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Kharseeva GG, Mangutov EO, Alutina EL, But OM, Pakhomova AE. Etiological significance of Corynebacterium spp. in the development of diseases of the respiratory tract. Klin Lab Diagn 2021; 66:673-677. [PMID: 34882352 DOI: 10.51620/0869-2084-2021-66-11-673-677] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Corynebacterium spp. It is associated with inflammatory diseases of the respiratory tract (tracheitis, pharyngitis, rhinosinusitis, bronchitis, pneumonia, etc.). C. pseudodiphtheriticum can be the causative agent of bacterial coinfection in patients with a new coronavirus infection (COVID-19). The aim is to determine the pathogenic properties and resistance to antimicrobial drugs of Corynebacterium spp. strains to establish their etiological significance in the development of inflammatory diseases of the respiratory tract. Strains of Corynebacterium spp. isolated from patients with inflammatory diseases of the respiratory tract (43 pcs.) and practically healthy individuals (29 pcs.). Isolates were identified by mass spectrometric method (MALDI-TOF MS), their cytopathic effect in CHO-K1 cell culture, hemolytic, urease activity, antimicrobial drug resistance were determined. Strains of Corynebacterium spp. isolated from patients in the amount of 105 CFU/ml or more, practically healthy - 104 CFU/ml or less. Isolates of Corynebacterium spp. patients had a more pronounced cytopathic effect (83.7±11.1%) and were more often resistant to antimicrobial drugs than those isolated from practically healthy. To establish the etiological significance of Corynebacterium spp. isolates. in the development of inflammatory diseases of the respiratory tract, it is advisable to determine their amount in biological material (105 CFU/ml or more), the cytopathic effect on CHO-K1 cell culture, as well as the presence of multiple resistance to antimicrobial drugs. Differences in the characteristics of Corynebacterium spp. isolates. from patients with respiratory tract pathology and practically healthy individuals are associated with the strain, not the species, of corynebacteria.
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Affiliation(s)
- Galina G Kharseeva
- Federal State Educational Institution of Higher Education «Rostov State Medical University» Ministry of Health of Russia
| | - E O Mangutov
- Federal State Educational Institution of Higher Education «Rostov State Medical University» Ministry of Health of Russia
| | - E L Alutina
- Federal State Educational Institution of Higher Education «Rostov State Medical University» Ministry of Health of Russia
| | - O M But
- Municipal budgetary health care institution, «City hospital № 20 of Rostov-on-Don»
| | - A E Pakhomova
- Federal State Educational Institution of Higher Education «Rostov State Medical University» Ministry of Health of Russia
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Reddy K, Gericke S, Rabie H, Pienaar C, Maloba M. Exudative pharyngitis and Corynebacterium pseudodiphtheriticum: A case report and review of the literature. S Afr J Infect Dis 2021; 36:225. [PMID: 34485497 PMCID: PMC8377973 DOI: 10.4102/sajid.v36i1.225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 01/11/2021] [Indexed: 11/29/2022] Open
Abstract
Corynebacterium pseudodiphtheriticum is an established member of the normal flora of the respiratory tract. This organism is an emerging cause of respiratory tract infection, as well as infection of the skin and skin structures, urinary tract and other sterile sites. The syndrome of C. pseudodiphtheriticum exudative pharyngitis is a diagnostic challenge of particular relevance in recent times as this organism can be confused with Corynebacterium diphtheriae in the clinical setting and in the laboratory. We report a case of exudative pharyngitis, possibly due to C. pseudodiphtheriticum, in a 14-month old, incompletely vaccinated, human immunodeficiency virus (HIV)-positive infant and review the role of this organism in terms of its microbiological profile and identification, disease spectrum and antimicrobial susceptibility pattern.
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Affiliation(s)
- Kessendri Reddy
- Department of Microbiology, National Health Laboratory Services Tygerberg, Cape Town, South Africa.,Division of Medical Microbiology and Immunology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Sebastian Gericke
- Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Helena Rabie
- Division of Paediatric Infectious Diseases, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Colette Pienaar
- Department of Microbiology, National Health Laboratory Services Tygerberg, Cape Town, South Africa.,Division of Medical Microbiology and Immunology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Motlatji Maloba
- Department of Medical Microbiology, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
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Abstract
Like other microbes that live on or in the human body, the bacteria that inhabit the upper respiratory tract, in particular the nasal cavity, have evolved to survive in an environment that presents a number of physical and chemical challenges; these microbes are constantly bombarded with nutritional fluctuations, changes in humidity, the presence of inhaled particulate matter (odorants and allergens), and competition with other microbes. Indeed, only a specialized set of species is able to colonize this niche and successfully contend with the host's immune system and the constant threat from competitors. To this end, bacteria that live in the nasal cavity have evolved a variety of approaches to outcompete contenders for the limited nutrients and space; broadly speaking, these strategies may be considered a type of "bacterial warfare." A greater molecular understanding of bacterial warfare has the potential to reveal new approaches or molecules that can be developed as novel therapeutics. As such, there are many studies within the last decade that have sought to understand the complex polymicrobial interactions that occur in various environments. Here, we review what is currently known about the age-dependent structure and interbacterial relationships within the nasal microbiota and summarize the molecular mechanisms that are predicted to dictate bacterial warfare in this niche. Although the currently described interactions are complex, in reality, we have likely only scratched the surface in terms of a true understanding of the types of interbacterial competition and cooperation that are thought to take place in and on the human body.
