the diagnosis for Corynebacterium infection.
Collapse
Affiliation(s)
- Rong Bao
- Department of Clinical Microbiology Laboratory, Respiratory, Zhongshan Hospital, Fudan University, Shanghai 20032, China
| | | | | | - Zhaoyan Zhou
- Department of Clinical Microbiology Laboratory, Respiratory, Zhongshan Hospital, Fudan University, Shanghai 20032, China
| |
Collapse
|
35
|
Alibi S, Ferjani A, Boukadida J, Cano ME, Fernández-Martínez M, Martínez-Martínez L, Navas J. Occurrence of Corynebacterium striatum as an emerging antibiotic-resistant nosocomial pathogen in a Tunisian hospital. Sci Rep 2017; 7:9704. [PMID: 28848236 PMCID: PMC5573724 DOI: 10.1038/s41598-017-10081-y] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 08/04/2017] [Indexed: 11/17/2022] Open
Abstract
Corynebacterium striatum is a nosocomial opportunistic pathogen increasingly associated with a wide range of human infections and is often resistant to several antibiotics. We investigated the susceptibility of 63 C. striatum isolated at the Farhat-Hached hospital, Sousse (Tunisia), during the period 2011–2014, to a panel of 16 compounds belonging to the main clinically relevant classes of antimicrobial agents. All strains were susceptible to vancomycin, linezolid, and daptomycin. Amikacin and gentamicin also showed good activity (MICs90 = 1 and 2 mg/L, respectively). High rates of resistance to penicillin (82.5%), clindamycin (79.4%), cefotaxime (60.3%), erythromycin (47.6%), ciprofloxacin (36.5%), moxifloxacin (34.9%), and rifampicin (25.4%) were observed. Fifty-nine (93.7%) out of the 63 isolates showed resistance to at least one compound and 31 (49.2%) were multidrug-resistant. Twenty-nine resistance profiles were distinguished among the 59 resistant C. striatum. Most of the strains resistant to fluoroquinolones showed a double mutation leading to an amino acid change in positions 87 and 91 in the quinolone resistance-determining region of the gyrA gene. The 52 strains resistant to penicillin were positive for the gene bla, encoding a class A β-lactamase. Twenty-two PFGE patterns were identified among the 63 C. striatum, indicating that some clones have spread within the hospital.
Collapse
Affiliation(s)
- Sana Alibi
- Laboratoire de microbiologie-immunologie, unite de recherché "caractérisation génomique des agents infectieux UR12SP34", CHU Farhat-Hached, Sousse, Tunisia.,Faculté des sciences de Bizerte, Université de Carthage, Jarzouna, Tunisia
| | - Asma Ferjani
- Laboratoire de microbiologie-immunologie, unite de recherché "caractérisation génomique des agents infectieux UR12SP34", CHU Farhat-Hached, Sousse, Tunisia
| | - Jalel Boukadida
- Laboratoire de microbiologie-immunologie, unite de recherché "caractérisation génomique des agents infectieux UR12SP34", CHU Farhat-Hached, Sousse, Tunisia
| | - María Eliecer Cano
- Servicio de Microbiología, Hospital Universitario Marqués de Valdecilla-IDIVAL, Santander, Spain
| | - Marta Fernández-Martínez
- Servicio de Microbiología, Hospital Universitario Marqués de Valdecilla-IDIVAL, Santander, Spain
| | - Luis Martínez-Martínez
- Unidad de Gestión Clínica, Hospital Universitario Reina Sofía, Córdoba, Spain.,Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain.,Departamento de Microbiología, Universidad de Córdoba, Córdoba, Spain
| | - Jesús Navas
- Departamento de Biología Molecular, Universidad de Cantabria, Santander, Spain.
