Medical Intensive Care Unit, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, 1 Shuai Fu Yuan, Beijing, 100730, China.
Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
BMC Infect Dis. 2024 Sep 17;24(1):988. doi: 10.1186/s12879-024-09883-z.
Corynebacterium striatum (C. striatum), a common skin and mucosal colonizer, is increasingly considered as an opportunistic pathogen causing bloodstream infections (BSIs). This study aims to investigate the clinical features and outcomes of C. striatum-BSI.
We included hospitalized cases with C. striatum-positive blood cultures from January 2014 to June 2022 and classified them into C. striatum-BSI group and contamination group; Clinical characteristics, treatments, and outcomes were compared between the C. striatum-BSI group and contamination group, Methicillin-resistant Staphylococcus aureus (MRSA)-BSI and Methicillin-resistant Staphylococcus epidermidis (MRSE)-BSI.
Fifty-three patients with positive C. striatum blood cultures were identified. Among them, 25 patients were classified as C. striatum-BSI, with 21 as contamination cases. And 62 cases of MRSA-BSI and 44 cases of MRSE-BSI were identified. Compared to the contaminated group, the C. striatum-BSI group had a shorter time to positivity of blood cultures (27.0 h vs. 42.5 h, P = 0.011). C. striatum-BSI group had a longer time to positivity (27 h) when compared to both the MRSA (20 h) and MRSE groups (19 h) (p < 0.05). Appropriate therapy within 24 h of BSI onset was significantly lower in the C. striatum group (28%) compared to the MRSA (64.5%) and MRSE (65.9%) groups (p < 0.005). The 28-day mortality was higher in the C. striatum group (52.0%) compared to the MRSA (25.8%) and MRSE (18.2%) groups. CONCLUSIONS: Given the distinct characteristics of C. striatum-BSI, including a longer time to positivity than other Gram-positive bacteria and higher mortality rates, we suggest prescribing early appropriate antibiotics if C. striatum-BSI is suspected.
棒状杆菌（C. striatum）是一种常见的皮肤和黏膜定植菌，越来越被认为是引起血流感染（BSI）的机会致病菌。本研究旨在探讨 C. striatum-BSI 的临床特征和结局。
我们纳入了 2014 年 1 月至 2022 年 6 月间 C. striatum 阳性血培养的住院患者，并将其分为 C. striatum-BSI 组和污染组；比较 C. striatum-BSI 组和污染组、耐甲氧西林金黄色葡萄球菌（MRSA）-BSI 和耐甲氧西林表皮葡萄球菌（MRSE）-BSI 的临床特征、治疗和结局。
共确定了 53 例 C. striatum 阳性血培养患者，其中 25 例患者被归类为 C. striatum-BSI，21 例为污染病例。此外，还确定了 62 例 MRSA-BSI 和 44 例 MRSE-BSI 病例。与污染组相比，C. striatum-BSI 组血培养阳性时间更短（27.0 小时 vs. 42.5 小时，P=0.011）。与 MRSA（20 小时）和 MRSE（19 小时）相比，C. striatum-BSI 组的阳性时间更长（27 小时）（p<0.05）。BSI 发病后 24 小时内接受适当治疗的 C. striatum 组（28%）明显低于 MRSA（64.5%）和 MRSE（65.9%）组（p<0.005）。C. striatum 组 28 天死亡率（52.0%）明显高于 MRSA（25.8%）和 MRSE（18.2%）组。
鉴于 C. striatum-BSI 的独特特征，包括比其他革兰氏阳性菌更长的阳性时间和更高的死亡率，如果怀疑 C. striatum-BSI，我们建议早期给予适当的抗生素治疗。