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Infection and colonization by Corynebacterium pseudodiphtheriticum: a 9-year observational study in a university central hospital. Eur J Clin Microbiol Infect Dis 2020; 39:1745-1752. [PMID: 32367215 DOI: 10.1007/s10096-020-03891-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 04/01/2020] [Indexed: 10/24/2022]
Abstract
Despite constituting part of the human commensal flora, Corynebacterium pseudodiphtheriticum has been recognized as a potentially infectious agent, most frequently in immunocompromised patients or individuals with other morbidity factors, but significant association to comorbid states remains unproven. This study's purpose was to assess clinical significance, risk factors for infection and antimicrobial susceptibility of C. pseudodiphtheriticum isolates. A retrospective observational study was conducted. Relevance of isolation was determined by clinical, laboratory, and imaging criteria. Forty-nine isolates occurred in 47 episodes. Colonization was assumed in 12% and infection in 78%, of which 51% were nosocomial. Patients with infection were older, with male predominance; both age and gender were statistically significant (p < 0.05) between infection and colonization groups. Although dyslipidemia (58%), arterial hypertension (58%), invasive procedures (56%), and chronic lung disease (50%) were prevalent in the infection group, no comorbidity was a significant risk factor for infection compared with colonization. Charlson comorbidity index showed no statistically difference between groups. Mortality rate was 14% in infection. Respiratory samples were the main isolation product; all tested strains were susceptible to amoxicillin/clavulanate and vancomycin. Resistant strains were observed for clindamycin (77%) and erythromycin (48%). C. pseudodiphtheriticum isolation was associated with infection in most cases. Despite the high prevalence of comorbidities and invasive procedures, no factors other than age and gender were significantly associated with infection. Although C. pseudodiphtheriticum may constitute a contaminant or colonizer in clinical samples, positive cultures in patients with signs and symptoms consistent with infection should not be neglected.
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Clariot S, Constant O, Lepeule R, Fihman V, Razazi K, Cook F, Attias A, Merle JC, Hemery F, Levesque E, Decousser JW, Langeron O, Mongardon N. Clinical relevance and impact of Corynebacterium isolation in lower respiratory tract of critically ill patients requiring mechanical ventilation. Infection 2020; 48:413-420. [PMID: 32185636 PMCID: PMC7222949 DOI: 10.1007/s15010-020-01411-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Accepted: 03/06/2020] [Indexed: 01/10/2023]
Abstract
Purpose Corynebacterium spp. (C. spp.) is commonly considered as a contaminant in respiratory specimens. No study has ever focused on its clinical relevance in the lower respiratory tract of patients admitted to the intensive care unit (ICU) and requiring mechanical ventilation. The aims were to describe the characteristics of ICU patients with a C. spp. positive deep respiratory specimen, to investigate the impact of C. spp. on the occurrence of pneumonia, and to evaluate the outcomes of these pneumonia. Methods We retrospectively included all adult patients admitted to ICU in a 1000-bed University Hospital (2007–2017) who had a C. spp. positive lower respiratory tract specimen at a significant quantitative level. We used clinical, radiological, and microbiological criteria to classify the likelihood of such pneumonia. Results Among the 31 patients included, acute respiratory failure and postoperative care after major surgery were the main reasons of admission. SAPS II was 47 [34–60]. C. spp. pneumonia was considered as probable, possible and unlikely in 10, 14, and 7 patients, respectively. Fifty-two and 94% of C. spp. strains were sensitive to amoxicillin, and vancomycin/linezolid, respectively. Seventeen patients had a complete course of antibiotic against C. spp. The overall ICU mortality was 58%. Conclusion Corynebacterium spp seems to be responsible for authentic pneumonia in mechanically ventilated patients. It should be considered as clinically relevant when predominantly present in respiratory specimen from patients suspected with pneumonia in ICU, and empirically treated.
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Affiliation(s)
- Simon Clariot
- Service d'Anesthésie-Réanimation Chirurgicale, DMU CARE, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, CHU Henri Mondor, 51 avenue du Maréchal de Lattre de Tassigny, 94000, Créteil, France
| | - Ophélie Constant
- Service d'Anesthésie-Réanimation Chirurgicale, DMU CARE, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, CHU Henri Mondor, 51 avenue du Maréchal de Lattre de Tassigny, 94000, Créteil, France
| | - Raphaël Lepeule
- Unité Transversale de Traitement Des Infections (UT2I), Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, 94010, Créteil, France
| | - Vincent Fihman
- Unité de Bactériologie-Hygiène, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor Henri Mondor, 94010, Créteil, France.,Faculté de Santé, EA DYNAMYC UPEC, Ecole Nationale Vétérinaire d'Alfort, 94010, Créteil, France
| | - Keyvan Razazi
- Service de Réanimation Médicale, Groupe de Recherche Clinique CARMAS, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, 94010, Créteil, France
| | - Fabrice Cook
- Service d'Anesthésie-Réanimation Chirurgicale, DMU CARE, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, CHU Henri Mondor, 51 avenue du Maréchal de Lattre de Tassigny, 94000, Créteil, France
| | - Arié Attias
- Service d'Anesthésie-Réanimation Chirurgicale, DMU CARE, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, CHU Henri Mondor, 51 avenue du Maréchal de Lattre de Tassigny, 94000, Créteil, France
| | - Jean-Claude Merle
- Service d'Anesthésie-Réanimation Chirurgicale, DMU CARE, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, CHU Henri Mondor, 51 avenue du Maréchal de Lattre de Tassigny, 94000, Créteil, France
| | - François Hemery
- Département d'Informatique Médicale, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, 94010, Créteil, France
| | - Eric Levesque
- Service d'Anesthésie-Réanimation Chirurgicale, DMU CARE, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, CHU Henri Mondor, 51 avenue du Maréchal de Lattre de Tassigny, 94000, Créteil, France.,Faculté de Santé, Univ Paris Est Creteil, 94010, Créteil, France.,Faculté de Santé, EA DYNAMYC UPEC, Ecole Nationale Vétérinaire d'Alfort, 94010, Créteil, France
| | - Jean-Winoc Decousser
- Unité de Bactériologie-Hygiène, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor Henri Mondor, 94010, Créteil, France.,Faculté de Santé, Univ Paris Est Creteil, 94010, Créteil, France.,Faculté de Santé, EA DYNAMYC UPEC, Ecole Nationale Vétérinaire d'Alfort, 94010, Créteil, France
| | - Olivier Langeron
- Service d'Anesthésie-Réanimation Chirurgicale, DMU CARE, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, CHU Henri Mondor, 51 avenue du Maréchal de Lattre de Tassigny, 94000, Créteil, France.,Faculté de Santé, Univ Paris Est Creteil, 94010, Créteil, France
| | - Nicolas Mongardon
- Service d'Anesthésie-Réanimation Chirurgicale, DMU CARE, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, CHU Henri Mondor, 51 avenue du Maréchal de Lattre de Tassigny, 94000, Créteil, France. .,Faculté de Santé, Univ Paris Est Creteil, 94010, Créteil, France. .,U955-IMRB, Equipe 03 "Pharmacologie et technologies pour les malades cardiovasculaires (PROTECT)", Inserm, Université Paris Est Creteil, Ecole Nationale Vétérinaire D'Alfort, 94700, Maisons-Alfort, France.