| |
Collapse
|
36
|
Steensels D, Deplano A, Denis O, Simon A, Verroken A. MALDI-TOF MS typing of a nosocomial methicillin-resistant Staphylococcus aureus outbreak in a neonatal intensive care unit. Acta Clin Belg 2017; 72:219-225. [PMID: 27344933 DOI: 10.1080/17843286.2016.1198521] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND The early detection of a methicillin-resistant Staphylococcus aureus (MRSA) outbreak is decisive to control its spread and rapidly initiate adequate infection control measures. Therefore, prompt determination of epidemiologic relatedness of clinical MRSA isolates is essential. Genetic typing methods have a high discriminatory power but their availability remains restricted. In this study, we aimed to challenge matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) as a typing tool of a nosocomial MRSA outbreak in a neonatal intensive care unit. METHODS Over a 2-year period, 15 MRSA isolates were recovered from patients (n = 14) and health care workers (n = 1) at the neonatal intensive care unit. Five reference strains were included for comparison. Identification was performed by MALDI-TOF MS and susceptibility profiles determined by automated broth microdilution. Typing analysis by MALDI-TOF MS included mean spectrum profiles and subsequent dendrogram creation using BioNumerics software. Results were compared with spa typing and pulsed-field gel electrophoresis (PFGE). RESULTS Our study showed good concordance (93%) between PFGE, spa typing, and MALDI-TOF MS for the outbreak-related MRSA strains. MALDI-TOF MS typing showed excellent typeability and discriminatory power but showed poor reproducibility. CONCLUSIONS This study is one of the first to document the potential usefulness of MALDI-TOF MS with standardized data analysis as a typing tool for investigating a nosocomial MRSA outbreak. A concordance of 93% compared to reference typing techniques was observed. However, because of poor reproducibility, long-term follow-up of prospective isolated strains is not practical for routine use. Further studies are needed to confirm our observations.
Collapse
Affiliation(s)
- Deborah Steensels
- Laboratoire de microbiologie, Cliniques universitaires Saint-Luc – Université catholique de Louvain, Brussels, Belgium
| | - Ariane Deplano
- Department of Clinical Microbiology, National Reference Center S. aureus, ULB Erasme University Hospital, Brussels, Belgium
| | - Olivier Denis
- Department of Clinical Microbiology, National Reference Center S. aureus, ULB Erasme University Hospital, Brussels, Belgium
| | - Anne Simon
- Laboratoire de microbiologie, Cliniques universitaires Saint-Luc – Université catholique de Louvain, Brussels, Belgium
| | - Alexia Verroken
- Laboratoire de microbiologie, Cliniques universitaires Saint-Luc – Université catholique de Louvain, Brussels, Belgium
- Institut de recherche expérimentale et Clinique (IREC), pôle de microbiologie (MBLG), Université catholique de Louvain, Brussels, Belgium
| |
Collapse
|
37
|
Tanrıverdi Y, Korkmaz F, Birinci A. Hastanemizde 2014-2017 yıllarında üreyen Corynebacterium izolatlarının değerlendirilmesi. KOCAELI ÜNIVERSITESI SAĞLIK BILIMLERI DERGISI 2017. [DOI: 10.30934/kusbed.319802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
38
|
Kuriyan AE, Sridhar J, Flynn HW, Huang LC, Yannuzzi NA, Smiddy WE, Davis JL, Albini TA, Berrocal AM, Miller D. Endophthalmitis Caused by Corynebacterium Species: Clinical Features, Antibiotic Susceptibility, and Treatment Outcomes. Ophthalmol Retina 2017; 1:200-205. [PMID: 28971164 DOI: 10.1016/j.oret.2016.11.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE To report the clinical features, antibiotic susceptibility profiles, treatment, and visual acuity (VA) outcomes of endophthalmitis caused by Corynebacterium species. DESIGN Retrospective case series. SUBJECTS Patients with endophthalmitis caused by Corynebacterium species. METHODS Microbiology database records were retrospectively reviewed for all patients with endophthalmitis caused by Corynebacterium species from January 1, 1990 to December 31, 2012 at a large university referral center. The corresponding clinical records were then reviewed to evaluate the endophthalmitis clinical features and treatment outcomes. MAIN OUTCOME MEASURES presenting clinical features, visual acuity outcomes, and antibiotic susceptibility patterns. RESULTS Of 10 patients identified, clinical settings included post-cataract surgery (n = 6), post-penetrating keratoplasty (n = 2), and post-trabeculectomy (n = 2). The mean time from surgical procedure to presentation with endophthalmitis was 6.8 months (range: 1 day to 28 months). All isolates were vancomycin susceptible. Presenting VA ranged from 7/200 to no light perception. Initial treatment strategies were vitreous tap and intravitreal antibiotic injection (n = 5) and pars plana vitrectomy with intravitreal antibiotic injection (n = 5). VA outcomes were ≥ 20/60 in 5 (50%) of 10 patients and ≤ 20/400 in 5 (50%) of 10 patients. CONCLUSIONS The most common clinical setting was post-cataract surgery. All isolates were susceptible to vancomycin. Despite prompt treatment with appropriate antibiotics, there were variable visual outcomes.
