Encrusted cystitis caused by corynebacterium urealyticum: a case report with novel treatment strategy of intravesical dimethyl sulfoxide

ABSTRACT Encrusted cystitis (EC) was first described as chronic cystitis with mucosal calcification in 1914 (1). It is a very rare chronic inflammatory disease presenting with dysuria, pelvic pain and gross hematuria. Voided urine contains mucus or calcified mucopurulent stone like particles. Urinalysis always reveals alkaline pH. It may be present in healthy individuals with no predisposing etiological factors (2-4). Etiologically, previous urological diseases, immunosuppression, urinary infection with urea splitting bacteria, or urological interventions resulting in bladder mucosa trauma may also be present (5, 6). In the present case report, we describe a novel treatment for EC with intravesical dimethyl sulfoxide.

Multiplex polymerase chain reaction to identify and determine the toxigenicity of Corynebacterium spp with zoonotic potential and an overview of human and animal infections

Corynebacterium diphtheriae, Corynebacterium ulcerans and Corynebacterium pseudotuberculosis constitute a group of potentially toxigenic microorganisms that are related to different infectious processes in animal and human hosts. Currently, there is a lack of information on the prevalence of disease caused by these pathogens, which is partially due to a reduction in the frequency of routine laboratory testing. In this study, a multiplex polymerase chain reaction (mPCR) assay that can simultaneously identify and determine the toxigenicity of these corynebacterial species with zoonotic potential was developed. This assay uses five primer pairs targeting the following genes: rpoB (Corynebacterium spp), 16S rRNA (C. ulcerans and C. pseudotuberculosis), pld (C. pseudotuberculosis), dtxR (C. diphtheriae) and tox [diphtheria toxin (DT) ]. In addition to describing this assay, we review the literature regarding the diseases caused by these pathogens. Of the 213 coryneform strains tested, the mPCR results for all toxigenic and non-toxigenic strains of C . diphtheriae, C. ulcerans and C. pseudotuberculosis were in 100% agreement with the results of standard biochemical tests and PCR-DT. As an alternative to conventional methods, due to its advantages of specificity and speed, the mPCR assay used in this study may successfully be applied for the diagnosis of human and/or animal diseases caused by potentially toxigenic corynebacterial species.

Isolation, speciation, and antibiogram of clinically relevant non-diphtherial Corynebacteria (Diphtheroids).

Purpose: Coryneform or the non-diphtherial Corynebacterium species largely remains a neglected group with the traditional consideration of these organisms as contaminants. This concept, however, is slowly changing in the light of recent observations. This study has been done to find out the species distribution and antibiogram of various members of the clinically relevant Coryneform group, isolated from various clinical materials. Materials and Methods: One hundred and fourteen non-duplicate isolates of diphtheroids from various clinical isolates were selected for the study. The isolates were identified to the species level by using a battery of tests; and antimicrobial susceptibility was tested by using a combination of Clinical and Laboratory Standards Institute (CLSI) and the British Society for Antimicrobial Chemotherapy (BSAC) guidelines, in the absence of definitive CLSI guidelines. Results: Corynebacterium amycolatum was the predominant species (35.9%) in our series followed by the CDC Group G organisms (15.7%). Each of the remaining 19 species comprised of less than 10% of the isolates. More than half the total isolates were resistant to the penicillins, erythromycin, and clindamycin; while excellent activity (all the strains being susceptible) was shown by vancomycin, linezolid, and tigecycline. Chloramphenicol and tetracycline also had good activity in inhibiting more than 80% of the isolates. Multiply drug resistance was exhibited by all the species. Conclusion: This study was an attempt to establish the clinical significance of coryneform organisms. The high level of resistance shown by this group to some of the common antibacterial agents highlights the importance of processing these isolates in select conditions to guide the clinicians towards an appropriate therapy.

Difteria pelo Corynebacterium ulcerans: uma zoonose emergente no Brasil e no mundo / Corynebacterium ulcerans diphtheria: an emerging zoonosis in Brazil and worldwide / Difteria por Corynebacterium ulcerans: una zoonosis emergente en Brasil y en el mundo

O artigo revisa a literatura sobre a emergência de infecções humanas causadas por Corynebacterium ulcerans em diversos países, incluindo o Brasil. Foi realizada análise de artigos publicados entre 1926 e 2011 nas bases Medline/PubMed e SciELO, bem como artigos e informes do Ministério da Saúde. Apresenta-se um esquema de triagem, rápido, econômico e de fácil execução, capaz de permitir a realização do diagnóstico presuntivo de C. ulcerans e C. diphtheriae na maioria dos laboratórios brasileiros públicos e privados. A circulação de C. ulcerans em vários países, aliada aos recentes casos de isolamento do patógeno no Rio de Janeiro, é um alerta a clínicos, veterinários e microbiologistas sobre a ocorrência de difteria zoonótica e a circulação do C. ulcerans em regiões urbanas e rurais do território nacional e/ou da América Latina.