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Bishai WR, Timmins GS. Potential for breath test diagnosis of urease positive pathogens in lung infections. J Breath Res 2019; 13:032002. [DOI: 10.1088/1752-7163/ab2225] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Walker RE, Walker CG, Camargo CA, Bartley J, Flint D, Thompson JMD, Mitchell EA. Nasal microbial composition and chronic otitis media with effusion: A case-control study. PLoS One 2019; 14:e0212473. [PMID: 30794625 PMCID: PMC6386383 DOI: 10.1371/journal.pone.0212473] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 02/04/2019] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES Chronic otitis media with effusion (COME) in children can cause prolonged hearing loss, which is associated with an increased risk of learning delays and behavioural problems. Dispersal of bacterial pathogens from the nasal passages to the middle ear is implicated in COME. We sought to determine whether there is an association between nasal microbial composition and COME in children. METHODS A case-control study of children aged 3 and 4 years was conducted. Cases undergoing placement of tympanostomy tubes for COME were compared to healthy controls. Nasal swabs were collected and a questionnaire was administered. The V1-3 region of the 16S rRNA gene was amplified, and sequenced on the Illumina MiSeq. RESULTS 73 children with COME had a lower Shannon diversity index than 105 healthy controls (1.62 [.80] versus 1.88 [.84], respectively; P = .046). The nasal microbiota of cases and controls differed in composition using Bray-Curtis dissimilarity (p = 0.002). Children with COME had a higher abundance of otopathogens and lower abundance of commensals including alpha haemolytic Streptococci and Lactococcus. Cluster analysis revealed 4 distinct nasal microbial profiles. Profiles that were Corynebacterium-dominated (aOR 4.18 [95%CI, 1.68-10.39], Streptococcus-dominated (aOR 3.12 [95%CI, 1.08-9.06], or Moraxella-dominated (aOR 4.70 [95%CI, 1.73-12.80] were associated with COME, compared to a more mixed microbial profile when controlling for age, ethnicity, and recent antibiotics use. CONCLUSIONS Children with COME have a less diverse nasal microbial composition with a higher abundance of pathogens, compared to healthy children who have a more mixed bacterial profile with a higher abundance of commensals. Further research is required to determine how nasal microbiota may relate to the pathogenesis or maintenance of COME, and whether modification of the nasal microbiota can prevent or treat children at risk of COME.
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Affiliation(s)
- Rebecca E. Walker
- Department of Paediatrics: Child and Youth Health, The University of Auckland, Auckland, New Zealand
| | - Caroline G. Walker
- Centre for Longitudinal Research–He Ara ki Mua, Department of Population Health, The University of Auckland, Auckland, New Zealand
| | - Carlos A. Camargo
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Jim Bartley
- Division of Otolaryngology-Head and Neck Surgery, Counties-Manukau District Health Board, Manukau SuperClinic, Manukau City, Auckland, New Zealand
| | - David Flint
- Division of Otolaryngology-Head and Neck Surgery, Counties-Manukau District Health Board, Manukau SuperClinic, Manukau City, Auckland, New Zealand
| | - John M. D. Thompson
- Department of Paediatrics: Child and Youth Health, The University of Auckland, Auckland, New Zealand
| | - Edwin A. Mitchell
- Department of Paediatrics: Child and Youth Health, The University of Auckland, Auckland, New Zealand
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Yang K, Kruse RL, Lin WV, Musher DM. Corynebacteria as a cause of pulmonary infection: a case series and literature review. Pneumonia (Nathan) 2018; 10:10. [PMID: 30324081 PMCID: PMC6173903 DOI: 10.1186/s41479-018-0054-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 09/18/2018] [Indexed: 11/23/2022] Open
Abstract
Background In most cases of community-acquired pneumonia (CAP), an etiologic agent is not determined; the most common report from the microbiological evaluation of sputum cites “normal respiratory flora.” Non-diphtheria Corynebacterium spp., a component of this flora, is commonly viewed as a contaminant, but it may be the cause of pneumonia and the frequency with which it causes CAP may be underestimated. Case presentations This report present 3 cases of CAP in which Corynebacterium spp. was clearly the predominant isolate; identification was confirmed by matrix-assisted laser desorption ionization time of flight (MALDI-TOF) mass spectrometry. Two cases were caused by C. propinquum and one by C. striatum. Two patients had a tracheostomy and one was on hemodialysis. Patients who received an appropriate antibiotic responded well. Conclusion When identified as the predominant isolate in sputum from a patient with CAP, Corynebacterium spp. should be considered as a potential cause of the infection. In cases with patients who have compromised airway clearance or who are immunocompromised, microaspiration may be responsible. While some Corynebacterium spp. are suspectible to antibiotics usually prescribed for CAP, others are susceptible only to vancomycin or aminoglycosides. Vancomycin is thus the appropriate empiric antibiotic, pending speciation and susceptibility test results. The number of reported cases with result of antibiotic susceptibility testing, however, remains limited, and further investigation is needed. Non-diphtheria Corynebacterium spp. represent a noteworthy clinical cause of pneumonia. Identification by Gram stain and as a predominant organism on culture demands careful consideration for management.