Collapse
Affiliation(s)
- Ajay E Kuriyan
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, Florida.,Department of Ophthalmology, Flaum Eye Institute, University of Rochester Medical Center, Rochester, NY
| | - Jayanth Sridhar
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, Florida
| | - Harry W Flynn
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, Florida
| | - Laura C Huang
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, Florida
| | - Nicolas A Yannuzzi
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, Florida
| | - William E Smiddy
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, Florida
| | - Janet L Davis
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, Florida
| | - Thomas A Albini
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, Florida
| | - Audina M Berrocal
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, Florida
| | - Darlene Miller
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, Florida
| |
Collapse
|
39
|
Mediano P, Fernández L, Jiménez E, Arroyo R, Espinosa-Martos I, Rodríguez JM, Marín M. Microbial Diversity in Milk of Women With Mastitis: Potential Role of Coagulase-Negative Staphylococci, Viridans Group Streptococci, and Corynebacteria. J Hum Lact 2017; 33:309-318. [PMID: 28418794 DOI: 10.1177/0890334417692968] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Lactational mastitis constitutes a significant cause of premature weaning. However, its etiology, linked to the presence of pathogenic microorganisms, has been scarcely reported. Research aim: The aim of this study was to describe the microbial diversity in milk samples from women suffering from lactational mastitis and to identify more accurately a collection of isolates belonging to coagulase-negative staphylococci, streptococci, and coryneform bacteria. METHODS This is a cross-sectional descriptive one-group study. A total of 5,009 isolates from 1,849 mastitis milk samples was identified by culture, biochemical, and/or molecular methods at the species or genus level. A more precise identification of a collection of 211 isolates was carried out by 16S rRNA gene sequencing. RESULTS Mean total bacterial count in milk samples was 4.11 log10 colony-forming units/ml, 95% confidence interval [4.08, 4.15]. Staphylococcus epidermidis was the most common species being isolated from 91.56% of the samples, whereas Staphylococcus aureus was detected in 29.74%. Streptococci and corynebacteria constituted the second (70.20%) and third (16.60%) most prevalent bacterial groups, respectively, found in this study. In contrast, Candida spp. was present in only 0.54% of the samples. Sequencing of the 16S rRNA gene revealed a high diversity of bacterial species among identified isolates. CONCLUSION Many coagulase-negative staphylococci, viridans group streptococci, and corynebacteria, usually dismissed as contaminant bacteria, may play an important role as etiologic agents of mastitis. Proper diagnosis of mastitis should be established after performing microbiological testing of milk based on standardized procedures. A reliable analysis must identify the mastitis-causing pathogen(s) at the species level and its(their) concentration(s).