The article is a literature review on the emergence of human infections caused by Corynebacterium ulcerans in many countries including Brazil. Articles in Medline/PubMed and SciELO databases published between 1926 and 2011 were reviewed, as well as articles and reports of the Brazilian Ministry of Health. It is presented a fast, cost-effective and easy to perform screening test for the presumptive diagnosis of C. ulcerans and C. diphtheriae infections in most Brazilian public and private laboratories. C. ulcerans spread in many countries and recent isolation of this pathogen in Rio de Janeiro, southeastern Brazil, is a warning to clinicians, veterinarians, and microbiologists on the occurrence of zoonotic diphtheria and C. ulcerans dissemination in urban and rural areas of Brazil and/or Latin America.

El articulo revisa la literatura sobre la emergencia de infecciones humanas causadas por Corynebacterium ulcerans en diversos países, incluyendo Brasil. Se realizó análisis de artículos publicados entre 1926 y 2011 en las bases Medline/Pubmed y SciELO, así como artículos e informes del Ministerio Brasileño de la Salud. Se presenta un esquema de selección, rápido, económico y de fácil ejecución, capaz de permitir la realización del diagnóstico presuntivo de C. ulcerans y C. diphtheriae en la mayoría de los laboratorios brasileños públicos y privados. La circulación de C. ulcerans en varios países, aliada a los recientes casos de aislamiento del patógeno en Rio de Janeiro (Sureste de Brasil), es un alerta a clínicos, veterinarios y microbiólogos sobre la ocurrencia de difteria zoológica y la circulación de C. ulcerans en regiones urbanas y rurales del territorio nacional y/o de América Latina.

Microbiological and host features associated with corynebacteriosis in cancer patients: a five-year study

During a five-year period, 932 clinical isolates from cancer patients treated in a Brazilian reference centre were identified as corynebacteria; 86 percent of the cultures came from patients who had been clinically and microbiologically classified as infected and 77.1 percent of these patients had been hospitalised (71.1 percent from surgical wards). The adult solid tumour was the most common underlying malignant disease (66.7 percent). The univariate and multivariate analyses showed that hospitalised patients had a six-fold greater risk (OR = 5.5, 95 percent CI = 1.15-26.30 p = 0.033) related to 30-day mortality. The predominant species were Corynebacterium amycolatum (44.7 percent), Corynebacterium minutissimum (18.3 percent) and Corynebacterium pseudodiphtheriticum (8.5 percent). The upper urinary tracts, surgical wounds, lower respiratory tracts, ulcerated tumours and indwelling venous catheters were the most frequent sources of C. amycolatum strains. Corynebacterium jeikeium infection occurred primarily in neutropenic patients who have used venous catheters, while infection caused by C. amycolatum and other species emerged mainly in patients with solid tumours.

Corynebacterium striatum infecting a malignant cutaneous lesion: the emergence of an opportunistic pathogen / Corynebacterium striatum infectando lesão cutânea maligna: a emergência de um patógeno oportunista

We described a case of a 27-year old male patient with skin and soft tissue infection of a neoplastic lesion caused by Corynebacterium striatum, an organism which has been rarely described as a human pathogen. Identification was confirmed by DNA sequencing. Successful treatment with penicillin was achieved. The role of the C. striatum as an emerging opportunistic pathogen is discussed.

Descrevemos infecção de lesão neoplásica em paciente masculino de 27 anos, envolvendo pele e partes moles, causada por Corynebacterium striatum, um microrganismo raramente descrito como patógeno humano. A identificação foi confirmada por seqüenciamento de DNA. O paciente foi tratado com penicilina, com sucesso. O papel do C. striatum como patógeno oportunista é discutido.