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Affiliation(s)
| | | | - Weijie V Lin
- 1Baylor College of Medicine, Houston, TX 77030 USA
| | - Daniel M Musher
- 1Baylor College of Medicine, Houston, TX 77030 USA.,2Infectious Disease Section, Michael E. DeBakey Veterans Affairs Medical Center, 2002 Holcombe Boulevard, Houston, TX 77030 USA
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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.
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Chandran R, Puthukkichal DR, Suman E, Mangalore SK. Diphtheroids-Important Nosocomial Pathogens. J Clin Diagn Res 2016; 10:DC28-DC31. [PMID: 28208859 DOI: 10.7860/jcdr/2016/19098.9043] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 10/14/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Diphtheroids are defined as aerobic, non-sporulating, pleomorphic Gram-positive bacilli which are more uniformly stained than Corynebacterium diphtheriae, lack the metachromatic granules and are arranged in a palisade manner. They are usually commensals of the skin and mucous membranes. They differ from C.diphtheriae in biochemical rea-ctions as well as in toxin production. Since, they are usually found as commensals on the skin, they are often considered as mere contaminants when isolated from clinical samples. However, there are increasing reports of these organisms being associated with various infections. Hence, we felt the need to study the common species associated with infections and know the properties of these organisms which are otherwise considered as mere laboratory contaminants. AIM To identify the various species of diphtheroids isolated as pure growth from clinical specimens whose Gram's smear revealed numerous inflammatory cells with Gram positive bacilli and had clinical evidence. MATERIALS AND METHODS A total of 100 isolates of Gram-positive bacilli from 16,242 clinical samples received in the Microbiology Department of Kasturba Medical College were considered for this study from Dec 2013-Dec 2014. Gram-positive bacilli which were seen in the smear along with pus cells, isolated as pure growth and reported as "Corynebacterium spp having clinical significance" were taken for this study while those which were reported as 'Probable skin contaminants' were excluded from this study. Species identification of Gram-positive bacilli was done by biochemical reactions. Antibiotic susceptibility test was done by Kirby-Bauer disk diffusion method. Biofilm production was done by the microtitre plate method of O'Toole and Kolter and statistical analysis was done by using proportion test and Chi-square test. RESULTS Various species of diphtheroids were isolated from different clinical specimens. C. pseudotuberculosis, C. renale, C. ulcerans, C. striatum, C. minutissimum, Corynebacterium haemolyticum isolated from catheter tips, sputum, tracheostomy secretions and wound infections were highly resistant to many antibiotics while isolates from blood namely C. pseudotuberculosis, C. minutissimum, C. ulcerans and C. renale were nearly sensitive to most of them. It was also interesting to note that there was an increased rate of biofilm production in these isolates. CONCLUSION Corynebacterium pseudotuberculosis, Coryne- bacterium ulcerans, Corynebacterium renale, Corynebacterium bovis, Corynebacterium striatum, Corynebacterium minutissimum, Corynebacterium pseudodiphtheriticum and Corynebacterium haemolyticum may survive in the form of biofilms in hospitals and cause multidrug resistant infections. Hence, we need to judiciously identify these organisms, find their antimicrobial susceptibility, treat them and thus prevent infections in hospitals.
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Affiliation(s)
- Reshmi Chandran
- Ex Postgraduate Student, Department of Microbiology, Kasturba Medical College, Manipal University , Mangalore, Karnataka, India
| | - Dinju Raj Puthukkichal
- Ex Postgraduate Student, Department of Microbiology, Kasturba Medical College, Manipal University , Mangalore, Karnataka, India
| | - Ethel Suman
- Associate Professor, Department of Microbiology, Kasturba Medical College, Manipal University , Mangalore, Karnataka, India
| | - Shashidhar Kotian Mangalore
- Selection Grade Lecturer, Department of Community Medicine, Kasturba Medical College, Manipal University , Mangalore, Karnataka, India
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11
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Furiasse D, Gasparotto AM, Monterisi A, Castellano G, Rocchi M. [Pneumonia caused byCorynebacterium pseudodiphtheriticum]. Rev Argent Microbiol 2016; 48:290-292. [PMID: 27836329 DOI: 10.1016/j.ram.2016.05.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Revised: 05/10/2016] [Accepted: 05/24/2016] [Indexed: 11/28/2022] Open
Abstract
Microorganisms of the genera Corynebacterium, specie pseudodiphtheriticum are a part of the indigenous microbiota of human skin and oropharinx. Nevertheless in recent decades these bacilli are emerging as opportunistic pathogens causing clinically significant infections in patients with previous compromise. We report the case of a 76 years old female patient, with a history of hypertension, hypothyroidism, type 2 diabetes and chronic renal failure, who presented pneumonia during their stay at the intensive care unit. The induced sputum revealed a representative sample with monomicrobial gram positive pleomorphic coryneform rods (Gram stain) and cultures demonstrated the presence of C. pseudodiphtheriticum as the only bacteria recovered. The pacient received an empirical third generation cephalosporin medication with a succesfull recovery.