Collapse
Affiliation(s)
- Pilar Mediano
- 1 Departamento de Nutrición, Bromatología y Tecnología de los Alimentos, Universidad Complutense de Madrid, Madrid, Spain
| | - Leonides Fernández
- 1 Departamento de Nutrición, Bromatología y Tecnología de los Alimentos, Universidad Complutense de Madrid, Madrid, Spain
| | - Esther Jiménez
- 1 Departamento de Nutrición, Bromatología y Tecnología de los Alimentos, Universidad Complutense de Madrid, Madrid, Spain.,2 Probisearch SL, Tres Cantos, Madrid, Spain
| | - Rebeca Arroyo
- 1 Departamento de Nutrición, Bromatología y Tecnología de los Alimentos, Universidad Complutense de Madrid, Madrid, Spain.,2 Probisearch SL, Tres Cantos, Madrid, Spain
| | - Irene Espinosa-Martos
- 1 Departamento de Nutrición, Bromatología y Tecnología de los Alimentos, Universidad Complutense de Madrid, Madrid, Spain.,2 Probisearch SL, Tres Cantos, Madrid, Spain
| | - Juan M Rodríguez
- 1 Departamento de Nutrición, Bromatología y Tecnología de los Alimentos, Universidad Complutense de Madrid, Madrid, Spain
| | - María Marín
- 1 Departamento de Nutrición, Bromatología y Tecnología de los Alimentos, Universidad Complutense de Madrid, Madrid, Spain
| |
Collapse
|
40
|
Kimura SI, Gomyo A, Hayakawa J, Akahoshi Y, Harada N, Ugai T, Komiya Y, Kameda K, Wada H, Ishihara Y, Kawamura K, Sakamoto K, Sato M, Terasako-Saito K, Kikuchi M, Nakasone H, Kanda J, Kako S, Tanihara A, Kanda Y. Clinical characteristics and predictive factors for mortality in coryneform bacteria bloodstream infection in hematological patients. J Infect Chemother 2016; 23:148-153. [PMID: 28011352 DOI: 10.1016/j.jiac.2016.11.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 10/23/2016] [Accepted: 11/22/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND We examined the clinical characteristics and predictive factors for mortality in coryneform bacteria bloodstream infection in hematological patients. METHODS We searched for hematological patients who had positive blood cultures for coryneform bacteria at our center between April 2007 and January 2016. Patients with definite bloodstream infections were included. We started species identification in April 2014. RESULTS Twenty of twenty-eight cases with a positive blood culture for coryneform bacteria were regarded as definite infections. Sixteen and two patients were allogeneic and autologous hematopoietic stem cell transplantation (HSCT) recipients, respectively. Corynebacterium striatum was identified in all nine of the cases tested and one patient was co-infected with Corynebacterium amycolatum. None of the patients died directly due to coryneform bacteria infection. The survival rates at 30, 60 and 180 days were 100%, 73.7% and 51.3%, respectively. Causes of mortality included progression of the underlying disease (n = 6), other infections (n = 4) and HSCT complications (n = 2). Mixed infection (hazard ratio (HR) 5.47, 95% confidence interval (CI) 1.30-23.0), renal impairment (HR 6.31, 95% CI 1.06-37.4) and absence of a central venous (CV) catheter at the onset (HR 6.39, 95% CI 1.04-39.45) were identified as predictive factors for mortality. CONCLUSION Most of the coryneform bacteria bloodstream infections occurred in HSCT recipients. Contamination seemed to be less common when coryneform bacteria were detected in blood in hematological patients. Although coryneform bacteria bloodstream infection seemed to mostly be manageable, the prognosis was not desirable, particularly in patients with mixed infection, renal impairment and absence of a CV catheter.
Collapse
Affiliation(s)
- Shun-Ichi Kimura
- Division of Hematology, Saitama Medical Center, Jichi Medical University, Japan
| | - Ayumi Gomyo
- Division of Hematology, Saitama Medical Center, Jichi Medical University, Japan
| | - Jin Hayakawa
- Division of Hematology, Saitama Medical Center, Jichi Medical University, Japan
| | - Yu Akahoshi
- Division of Hematology, Saitama Medical Center, Jichi Medical University, Japan
| | - Naonori Harada
- Division of Hematology, Saitama Medical Center, Jichi Medical University, Japan
| | - Tomotaka Ugai
- Division of Hematology, Saitama Medical Center, Jichi Medical University, Japan
| | - Yusuke Komiya
- Division of Hematology, Saitama Medical Center, Jichi Medical University, Japan
| | - Kazuaki Kameda
- Division of Hematology, Saitama Medical Center, Jichi Medical University, Japan
| | - Hidenori Wada
- Division of Hematology, Saitama Medical Center, Jichi Medical University, Japan
| | - Yuko Ishihara
- Division of Hematology, Saitama Medical Center, Jichi Medical University, Japan
| | - Koji Kawamura
- Division of Hematology, Saitama Medical Center, Jichi Medical University, Japan
| | - Kana Sakamoto
- Division of Hematology, Saitama Medical Center, Jichi Medical University, Japan
| | - Miki Sato
- Division of Hematology, Saitama Medical Center, Jichi Medical University, Japan
| | | | - Misato Kikuchi
- Division of Hematology, Saitama Medical Center, Jichi Medical University, Japan
| | - Hideki Nakasone
- Division of Hematology, Saitama Medical Center, Jichi Medical University, Japan
| | - Junya Kanda
- Division of Hematology, Saitama Medical Center, Jichi Medical University, Japan
| | - Shinichi Kako
- Division of Hematology, Saitama Medical Center, Jichi Medical University, Japan
| | - Aki Tanihara
- Division of Hematology, Saitama Medical Center, Jichi Medical University, Japan
| | - Yoshinobu Kanda
- Division of Hematology, Saitama Medical Center, Jichi Medical University, Japan.