Cutaneous infection caused by Corynebacterium pseudodiphtheriticum: a microbiological report / Infecção cutânea causada por Corynebacterium pseudodiphtheriticum: relato microbiológico

We report here a rare case of cutaneous infection due to Corynebacterium pseudodiphtheriticum. The patient presented to the clinical laboratory with a skin ulcer on his left leg. Gram-stained preparation of the purulent secretion revealed the presence of numerous rod-shaped Gram-positive organisms in the absence of any other species. The organism was grown in pure culture on sheep blood agar and was further identified as C. pseudodiphtheriticum using a commercial identification system (API-Coryne, BioMérieux, France). The infection was successfully treated with ciprofloxacin. This case emphasizes the importance of the clinical microbiology laboratory in correctly identifying Gram-positive organisms obtained in pure culture from skin ulcers.

Reportamos o isolamento de Corynebacterium pseudodiphtheriticum de um caso de infecção cutânea. O paciente apresentou-se ao laboratório clínico com uma úlcera na perna esquerda. A coloração de Gram do material revelou a presença de bacilos Gram-positivos e ausência de outras espécies bacterianas. O organismo foi isolado em cultura pura no ágar sangue de carneiro e foi identificado como C. pseudodiphtheriticum através de um sistema de identificação comercial (API-Coryne, BioMérieux, França). A infecção foi tratada com sucesso através do uso de ciprofloxacina. Este caso reforça a importância do laboratório de microbiologia clínica na identificação de organismos Gram-positivos isolados de cultura pura de amostras de úlceras cutâneas.

Bacteriological & epidemiological characteristics of diphtheria cases in & around Delhi -a retrospective study.

BACKGROUND & OBJECTIVE: Diphtheria infections caused by the different toxigenic biotypes of Corynebacterium diphtheriae are endemic in Delhi. Information on biochemical identification, toxigenicity and antimicrobial susceptibility to this bacterium is scanty. This retrospective study was carried out to identify isolated Corynebacteria biochemically, determine their toxigenicity, drug sensitivity and some epidemiological characteristics of diphtheria cases from Delhi and adjoining States for the period 1998-2004. METHODS: A total of 1118 throat and 585 nasal swabs were used to detect human pathogenic corynebacteria. WHO recommended methods were used for the detection, screening, toxigenicity and antibiogram pattern of the isolates. RESULTS: Among 493 (44.1%) cases detected positive for corynebacteria 71.8 per cent were pharyngeal, 20.9 per cent nasopharyngeal and rest 7.3 per cent nasal diphtheria cases. Biochemical identification revealed two species i.e., C. diphtheriae and C. pseudodiphtheriticum. In C. diphtheriae three biotypes were detected viz., intermedius (95.5%), gravis (3.4%) and mitis (1.1%). Toxin was expressed by 96 per cent isolates of C. diphtheriae. Cases were recorded from Delhi and four adjoining States. Sex ratio among male to female was 1.6:1. Prime victims were less than 9 yr old children (93.3%). Unvaccinated children (70.2%) were the main sufferers. Fatality rate was highest in Delhi cases (16.8%) followed by UP (14.6%) and Haryana (5.9%). INTERPRETATION & CONCLUSION: Standard methods revealed the replacement of C. diphtheriae var mitis with var intermedius and occurrence of diphtheria infections due to other human pathogenic corynebacteria. It is imperative to have good bacteriological facilities to have better surveillance with regular monitoring in the endemic areas to keep the disease under control.

Fatal case of bacteremia caused by an atypical strain of Corynebacterium mucifaciens

Corynebacterium species have often been considered normal skin flora or contaminants; however, in recent years they have been increasingly implicated in serious infections. Moreover, many new species have been discovered and old species renamed, especially after molecular biology techniques were introduced. Corynebacterium mucifaciens is mainly isolated from blood and from other normally-sterile body fluids; it forms slightly yellow, mucoid colonies on blood agar. We report a fatal case of bacteremia due to an atypical strain of C. mucifaciens. This strain had atypical colony morphology; analysis of the 16S rRNA gene was used to define the species.

