Microbiology Department, Raymond Poincaré University Hospital, APHP, Referral Center for Bone and Joint Infection, 104 Bd R. Poincaré, 92380, Garches, France.
Microbiology Department, Ambroise Paré University Hospital, APHP, Referral Center for Bone and Joint infection, 9 Av Charles de Gaulle, 92100, Boulogne-Billancourt, France.
Eur J Clin Microbiol Infect Dis. 2019 Jul;38(7):1269-1278. doi: 10.1007/s10096-019-03542-x. Epub 2019 Mar 22.
Corynebacterium striatum is a ubiquitous colonizer of human skin and mucous membranes. It is increasingly involved in infections, especially with prosthetic devices or in immunocompromised individuals. Microbiological diagnosis is challenging and bacterial resistance is a major concern. We performed a retrospective study of monomicrobial bone and joint infections (BJI) due to C. striatum in two referral centers from April 2012 to July 2017. We collected the patients' clinical and microbiological characteristics and outcomes. We also performed a literature review of BJI due to C. striatum. We identified 12 cases (nine prosthetic joint infections, one osteosynthetic device infection, one non-union, and one arthritis) in 11 patients, five of which were immunocompromised. Microbiological diagnosis was performed with prolonged culture media. Ten out of 12 strains were susceptible to aminopenicillin, a drug class not recommended for testing by the EUCAST/CASFM guidelines, and 8/12 patients were treated with amoxicillin-rifampicin. The cure rate was 8/12, after a median follow-up period of 487.5 days (IQR 140.3-1348.5). Twelve cases of BJI due to C. striatum were previously reported. Among them, 5/12 patients were immunocompromised, 3/12 cases were acute BJI, and 2/12 were device-related infections. The diagnosis was performed by PCR in one case, and 10/12 patients were treated with glycolipopeptides, with a cure rate of 11/12. We report the largest cohort of monomicrobial BJI with C. striatum. Determination of aminopenicillin susceptibility is essential since it is frequently active in our experience, even in BJI. The cure rate of this infection seems high.
棒状杆菌是一种普遍定植于人体皮肤和黏膜的细菌。它越来越多地与感染有关，尤其是在有假体装置的情况下，或在免疫功能低下的个体中。微生物学诊断具有挑战性，细菌耐药性是一个主要关注点。我们对 2012 年 4 月至 2017 年 7 月期间在两个转诊中心发生的由 C. striatum 引起的单一微生物性骨和关节感染（BJI）进行了回顾性研究。我们收集了患者的临床和微生物学特征及结果。我们还对由 C. striatum 引起的 BJI 进行了文献复习。我们在 11 名患者中发现了 12 例（9 例假体关节感染、1 例骨合成装置感染、1 例骨不连和 1 例关节炎），其中 5 例为免疫功能低下。通过延长培养介质进行微生物学诊断。12 株中有 10 株对氨青霉素敏感，而 EUCAST/CASFM 指南不推荐对此类药物进行测试，其中 8/12 例患者接受阿莫西林-利福平治疗。在中位随访期为 487.5 天（IQR 140.3-1348.5）后，治愈率为 8/12。以前曾报道过 12 例由 C. striatum 引起的 BJI。其中，5/12 例患者免疫功能低下，3/12 例为急性 BJI，2/12 例为器械相关感染。1 例通过 PCR 进行诊断，10/12 例患者接受糖脂肽治疗，治愈率为 11/12。我们报告了由 C. striatum 引起的最大单一微生物性 BJI 队列。确定氨苄青霉素的敏感性非常重要，因为根据我们的经验，即使在 BJI 中，它也经常有效。这种感染的治愈率似乎很高。