| |
Collapse
|
41
|
MALDI-TOF MS meets WGS in a VRE outbreak investigation. Eur J Clin Microbiol Infect Dis 2016; 36:495-499. [PMID: 27889877 DOI: 10.1007/s10096-016-2824-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 10/17/2016] [Indexed: 10/20/2022]
Abstract
The use of MALDI-TOF MS (matrix-assisted laser desorption/ ionization-time of flight mass spectrometry) and WGS (whole genome sequencing) has been described for identification and strain relatedness determination. We describe the complementary use of MALDI-TOF MS and WGS in a VRE (vancomycin-resistant enterococci) outbreak investigation, and discuss some of the challenges with defining strain similarity across these two platforms. Although both assays indicated multiple clusters involved in the outbreak of vancomycin resistant Enterococcus faecium isolates from positive blood cultures of four haematology-oncology patients, the small cohort and discrepancies between findings indicate the limitations of MALDI-TOF MS and the cautious interpretation of MALDI-TOF MS dendrograms during outbreaks. For definitive determination of the evolutionary distance between isolates, WGS can be used.
Collapse
|
42
|
The Technical and Biological Reproducibility of Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry (MALDI-TOF MS) Based Typing: Employment of Bioinformatics in a Multicenter Study. PLoS One 2016; 11:e0164260. [PMID: 27798637 PMCID: PMC5087883 DOI: 10.1371/journal.pone.0164260] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Accepted: 09/22/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The technical, biological, and inter-center reproducibility of matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI TOF MS) typing data has not yet been explored. The aim of this study is to compare typing data from multiple centers employing bioinformatics using bacterial strains from two past outbreaks and non-related strains. MATERIAL/METHODS Participants received twelve extended spectrum betalactamase-producing E. coli isolates and followed the same standard operating procedure (SOP) including a full-protein extraction protocol. All laboratories provided visually read spectra via flexAnalysis (Bruker, Germany). Raw data from each laboratory allowed calculating the technical and biological reproducibility between centers using BioNumerics (Applied Maths NV, Belgium). RESULTS Technical and biological reproducibility ranged between 96.8-99.4% and 47.6-94.4%, respectively. The inter-center reproducibility showed a comparable clustering among identical isolates. Principal component analysis indicated a higher tendency to cluster within the same center. Therefore, we used a discriminant analysis, which completely separated the clusters. Next, we defined a reference center and performed a statistical analysis to identify specific peaks to identify the outbreak clusters. Finally, we used a classifier algorithm and a linear support vector machine on the determined peaks as classifier. A validation showed that within the set of the reference center, the identification of the cluster was 100% correct with a large contrast between the score with the correct cluster and the next best scoring cluster. CONCLUSIONS Based on the sufficient technical and biological reproducibility of MALDI-TOF MS based spectra, detection of specific clusters is possible from spectra obtained from different centers. However, we believe that a shared SOP and a bioinformatics approach are required to make the analysis robust and reliable.