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Affiliation(s)
- Daniela Furiasse
- Departamento de Bacteriología, Hospital Nacional de Clínicas, UNC, Córdoba, Argentina
| | - Ana M Gasparotto
- Departamento de Bacteriología, Hospital Nacional de Clínicas, UNC, Córdoba, Argentina
| | - Aída Monterisi
- Departamento de Bacteriología, Hospital Nacional de Clínicas, UNC, Córdoba, Argentina
| | - Gabriela Castellano
- Servicio de Nefrología, Hospital Nacional de Clínicas, UNC, Córdoba, Argentina
| | - Marta Rocchi
- Departamento de Bacteriología, Hospital Nacional de Clínicas, UNC, Córdoba, Argentina.
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12
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Burkovski A. Corynebacterium pseudodiphtheriticum: Putative probiotic, opportunistic infector, emerging pathogen. Virulence 2016; 6:673-4. [PMID: 26252066 DOI: 10.1080/21505594.2015.1067747] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- Andreas Burkovski
- a Professur für Mikrobiologie; Friedrich-Alexander-Universität Erlangen-Nürnberg ; Erlangen , Germany
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13
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Van Roeden SE, Thijsen SF, Sankatsing SUC, Limonard GJM. Clinical relevance of Corynebacterium pseudodiphtheriticum in lower respiratory tract specimens. Infect Dis (Lond) 2015. [PMID: 26211497 DOI: 10.3109/23744235.2015.1070962] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Corynebacterium pseudodiphtheriticum may be present as commensal flora of the respiratory tract and therefore it may be difficult to assess clinical relevance when it is cultured from lower respiratory tract specimens. Our objective was to determine the clinical relevance of C. pseudodiphtheriticum as a lower respiratory tract pathogen and to define patients at risk of developing lower respiratory tract infections caused by C. pseudodiphtheriticum. METHODS We retrospectively identified all lower respiratory tract cultures positive for C. pseudodiphtheriticum over a 10-year period and assessed clinical relevance by predefined criteria. RESULTS Clinical relevance was likely or possible in 86% of patients. Pre-existent comorbidity was present in 86% of patients, mostly underlying cardiac or pulmonary disease. All isolates were susceptible to amoxicillin. CONCLUSION C. pseudodiphtheriticum should be considered a clinically relevant pathogen when cultured from the lower respiratory tract in symptomatic patients.
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Affiliation(s)
- Sonja E Van Roeden
- a From the Department of Internal Medicine , Diakonessenhuis Utrecht , The Netherlands
| | - Steven F Thijsen
- b Department of Medical Microbiology and Immunology , Diakonessenhuis Utrecht , The Netherlands
| | - Sanjay U C Sankatsing
- a From the Department of Internal Medicine , Diakonessenhuis Utrecht , The Netherlands
| | - Gijs J M Limonard
- c Department of Pulmonary Diseases , Diakonessenhuis Utrecht , The Netherlands
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14
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Roy S, Marla S, Praneetha DC. Recognition of Corynebacterium pseudodiphtheriticum by Toll-like receptors and up-regulation of antimicrobial peptides in human corneal epithelial cells. Virulence 2015; 6:716-21. [PMID: 26125127 DOI: 10.1080/21505594.2015.1066063] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Bacterial keratitis is a major cause of corneal ulcers in developing and industrialized nations. In this study, we examined the host innate immune responses to Corynebacterium pseudodiphtheriticum, often overlooked as commensal, in human corneal epithelial cells. The expressions of innate immune mediators were determined by quantitative PCR from corneal ulcers of patients and immortalized human corneal epithelial cells (HCEC). We have found an elevated expression of Toll like receptors (TLRs) along with IL-6 and IL-1β from both ulcers and epithelial cells infected with C. pseudodiphtheriticum. Activation of NF-κB and MAPK signaling pathways were also observed in HCEC in response to C. pseudodiphtheriticum. In addition, we found a significant increase in the expression of antimicrobial peptides S100A8, S100A9 and human β-defensin 1 from both corneal ulcers and HCEC.
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Affiliation(s)
- Sanhita Roy
- a Prof. Brien Holden Eye Research Center; Hyderabad Eye Research Foundation; LV Prasad Eye Institute ; Hyderabad , India
| | - Sushma Marla
- a Prof. Brien Holden Eye Research Center; Hyderabad Eye Research Foundation; LV Prasad Eye Institute ; Hyderabad , India
| | - D C Praneetha
- a Prof. Brien Holden Eye Research Center; Hyderabad Eye Research Foundation; LV Prasad Eye Institute ; Hyderabad , India
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15
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Duignan ES, Farrell S, Treacy MP, Fulcher T, O'Brien P, Power W, Murphy CC. Corneal inlay implantation complicated by infectious keratitis. Br J Ophthalmol 2015; 100:269-73. [PMID: 26124460 DOI: 10.1136/bjophthalmol-2015-306641] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 06/06/2015] [Indexed: 11/03/2022]
Abstract
BACKGROUND/AIMS To report five cases of infectious keratitis following corneal inlay implantation for the surgical correction of presbyopia. METHODS This was a retrospective, observational case series. Five eyes of five patients were identified consecutively in two emergency departments during a 1-year period, from November 2013 to November 2014. Patients' demographics, clinical features, treatment and outcomes are described. RESULTS There were four female patients and one male, aged 52-64 years. Three patients had the KAMRA inlay (AcuFocus) and two had the Flexivue Microlens inlay (Presbia Coöperatief U.A.) inserted for the treatment of presbyopia and they presented from 6 days to 4 months postoperatively. Presenting uncorrected vision ranged from 6/38 to counting fingers. One patient's corneal scrapings were positive for a putatively causative organism, Corynebacterium pseudodiphtheriticum, and all patients responded to broad-spectrum fortified topical antibiotics. All patients lost vision with final uncorrected visual acuity ranging from 6/12 to 6/60 and best-corrected vision ranging from 6/7.5 to 6/12. Two patients' corneal inlays were explanted and three remained in situ at last follow-up. CONCLUSIONS Infectious keratitis can occur at an early or late stage following corneal inlay implantation. Final visual acuity can be limited by stromal scarring; in the cases where the infiltrate was small and off the visual axis at the time of presentation, the final visual acuity was better than those patients who presented with larger lesions affecting the visual axis. Though infection may necessitate removal of the inlay, early positive response to treatment may enable the inlay to be left in situ.
