NON-DIPHTHERIAE CORYNEBACTERIUM SPECIES AS EMERGING PATHOGENS: CASE SERIES FROM A TERTIARY CARE HOSPITAL IN WESTERN NEPAL
Background: Corynebacteria other than C diphtheriae are often regarded as commensals of the skin and mucosa. However, these Corynebacterium species were recently recognized as emerging pathogens, causing systemic infections. Six cases due to non-diphetherial Corynebacteria as primary pathogens are reported here.
Methods: This was an observational study. Therapeutic outcome along with demographic and clinical details were obtained from the patients’ records. Organisms were identified and antibiotic sensitivity testing was performed by conventional techniques.
Results: C. xerosis was isolated from three patients: one with non-healing wound over the face following scald injury; second, a post-operative wound infection; and third, a case of neonatal sepsis. Two cases with acute exacerbation of COPD (case 3 and 5), yielded C bovis and Corynebacterium spp. respectively. The later had a prolonged hospital stay showing concurrent infections with Acinetobacter and Candida spp. C falsenii, an unusual pathogen was recovered from blood of a 2 year septicemic child . The patients responded to appropriate antibiotic therapy and made substantial recovery.
Conclusions: This case series highlights the importance of non C. diphtheriae Corynebacteria as primary pathogens. Non-diphtherial Corynebacteria should not be discarded as commensals or contaminants. Timely identification, proper clinical correlation and appropriate therapeutic intervention can lead to favorable outcome.
Keywords:Non-diphtherial Corynebacteria, COPD, Sepsis, Wound infection
Brandenburg, A. H., Van Belkum, A., Van Pelt, C., Bruining, H. A., Mouton, J. W. & Verbrugh, H. A. (1996). Patient to patient spread of single strain of Corynebacterium striatum causing infections in surgical intensive care unit. Journal of Clinical Microbiology. 34(9), pp 2089-2094.
Cattani, S., Venturelli, C., Berardi, A., Buffetti, C., De Caris, V., Casolari, C., Piccinini, L., Pastorelli, S., Della Casa Muttini, E., Gallo, C., Rumpianesi, F. & Ferrari, F. (2000). Sepsis caused by Corynebacterium xerosis in neaonatology: report of a clinical case. Acta Biomed Anteneo Parmense. 71(suppl 1), pp 777-780.
Chow, S. K., Bui, U. & Clarridge, J. E. (2015). Corynebacterium bovis eye infection, Washington, USA, 2013. Emerging Infectious Disease. 21(9), pp 1687-1689.
Fernández-Garayzabal, J. F., Egido, R., Vela, A. I., Briones, V., Collins, M. D., Mateos, A., Hutson R. A., Dominguez L. & Goyacha J. (2003). Isolation of Corynebacterium falsenii and description of Corynebacterium aquilae sp. nov., from eagles. International Journal of Systematic and Evolutionary Microbiolog. 53(4), pp 1135-1138.
Forbes, B. A., Sahm, D. F. & Weissfeld, A. S. (2007), Listeria, Corynebacterium and similar organisms; In: BA. Forbes, Sahm D. F. Sahm, A. S. Weissfeld, ed. Bailey & Scott's Diagnostic Microbiology 12th edition, Philadelphia: Elsevier Inc., pp 288-302.
Funke, G., von Graevenitz, A., Clarridge, J. E. 3rd & Bernard, K. A. (1997). Clinical microbiology of coryneform bacteria. Clinical Microbiology Review. 10(1), pp125-159.
Lee, P. P., Ferguson, D. A. Jr. & Sarubbi, F. A. (2005). Corynebacterium striatum: An underappreciated community and nosocomial pathogen. Journal of Infection. 50(4), pp 338-343.
Murray, P. R. & Washington, J. A. (1975). Microscopic and bacteriologic analysis of expectorated sputum. Mayo Clinic Proceedings. 50(6), pp 339-344.
Pessantha, B., Farb, A., Lwin, T., Lloyd, B. & Virmani, R. (2003). Infectious endocarditis due to Corynebacterium xerosis . Cardiovascular Pathology. 12(2), pp 98-101.
Poorschen, R. K., Goodmen, Z. & Rafai, B. (1977). Isolation of Corynebacterium xerosis from clinical specimens: infection and colonization. American Journal of Clinical Pathology. 68(2), pp 290-293
Riegel, P., Ruimy, R., Christen, R. & Monteil, H. (1996). Species identities and antimicrobial susceptibilities of Corynebacteria isolated from various clinical resources. European Journal of Clinical Microbiology and Infectious Diseases. 15(8), pp 657-562.
Soriano, F., Rodriguez-Tudela, J. L., Fernandez-Roblas, R., Aguado, J. M. & Santamarýa, M. (1998). Skin
colonization by Corynebacterium groups D2 and JK in hospitalized patients. Journal of Clinical Microbiology.
(9), pp 1878-1880.
Superti, S. V., Martin, Dde. S., Caierão, J., Soares, F., Prochnow, T., Cantarelli V. V. & Zavascji A. P. (2009). Corynebacterium Striatum infecting a malignant cutaneous lesion: The emergence of an opportunistic
pathogen. Revista Instituto de Medicina Tropical de Sau Paulo. 51(2), pp 115-116.
Tam, P. I., Fisher, M. A. & Miller, N. S. (2010).Corynebacterium falsenii bacteremia occuring in an infant on vancomycin treatment. Journal of Clinical Microbiology. 48(9), pp 3440-5442.
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