Collapse
|
43
|
Ishiwada N, Watanabe M, Murata S, Takeuchi N, Taniguchi T, Igari H. Clinical and bacteriological analyses of bacteremia due to Corynebacterium striatum. J Infect Chemother 2016; 22:790-793. [PMID: 27654073 DOI: 10.1016/j.jiac.2016.08.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 08/16/2016] [Accepted: 08/17/2016] [Indexed: 01/13/2023]
Abstract
BACKGROUND Corynebacterium striatum was recently recognized as a potential pathogen of various infectious diseases. However, the clinical entity of this microorganism has not been clearly identified. Therefore, we analyzed C. striatum isolates from blood culture and explored their clinical determinants. METHODS We reviewed the medical records of all patients from whom C. striatum isolates were recovered from blood culture for analysis of the patients' backgrounds and clinical course including response to antimicrobial therapy and prognosis. RESULTS During the 5-year study period (January 2010 to December 2014), 24 C. striatum strains were isolated from blood samples, and the frequency of C. striatum bacteremia increased. The majority of the strains were multidrug resistant. All of the tested strains were susceptible to only vancomycin. The age at onset of C. striatum bacteremia encompassed all adult age groups, and at least one underlying condition was documented in all patients. Thirteen of the 24 patients were cured using appropriate antibiotics (true infection group); however, 11 of the 24 patients were cured using inappropriate antibiotic therapy or no antibiotics (contamination group). Malignancy and neutropenia significantly increased the odds of true C. striatum bloodstream infection. CONCLUSIONS The Corynebacterium species is often considered a contaminant when isolated in culture. Instead, particularly when the strain is isolated from blood, the species should be considered clinically relevant and identified to the species level; in addition, antimicrobial susceptibility testing is recommended.
Collapse
Affiliation(s)
- Naruhiko Ishiwada
- Department of Infectious Diseases, Medical Mycology Research Center, Chiba University, Chiba, Japan.
| | - Masaharu Watanabe
- Division of Clinical Laboratory, Chiba University Hospital, Chiba, Japan
| | - Shota Murata
- Division of Clinical Laboratory, Chiba University Hospital, Chiba, Japan
| | - Noriko Takeuchi
- Department of Infectious Diseases, Medical Mycology Research Center, Chiba University, Chiba, Japan
| | | | - Hidetoshi Igari
- Department of Infectious Diseases, Chiba University Hospital, Chiba, Japan
| |
Collapse
|
44
|
Qin L, Sakai Y, Bao R, Xie H, Masunaga K, Miura M, Hashimoto K, Tanamachi C, Hu B, Watanabe H. Characteristics of Multidrug-Resistant Corynebacterium spp. Isolated from Blood Cultures of Hospitalized Patients in Japan. Jpn J Infect Dis 2016; 70:152-157. [PMID: 27357981 DOI: 10.7883/yoken.jjid.2015.530] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Corynebacterium is a genus consisting of Gram-positive, rod-shaped bacteria, that is wildly distributed in nature. We report the epidemiological characterization of Corynebacterium spp. isolated from blood specimens at the Kurume University Hospital, between June 2008 and November 2011. Twenty-two strains that were likely Corynebacterium spp. were isolated from 22 hospitalized patients, of which 12 (54.5%) were identified as Corynebacterium striatum. Minimum inhibitory concentration tests were performed after biochemical and genotypic identifications. Biofilm production was detected using a 96-well microplate assay. The dissemination of C. striatum was investigated using pulsed-field gel electrophoresis (PFGE). All strains showed the tendency to be resistant to multiple drugs except vancomycin. Fourteen (82.4%) strains, including 9 C. striatum strains were capable of producing biofilms. Four distinct PFGE patterns were detected among C. striatum strains; 6 of which were identified as dominant pattern A (defined in this study) and had high biofilm production ability. During the 3-year monitoring period, these strains might have repeatedly infected the patients or could have readily colonized the hospital environments. C. striatum appeared to be a potential risk factor for bloodstream infections in hospitalized patients. More surveillance and enhanced control strategies are necessary to decrease Corynebacterium spp. infections in hospitals.