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Affiliation(s)
| | | | | | - Tim Fulcher
- Mater Misericordiae University Hospital, Dublin, Ireland
| | - Paul O'Brien
- Royal Victoria Eye and Ear Hospital, Dublin, Ireland
| | - William Power
- Royal Victoria Eye and Ear Hospital, Dublin, Ireland
| | - Conor C Murphy
- Royal Victoria Eye and Ear Hospital, Dublin, Ireland Department of Ophthalmology, Royal College of Surgeons in Ireland, Dublin, Ireland
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16
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Souza MC, dos Santos LS, Sousa LP, Faria YV, Ramos JN, Sabbadini PS, da Santos CS, Nagao PE, Vieira VV, Gomes DLR, Hirata Júnior R, Mattos-Guaraldi AL. Biofilm formation and fibrinogen and fibronectin binding activities by Corynebacterium pseudodiphtheriticum invasive strains. Antonie Van Leeuwenhoek 2015; 107:1387-99. [PMID: 25828766 DOI: 10.1007/s10482-015-0433-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Accepted: 03/18/2015] [Indexed: 11/30/2022]
Abstract
Biofilm-related infections are considered a major cause of morbidity and mortality in hospital environments. Biofilms allow microorganisms to exchange genetic material and to become persistent colonizers and/or multiresistant to antibiotics. Corynebacterium pseudodiphtheriticum (CPS), a commensal bacterium that colonizes skin and mucosal sites has become progressively multiresistant and responsible for severe nosocomial infections. However, virulence factors of this emergent pathogen remain unclear. Herein, we report the adhesive properties and biofilm formation on hydrophilic (glass) and hydrophobic (plastic) abiotic surfaces by CPS strains isolated from patients with localized (ATCC10700/Pharyngitis) and systemic (HHC1507/Bacteremia) infections. Adherence to polystyrene attributed to hydrophobic interactions between bacterial cells and this negatively charged surface indicated the involvement of cell surface hydrophobicity in the initial stage of biofilm formation. Attached microorganisms multiplied and formed microcolonies that accumulated as multilayered cell clusters, a step that involved intercellular adhesion and synthesis of extracellular matrix molecules. Further growth led to the formation of dense bacterial aggregates embedded in the exopolymeric matrix surrounded by voids, typical of mature biofilms. Data also showed CPS recognizing human fibrinogen (Fbg) and fibronectin (Fn) and involvement of these sera components in formation of "conditioning films". These findings suggested that biofilm formation may be associated with the expression of different adhesins. CPS may form biofilms in vivo possibly by an adherent biofilm mode of growth in vitro currently demonstrated on hydrophilic and hydrophobic abiotic surfaces. The affinity to Fbg and Fn and the biofilm-forming ability may contribute to the establishment and dissemination of infection caused by CPS.
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Affiliation(s)
- Monica Cristina Souza
- Laboratório de Difteria e Corinebactérias de Importância Clínica (LDCIC), Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro (UERJ), Av. 28 de Setembro, 87 - Fundos, 3°andar, Vila Isabel, Rio de Janeiro, RJ, 20.551-030, Brazil
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17
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Wang YFW, Fu J. Rapid laboratory diagnosis for respiratory infectious diseases by using MALDI-TOF mass spectrometry. J Thorac Dis 2014; 6:507-11. [PMID: 24822111 DOI: 10.3978/j.issn.2072-1439.2014.03.34] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Accepted: 03/27/2014] [Indexed: 11/14/2022]
Abstract
It is still challenging to prevent and treat respiratory infectious diseases. One critical step in the successful treatment of respiratory infections is rapid diagnosis by identifying the causative microorganisms in a timely fashion. However, traditional methods for identification of causative agents could not satisfy the need for rapid and accurate testing due to the limitations of technology-used. In recent years, matrix-assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF-MS) has been validated and used for rapid identification of microorganism and for potential discovery of diseases associated biomarkers. We reviewed recent advances of MALDI-TOF-MS as the laboratory diagnostic tool for the rapid laboratory diagnosis of microorganisms associated with respiratory infectious diseases, with the focus on rapid identification of pathogenic bacteria and molecular markers discovery using MALDI-TOF-MS. With the advanced technologies such as MALDI-TOF, early and targeted therapies based on rapid identification of pathogens and could lead to quick and effective treatment of respiratory infections and better patient management.
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Affiliation(s)
- Yun F Wayne Wang
- 1 Pathology & Laboratory Medicine, Emory University School Medicine and Grady Memorial Hospital, Atlanta, GA 30303, USA ; 2 Clinical Laboratory Diagnostic Center, Urumqi General Hospital of PLA, Urumqi 830000, China
| | - Jianfeng Fu
- 1 Pathology & Laboratory Medicine, Emory University School Medicine and Grady Memorial Hospital, Atlanta, GA 30303, USA ; 2 Clinical Laboratory Diagnostic Center, Urumqi General Hospital of PLA, Urumqi 830000, China
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18
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Olender A. Antibiotic resistance and detection of the most common mechanism of resistance (MLSB) of opportunistic Corynebacterium. Chemotherapy 2014; 59:294-306. [PMID: 24480817 DOI: 10.1159/000357467] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Accepted: 11/20/2013] [Indexed: 11/19/2022]
Abstract
BACKGROUND Determination of antibiotic resistance of opportunistic Corynebacterium colonizing the nose that cause infections and evaluation of the applicability of a simple method for detecting the most common constitutive-type resistance to macrolides, lincosamides and streptogramin B (MLSB). METHODS 70 isolates colonizing the nose and 70 clinical isolates of various infection sites were used and identified using APICoryne and 16S rRNA. Minimal inhibitory concentrations (MICs) were determined (Etest) for 12 antibiotics. MLSB was defined based on MIC, a simple method using two disks (erythromycin/clindamycin) and detection of the gene erm X (PCR). RESULTS There was a high percentage--in both groups at the same level--of strains with MLSB (88.5% colonizing the nose and 87.1% causing infections). Detection with the phenotypic method MLSB was confirmed genetically (erm X) in all cases. In both groups, a high percentage of resistance was found to trimethoprim/sulfamethoxazole (in both groups 71.4%), chloramphenicol (nose 44.2%/infections 37.1%), tetracycline (28 and 45.7%) and β-lactam antibiotics (18.5 and up to 32.8%). CONCLUSION Differences in antibiotic resistance were found between strains colonizing the respiratory tract and various infections. Isolates from infections more frequently exhibited multidrug resistance. The possibility of using a simple method was confirmed for MLSB detection, which can be applied to determine drug resistance in routine microbiological diagnostics of infections caused by opportunistic Corynebacterium.
