Yanai Mitsuru, Ogasawasa Maiko, Hayashi Yuta, Suzuki Kiyozumi, Takahashi Hiromichi, Satomura Atsushi
Nihon University School of Medicine, Department of Internal Medicine, Division of General Medicine, Tokyo, Japan.
Nihon University School of Medicine, Department of Internal Medicine, Division of General Medicine, Tokyo, Japan.
Braz J Infect Dis. 2018 Jan-Feb;22(1):24-29. doi: 10.1016/j.bjid.2017.12.002. Epub 2018 Jan 19.
Corynebacterium spp. are becoming recognized as pathogens that potentially cause various infections. We aimed to evaluate the clinical characteristics associated with Corynebacterium spp. bacteremia.
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.
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.
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.
棒状杆菌属正逐渐被认为是可能导致各种感染的病原体。我们旨在评估与棒状杆菌属菌血症相关的临床特征。
我们回顾性分析了2014年1月至2016年12月期间在一家大学医院血培养棒状杆菌属呈阳性的所有成年患者的病历。根据微生物检测结果和临床特征将患者分为菌血症组和污染组。评估患者的特征、分离菌株的抗菌药敏性、使用的抗菌药物以及患者的结局。
从63例患者的血样中分离出棒状杆菌属；纹带棒状杆菌是主要分离菌株。28例患者被确定患有菌血症。与污染组相比，菌血症组更常出现年龄较小（p = 0.023）、阳性检出时间较短（p = 0.006）、住院时间较长（p = 0.009）以及存在留置血管导管（p = 0.002）的情况。大多数菌血症患者的感染源是静脉导管。所有测试菌株对万古霉素敏感。尽管给予了适当的抗菌治疗，但27例菌血症患者中有4例死亡。
我们发现年龄较小、阳性检出时间较短以及存在留置导管与棒状杆菌属引起的菌血症有关。一旦从血液中分离出棒状杆菌属并怀疑有菌血症，应给予适当的抗菌药物。
