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Clinical characteristics and drug susceptibility patterns of Corynebacterium species in bacteremic patients with hematological disorders

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Abstract

The aim of this study was to clarify the clinical and microbiological characteristics of Corynebacterium bacteremia in hematological patients. We retrospectively reviewed the medical records of patients with Corynebacterium bacteremia from April 2013 to June 2018. The causative Corynebacterium species were identified using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Drug susceptibility tests were performed using the broth microdilution method recommended by the Clinical and Laboratory Standards Institute. In total, 147 cases of Corynebacterium bacteremia were identified during the study period. Corynebacterium striatum was the most frequent pathogen. Catheter-related bloodstream infection was diagnosed in 19.7% of all patients, and moderate/severe oral or severe gastrointestinal mucosal impairment was detected in 19.7%. Polymicrobial infection was found in about 20% of cases, with Enterococcus faecium being the most frequent isolate. The overall 30-day mortality was 34.7% (51/147). Multivariate analysis showed that E. faecium co-infection (odds ratio (OR) 9.3; 95% confidence interval (CI) 2.1–40), systemic corticosteroids (OR 3.6; 95% CI 1.4–8.9), other immunosuppressive drugs (OR 0.32; 95% CI 0.13–0.76), and a Pitt bacteremia score ≥4 (OR 12; 95% CI 3.9–40) were significant risk factors for overall 30-day mortality. The drug susceptibility rates for beta-lactam antimicrobial agents were quite low. All isolates were susceptible to glycopeptides and linezolid. However, some C. striatum isolates were resistant to daptomycin. Corynebacterium bacteremia can occur in the presence of several types of mucosal impairment. Our drug susceptibility data indicate that Corynebacterium bacteremia in hematological patients could be treated by glycopeptides or linezolid.

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The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We thank medical technologists of Toranomon Hospital, Hiroko Inagawa, Chikako Okada, Reiko Yabusaki, Mayumi Yamanaka, Masaru Baba, Emiko Miyajima, Noriko Watahiki, Hiromi Baba, Chiemi Yoshino, Tomohiro Tsubaki, Yoshiko Kakinohana, Ayumi Takamura, and Yusuke Endo, for their invaluable technical assistance.

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Authors and Affiliations

  1. Department of Infectious Diseases, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan

    Masahiro Abe, Muneyoshi Kimura, Sho Ogura & Hideki Araoka

  2. Department of Laboratory Medicine, Kameda Medical Center, Kamogawa, Chiba, Japan

    Hideyuki Maruyama, Tomohisa Watari & Yoshihito Otsuka

  3. Department of Hematology, Toranomon Hospital, Tokyo, Japan

    Shinsuke Takagi, Naoyuki Uchida & Shuichi Taniguchi

  4. Okinaka Memorial Institute for Medical Research, Tokyo, Japan

    Hideki Araoka

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  1. Masahiro Abe
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Contributions

MA, MK, YO, and HA designed the study. MA collected the clinical data, and HM, TW, and YO collected the microbiological data. MA analyzed data and wrote the original draft. MA, MK, HM, TW, SO, ST, NU, YO, SU-T, and HA contributed to the interpretation of the results and reviewed the manuscript and provided critical feedback to form the final version. All authors read the final manuscript before submission.

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Correspondence to Masahiro Abe.

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These investigations were approved by the Human Ethics Review Committees of Toranomon Hospital and Kameda Medical Center.

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This retrospective study was evaluated by the Human Ethics Review Committees of Toranomon Hospital and Kameda Medical Center and waived from the requirement of patient informed consent.

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All the authors in this study reviewed the study and agreed to publish this manuscript.

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The authors declare no competing interests.

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Abe, M., Kimura, M., Maruyama, H. et al. Clinical characteristics and drug susceptibility patterns of Corynebacterium species in bacteremic patients with hematological disorders. Eur J Clin Microbiol Infect Dis 40, 2095–2104 (2021). https://doi.org/10.1007/s10096-021-04257-8

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