Collapse
Affiliation(s)
- Liang Qin
- Graduate School of Health Care Sciences, Jikei Institute
| | | | | | | | | | | | | | | | | | | |
Collapse
|
45
|
Verma R, Kravitz GR. Corynebacterium striatum empyema and osteomyelitis in a patient with advanced rheumatoid arthritis. BMJ Case Rep 2016; 2016:bcr-2016-214691. [PMID: 26944378 DOI: 10.1136/bcr-2016-214691] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Corynebacterium striatum, which is a common coloniser of human skin and mucous membranes, is increasingly being recognised as an emerging pathogen. We present a case of a 69-year-old woman with empyema and osteomyelitis caused by C. striatum. To the best of our knowledge, this is the first case where these two infections from this bacterium were identified together in the same individual.
Collapse
Affiliation(s)
- Rajanshu Verma
- Department of Hospital Medicine (UHS), United Hospital, Allina Health, St Paul, Minnesota, USA
| | | |
Collapse
|
46
|
Saito S, Kawamura I, Tsukahara M, Uemura K, Ohkusu K, Kurai H. Cellulitis and Bacteremia due to Corynebacterium striatum Identified by Matrix-assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry. Intern Med 2016; 55:1203-5. [PMID: 27150881 DOI: 10.2169/internalmedicine.55.5484] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Corynebacterium striatum has been described as a pathogen in immunocompromised patients; however, correctly identifying Corynebacterium spp. is often difficult, and cases of cellulitis caused by C. striatum are only rarely reported. We herein describe a case of cellulitis and bacteremia due to C. striatum identified by matrix-assisted laser desorption ionization-time of flight mass spectrometry. Antimicrobial susceptibility testing was performed using the Strepto-Haemo Supplement method, and vancomycin was replaced by a narrow-spectrum oral amoxicillin.
Collapse
Affiliation(s)
- Sho Saito
- Division of Infectious Diseases, Shizuoka Cancer Center Hospital, Japan
| | | | | | | | | | | |
Collapse
|
47
|
van Belkum A, Chatellier S, Girard V, Pincus D, Deol P, Dunne WM. Progress in proteomics for clinical microbiology: MALDI-TOF MS for microbial species identification and more. Expert Rev Proteomics 2015; 12:595-605. [DOI: 10.1586/14789450.2015.1091731] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
|
48
|
Draft Genome Sequence of Corynebacterium striatum 1961 BR-RJ/09, a Multidrug-Susceptible Strain Isolated from the Urine of a Hospitalized 37-Year-Old Female Patient. GENOME ANNOUNCEMENTS 2015; 3:3/4/e00869-15. [PMID: 26251495 PMCID: PMC4541279 DOI: 10.1128/genomea.00869-15] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Corynebacterium striatum commonly colonizes the normal skin and nasopharyngeal tract of humans; however, this potentially pathogenic bacterium has been identified as the causative agent of several nosocomial infections. The current study describes the draft genome of strain 1961 BR-RJ/09, isolated from the urine of a hospitalized patient from Brazil.
Collapse
|
49
|
Jadhav S, Gulati V, Fox EM, Karpe A, Beale DJ, Sevior D, Bhave M, Palombo EA. Rapid identification and source-tracking of Listeria monocytogenes using MALDI-TOF mass spectrometry. Int J Food Microbiol 2015; 202:1-9. [DOI: 10.1016/j.ijfoodmicro.2015.01.023] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2014] [Revised: 01/20/2015] [Accepted: 01/24/2015] [Indexed: 11/29/2022]
|
50
|
Yoo G, Kim J, Uh Y, Lee HG, Hwang GY, Yoon KJ. Multidrug-Resistant Corynebacterium striatum Bacteremia: First Case in Korea. Ann Lab Med 2015; 35:472-3. [PMID: 26131424 PMCID: PMC4446591 DOI: 10.3343/alm.2015.35.4.472] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Revised: 12/10/2014] [Accepted: 04/01/2015] [Indexed: 11/20/2022] Open
Affiliation(s)
- Gilsung Yoo
- Department of Laboratory Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Juwon Kim
- Department of Laboratory Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Young Uh
- Department of Laboratory Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Hyeun Gyeo Lee
- Department of Laboratory Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Gyu Yel Hwang
- Department of Laboratory Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Kap Joon Yoon
- Department of Laboratory Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| |
Collapse
|