Babay Hanan A, Kambal Abdelmageed M
Department of Pathology/Microbiology (32), King Khalid University Hospital, PO Box 2925, Riyadh 11461, Kingdom of Saudi Arabia.
Saudi Med J. 2004 Aug;25(8):1073-9.
Coryneform bacteria have been increasingly recognized as opportunistic pathogens in recent years. The aim of this study is to identify and determine the antimicrobial susceptibility of coryneform bacteria isolated from blood cultures of patients seen at King Khalid University Hospital (KKUH), Riyadh, Kingdom of Saudi Arabia and review the literature.
All coryneform bacteria isolated from blood culture specimens between January 2001 and March 2003 were prospectively identified by API Coryne System (BioMerieux, France). Clinical data were collected from each patient's medical record. Antimicrobial susceptibility to 16 antimicrobial agents were determined by minimum inhibitory concentration (MIC) using E-test (AB Biodisk, Solna, Sweden).
Out of 50 coryneform bacteria isolated, 19 different species were identified. Corynebacterium propinquum was the most common species 6/50 (12%) followed by Corynebacterium auris 5/50 (10%), Corynebacterium afermentans, Corynebacterium striatum, Dermabacter hominis, Brevibacterium, and Arthrobacter species 4/50 (8%) each. Underlying chest diseases were common among the patients 11/50 (22%), followed by different surgeries 10/50 (20%). Of all, 12/50 (24%) patients were from different intensive care units (ICUs), 36/50 (72%) had either vascular, urinary or respiratory intubation. Three patients in ICUs died, one was an elderly patient with gastrointestinal bleeding and 2 teenagers (one had tracheoesophageal fistula and the other was post-arrest road traffic accident patient). Vancomycin was the most active antimicrobial agent against all coryneform species. The majority had MIC <1 ug/ml. For most isolates, the MIC90s of erythromycin, clindamycin, and ciprofloxacin were above the break points. Corynebacterium striatum was the only isolate susceptible to ampicillin.
This study revealed that coryneform bacteria are increasingly being recognized as a cause of serious infections in immunocompromised patients. We recommend identification and susceptibility testing of predominant isolates of coryneform bacteria from different clinical sites of seriously ill patients to select the antimicrobial agent necessary for clinical intervention.
近年来，棒状杆菌越来越被认为是机会性致病菌。本研究旨在鉴定和确定从沙特阿拉伯王国利雅得市哈立德国王大学医院（KKUH）患者血培养中分离出的棒状杆菌的抗菌药敏情况，并回顾相关文献。
对2001年1月至2003年3月从血培养标本中分离出的所有棒状杆菌，采用API Coryne系统（法国生物梅里埃公司）进行前瞻性鉴定。从每位患者的病历中收集临床数据。使用E-test（瑞典索尔纳市AB Biodisk公司）通过最低抑菌浓度（MIC）测定对16种抗菌药物的药敏情况。
在分离出的50株棒状杆菌中，鉴定出19种不同的菌种。近平棒状杆菌是最常见的菌种，6/50（12%），其次是耳棒状杆菌5/50（10%），发酵棒状杆菌、纹带棒状杆菌、人皮肤杆菌、短杆菌和节杆菌属各4/50（8%）。患者中潜在的胸部疾病很常见，11/50（22%），其次是不同的手术10/50（20%）。其中，12/50（24%）的患者来自不同的重症监护病房（ICU），36/50（72%）有血管、尿道或呼吸道插管。ICU中有3名患者死亡，1名是患有胃肠道出血的老年患者，2名是青少年（1名患有气管食管瘘，另1名是心脏骤停后的道路交通事故患者）。万古霉素是对所有棒状杆菌菌种最有效的抗菌药物。大多数菌株的MIC<1μg/ml。对于大多数分离株，红霉素、克林霉素和环丙沙星的MIC90高于断点值。纹带棒状杆菌是唯一对氨苄西林敏感的分离株。
本研究表明，棒状杆菌越来越被认为是免疫功能低下患者严重感染的病因。我们建议对来自重症患者不同临床部位的主要棒状杆菌分离株进行鉴定和药敏试验，以选择临床干预所需的抗菌药物。