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Affiliation(s)
- Alina Olender
- Department of Medical Microbiology, Medical University of Lublin, Lublin, Poland
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19
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Bernard K, Pacheco AL, Cunningham I, Gill N, Burdz T, Wiebe D. Emendation of the description of the species
Corynebacterium propinquum
to include strains which produce urease. Int J Syst Evol Microbiol 2013; 63:2146-2154. [DOI: 10.1099/ijs.0.046979-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Corynebacterium propinquum
is a Gram-positive rod occasionally recovered from clinical infections which, according to 16S rRNA gene sequencing, is most closely related (>99 % sequence similarity) to
Corynebacterium pseudodiphtheriticum
. The two species are very similar biochemically, commonly differentiated by a single test, the detection of urease, where strains of
C. propinquum
are described as being urease-non-producing and strains of
C. pseudodiphtheriticum
are described as urease-producing. In this study, historical and contemporary strains of
C. propinquum
and
C. pseudodiphtheriticum
from this laboratory were definitively characterized, which included use of rpoB sequencing. Urease-producing strains of
C. propinquum
as well as typical urease-non-producing isolates were identified after rpoB sequencing, with six of these being originally identified as
C. pseudodiphtheriticum
. Based on these observations, we propose emendation of the description of
C. propinquum
to include strains which produce urease. MALDI-TOF analysis may be a useful tool to differentiate these taxa. Existing commercial databases should be updated to include urease-positive strains of
C. propinquum
.
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Affiliation(s)
- Kathryn Bernard
- University of Manitoba, Department of Medical Microbiology, Winnipeg, Manitoba, Canada
- Special Bacteriology Unit, ARNI, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Ana Luisa Pacheco
- Special Bacteriology Unit, ARNI, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Ian Cunningham
- University of Manitoba, Department of Medical Microbiology, Winnipeg, Manitoba, Canada
| | - Navdeep Gill
- University of Victoria, Department of Biochemistry and Microbiology, Victoria, British Columbia, Canada
| | - Tamara Burdz
- Special Bacteriology Unit, ARNI, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Deborah Wiebe
- Special Bacteriology Unit, ARNI, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
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20
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Souza MCD, Santos LSD, Gomes DLR, Sabbadini PS, Santos CSD, Camello TCF, Asad LMBO, Rosa ACDP, Nagao PE, Hirata Júnior R, Guaraldi ALDM. Aggregative adherent strains of Corynebacterium pseudodiphtheriticum enter and survive within HEp-2 epithelial cells. Mem Inst Oswaldo Cruz 2013; 107:486-93. [PMID: 22666859 DOI: 10.1590/s0074-02762012000400008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2011] [Accepted: 02/15/2012] [Indexed: 11/21/2022] Open
Abstract
Corynebacterium pseudodiphtheriticum is a well-known human pathogen that mainly causes respiratory disease and is associated with high mortality in compromised hosts. Little is known about the virulence factors and pathogenesis of C. pseudodiphtheriticum. In this study, cultured human epithelial (HEp-2) cells were used to analyse the adherence pattern, internalisation and intracellular survival of the ATCC 10700 type strain and two additional clinical isolates. These microorganisms exhibited an aggregative adherence-like pattern to HEp-2 cells characterised by clumps of bacteria with a "stacked-brick" appearance. The differences in the ability of these microorganisms to invade and survive within HEp-2 cells and replicate in the extracellular environment up to 24 h post infection were evaluated. The fluorescent actin staining test demonstrated that actin polymerisation is involved in the internalisation of the C. pseudodiphtheriticum strains. The depolymerisation of microfilaments by cytochalasin E significantly reduced the internalisation of C. pseudodiphtheriticum by HEp-2 cells. Bacterial internalisation and cytoskeletal rearrangement seemed to be partially triggered by the activation of tyrosine kinase activity. Although C. pseudodiphtheriticum strains did not demonstrate an ability to replicate intracellularly, HEp-2 cells were unable to fully clear the pathogen within 24 h. These characteristics may explain how some C. pseudodiphtheriticum strains cause severe infection in human patients.