Single method to stain Malassezia furfur and Corynebacterium minutissimum in scales

E descrito um metodo simples e pratico para corar Malassezia furfur e Corynebacterium minutissimum nas escamas das lesoes. O material e colhido com o auxilio de fita durex que sera usada na maior parte das etapas do metodo para ajudar a facil execucao do processo de coloracao. Para colher as escamas, pequenos pedacos de fita durex com cerca de 4 cm de comprimento por 2 cm de largura sao colocados e pressionados sobre as lesoes, e quando retirados trazem aderidas as escamas furfuraceas na face com goma. Esses pedacos de fita durex sao imersos por alguns minutos no corante lactofenol-azul cotton e logo que as escamas estiverem coradas em azul sao lavadas em agua corrente para remover o excesso de corante azul, secos com papel de filtro, desidratados pela passagem em dois frascos de centrifugacao com xilol. O xilol dissolve a goma da fita durex e as escamas caem soltas no tubo. Apos centrifugacao e decantacao as escamas concentradas no fundo do tubo sao colhidas com alca de platina, colocadas em balsamo de Canada sobre uma lamina de microscopia e fechadas com uma laminula...

Aislamiento de corynebacterium urealyticum de muestras clínicas: identificación bioquímica y sensibilidad a 10 antibióticos / Corynebacterium urealyticum isolation from clinical specimens: biochemical identification and sensibility to ten antibiotics

Fueron estudiadas 21 cepas de Corynebacterium urealyticum aisladas de distintos pacientes: 19 (90,5 por ciento) de infecciones urinarias, 1 de un cálculo renal y la restante de un absceso retroperitoneal. Sobre 15 cepas tomadas al azar, se determinó la CIM de 10 antibióticos: vancomicina, ciprofloxacina, rifampicina, penicilina, cefalotina, ceftriaxona, imipenem, amikacina, gentamicina y cotrimoxazol. En 18 (85,7 ciento por ciento) pacientes los cultivos fueron monomicrobianos y en 3 (14,3 por ciento), asociados a otras bacterias. La totalidad de las cepas fueron catalasa y ureasa positivas. Ninguna redujo los nitratos ni fermentó los hidratos de carbono. Las 15 cepas sobre las que se determinó la CIM fueron totalmente sensibles a vancomicina y parcialmente sensibles a ciprofloxacina y rifampicina. La producción de ureasa y la no fermentación de la glucosa, asociadas a la multirresistencia, conforman elementos de inestimable valor para la identificación presuntiva del C. urealyticum

Avaliaçäo da atividade co-hemolítica de estreptococos, listerias e corinebactérias usando placas de agar sangue de carneiro e uma microtécnica quantitativa / Evaluation of cohemolytic activity in atreptococci, listeria and corynebacteria by using sheep blood agar plates and a quantitativemicroassay

Sinergismo e antagonismo hemolíticos entre estreptococos, listérias e corinebactérias foram avaliados em placas de agar sangue de carneiro, na presença de Staphylococcus aureus, Rhodococus(Corynebacterium) equi e Corynebacterium haemolyticum como amostras indicadoras.Hemólise sinérgica com R.(C.)equi e antagonismo hemolítico com S.aureus foram abservados com C.haemolyticum, Corynebacterium pseudotuberculosis, Corynebacterium ulcerans e Listeriaivanovii.Quando estas últimas foram também testadas como amostras indicadoras, somente C.haemolyticum fornaceu resultados inequívocos.C.haemolyticum pode ser útil para eliminar dúvidas causadas, no teste de CAMP, pelas reaçöes fracas ou näo específicas.Todas as amostras de Streptococus agalactiaetestadas e uma de Streptococus uberis foram positivas com S.aureus, mas apenas S.agalactiae deu reaçöes positivas com C.haemolyticum.R.(C.)equi, Corynebacterium hoagii(esta agora, também, considerada como R.equi) e Corynebacterium renale apresentaram sinergismo hemolítico com S.aureus.Quando esta indicadora foi substituída por C.haemolyticum, R.(C.)equi e C.hoagii foram positivas, mas näo C.renale.C.Haemolyticum apresentou resultados fracamente positivos com Listeria monocytogenes e antagonismo com L.ivanovii, enquanto tanto L.monocytogenes, quanto Listeria seeligeri forneceram reaçöes fracas com S.aureus.amostras de L.monocytogenes também foram positivas ou fracamente positivas com R.(C.)equi.Uma microtécnica precisa foi adaptada para a determinaçäo quantitativa da atividade co-hemolítica correlacionaram bem com os resultados obtidos em meio sólido.Uma exceçäo importante ocorreu com a ativadade co-hemolítica detectável entre listérias patogênicas, as quais apresentaram reaçöes duvidosas em placas de agar sangue.Além de facilitar o estudo das co-citolisinas bacterianas, a determinaçäo quantitativa da atividade co-hemolítica pode ser importante para diferenciar espécies patogênicas de Listeria.