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纹带棒状杆菌所致菌血症的临床与细菌学分析

Clinical and bacteriological analyses of bacteremia due to Corynebacterium striatum.

作者信息

Ishiwada Naruhiko, Watanabe Masaharu, Murata Shota, Takeuchi Noriko, Taniguchi Toshibumi, Igari Hidetoshi

机构信息

Department of Infectious Diseases, Medical Mycology Research Center, Chiba University, Chiba, Japan.

Division of Clinical Laboratory, Chiba University Hospital, Chiba, Japan.

出版信息

J Infect Chemother. 2016 Dec;22(12):790-793. doi: 10.1016/j.jiac.2016.08.009. Epub 2016 Sep 18.

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.

摘要

背景

纹带棒状杆菌最近被认为是多种传染病的潜在病原体。然而,这种微生物的临床特征尚未明确。因此,我们分析了从血培养中分离出的纹带棒状杆菌菌株,并探讨了其临床决定因素。

方法

我们回顾了所有从血培养中分离出纹带棒状杆菌菌株的患者的病历,以分析患者的背景和临床病程,包括对抗菌治疗的反应和预后。

结果

在5年研究期间(2010年1月至2014年12月),从血液样本中分离出24株纹带棒状杆菌菌株,纹带棒状杆菌菌血症的发生率有所增加。大多数菌株具有多重耐药性。所有测试菌株仅对万古霉素敏感。纹带棒状杆菌菌血症的发病年龄涵盖所有成年年龄组,所有患者均记录有至少一种基础疾病。24例患者中有13例使用适当抗生素治愈(真感染组);然而,24例患者中有11例使用不适当的抗生素治疗或未使用抗生素而治愈(污染组)。恶性肿瘤和中性粒细胞减少显著增加了纹带棒状杆菌真正血流感染的几率。

结论

棒状杆菌属在培养中分离时通常被认为是污染物。相反,特别是当该菌株从血液中分离出来时,应在临床上考虑该菌种并鉴定到种水平;此外,建议进行药敏试验。

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