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Affiliation(s)
- Monica Cristina de Souza
- Laboratório de Difteria e Corinebacterias de Importância Clínica, Instituto de Biologia Roberto Alcântara Gomes, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
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21
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Erturan G, Holme H, Iyer S. Corynebacterium pseudodiphtheriticum septic arthritis secondary to intra-articular injection – a case report and literature review. J Med Microbiol 2012; 61:860-863. [DOI: 10.1099/jmm.0.037937-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Gurhan Erturan
- Department of Trauma and Orthopaedics, Royal Berkshire Hospital, London Road, Reading RG1 5AN, UK
| | - Harriet Holme
- The Whittington Hospital, Magdala Avenue, London N19 5NF, UK
| | - Shabnam Iyer
- Department of Microbiology, Royal Berkshire Hospital, London Road, Reading RG1 5AN, UK
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22
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Gallenga P, Del Boccio M, Rapinese M, Di Iorio A, Toniato E, Martinotti S. Molecular Approach by PCR is the Best Method to Detect the Presence of Chlamydia Trachomatis and to Define the True Agent of Ocular Bacterial Inflammation. Int J Immunopathol Pharmacol 2011; 24:285-96. [DOI: 10.1177/039463201102400202] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Chlamydia trachomatis (Ct) is an atypical agent for acute, subclinical and chronic conjunctivitis in developed countries, as stated by the International League against Trachoma. In order to evaluate the presence of Ct, from a total of 3,520 patients visiting the consulting room of the Eye Clinic of G. d'Annunzio University of Chieti, Italy from 2006–2008, we enrolled 171 patients affected by occasional mild, moderate or severe conjunctivitis in a three-arm prospective open study, using traditional analysis such as Immune Fluorescent Assay and Enzyme–Linked Fluorescent Assay (IFA and ELFA) and molecular analysis with Polymerase Chain Reaction (PCR) procedure for Ct DNA research (Ct DNA). At the same time, microbiological culture was carried out for common germs and mycetes. These patients were analyzed at different subsequent times. In the first arm (Group A) of 82 patients with IFA and ELFA only 10 people (12.2%) resulted positive to Ct infection with both methods. The presence of Ct was never alone, but always overlapped with contaminants, like corynebacteria, staphylococci, streptococci and colonbacteria, randomly distributed, while no growth of mycetes was observed. Of these positive patients, only one 47-year-old female, suffering from a moderate form of ocular chlamydial infection, showed serological conversion against this infection; furthermore, this female had also been suffering from reactive arthritis for sometime. In the second arm (Group B) of 89 patients, we carried out PCR for Ct detection: 82 (94.25%) were found positive to Ct – DNA research, with common germ growth randomly associated, without sex or age prevalence, as in group A; no mycetes were found. The third arm (Group C) included 37 negative patients from Group A with severe or moderate chronic conjunctivitis, randomly recruited between relapsing cases, with the addition of the single previously positive seroconversion case, for a total of 38 patients, who were re-evaluated by PCR Ct-DNA analysis. All these patients, negative to IFA and ELFA, were positive to Ct-DNA analysis. These data indicate a higher rate of Ct infection in patients with severe or moderate chronic conjunctivitis, resistant to usual therapies even after eradication of common germs, thus showing the advantage of introducing this molecular technique of analysis in mild to severe chronic or recurrent conjunctivitis.
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Affiliation(s)
- P.E. Gallenga
- Dept. Surgical Science Clinical Experimental, Section of Ophthalmology
| | - M. Del Boccio
- Dept. Surgical Science Clinical Experimental, Section of Ophthalmology
| | - M. Rapinese
- Dept. Surgical Science Clinical Experimental, Section of Ophthalmology
| | | | - E. Toniato
- Dept. of Oncology and Neuroscience Biomedical Sciences. Faculty of Medicine, “G. d'Annunzio” University Chieti-Pescara
| | - S. Martinotti
- Dept. of Oncology and Neuroscience Biomedical Sciences. Faculty of Medicine, “G. d'Annunzio” University Chieti-Pescara
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23
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Bittar F, Cassagne C, Bosdure E, Stremler N, Dubus JC, Sarles J, Reynaud-Gaubert M, Raoult D, Rolain JM. Outbreak of Corynebacterium pseudodiphtheriticum infection in cystic fibrosis patients, France. Emerg Infect Dis 2010; 16:1231-6. [PMID: 20678316 PMCID: PMC3298292 DOI: 10.3201/eid1608.100193] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
An increasing body of evidence indicates that nondiphtheria corynebacteria may be responsible for respiratory tract infections. We report an outbreak of Corynebacterium pseudodiphtheriticum infection in children with cystic fibrosis (CF). To identify 18 C. pseudodiphtheriticum strains isolated from 13 French children with CF, we used molecular methods (partial rpoB gene sequencing) and matrix-assisted laser desorption ionization time-of-flight (MALDI-TOF) mass spectrometry. Clinical symptoms were exhibited by 10 children (76.9%), including cough, rhinitis, and lung exacerbations. The results of MALDI-TOF identification matched perfectly with those obtained from molecular identification. Retrospective analysis of sputum specimens by using specific real-time PCR showed that approximately 20% of children with CF were colonized with these bacteria, whereas children who did not have CF had negative test results. Our study reemphasizes the conclusion that correctly identifying bacteria at the species level facilitates detection of an outbreak of new or emerging infections in humans.
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Affiliation(s)
- Fadi Bittar
- Universite de la Mediterranée, Marseille, France
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24
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Martins CAS, Faria LMD, Souza MC, Camello TCF, Velasco E, Hirata Jr R, Thuler LCS, Mattos-Guaraldi AL. Microbiological and host features associated with corynebacteriosis in cancer patients: a five-year study. Mem Inst Oswaldo Cruz 2009; 104:905-13. [DOI: 10.1590/s0074-02762009000600015] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2009] [Accepted: 08/20/2009] [Indexed: 11/22/2022] Open
Affiliation(s)
- CAS Martins
- Ministério da Saúde, Brasil; Universidade do Estado do Rio de Janeiro, Brasil
| | | | - MC Souza
- Universidade do Estado do Rio de Janeiro, Brasil
| | - TCF Camello
- Universidade do Estado do Rio de Janeiro, Brasil
| | | | - R Hirata Jr
- Universidade do Estado do Rio de Janeiro, Brasil
| | - LCS Thuler
- Universidade Federal do Rio de Janeiro, Brasil
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