Clonal multidrug-resistant Corynebacterium striatum within a nosocomial environment, Rio de Janeiro, Brazil

Corynebacterium striatum is a potentially pathogenic microorganism with the ability to produce outbreaks of nosocomial infections. Here, we document a nosocomial outbreak caused by multidrug-resistant (MDR) C. striatum in Rio de Janeiro, Brazil. C. striatum identification was confirmed by 16S rRNA and rpoB gene sequencing. Fifteen C. striatum strains were isolated from adults (half of whom were 50 years of age and older). C. striatum was mostly isolated in pure culture from tracheal aspirates of patients undergoing endotracheal intubation procedures. The analysis by pulsed-field gel electrophoresis (PFGE) indicated the presence of four PFGE profiles, including two related clones of MDR strains (PFGE I and II). The data demonstrated the predominance of PFGE type I, comprising 11 MDR isolates that were mostly isolated from intensive care units and surgical wards. A potential causal link between death and MDR C. striatum (PFGE types I and II) infection was observed in five cases.

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.

First detection of Corynebacterium ulcerans producing a diphtheria-like toxin in a case of human with pulmonary infection in the Rio de Janeiro metropolitan area, Brazil

The frequency and severity of human infections associated with Corynebacterium ulcerans appear to be increasing in different countries. Here, we describe the first C. ulcerans strain producing a diphtheria-like toxin isolated from an elderly woman with a fatal pulmonary infection and a history of leg skin ulcers in the Rio de Janeiro metropolitan area.

Corinebacterioses humanas em países emergentes - Corynebacterium pseudodiphtheriticum - patógeno relevante / Human corynebacteriosis in emerging countries - Corynebacterium pseudodiphtheriticum - pathogen relevant

Diversas espécies pertencentes ao gênero Corynebacterium spp. têm sido frequentemente associadas com quadros graves de infecção (sepsis, endocardites, infecções cirúrgicas, próteses e infecções relacionadas ao cateter venoso, entre outras), particularmente, no ambiente nosocomial. Quando essas infecções estão relacionadas a espécies multirresistentes, estas são de difícil ou impossível tratamento. Escassos são os trabalhos realizados no Brasil que investigam a presença de amostras de corinebactérias relacionadas com processos infecciosos em pacientes atendidos em instituições públicas e privadas. No presente estudo, foram isoladas 163 amostras de corinebactérias, a partir de espécimes clínicos oriundos de pacientes atendidos no HUPE-UERJ. A maioria das amostras foi isolada do trato geniturinário e sítios intravenosos (46,6%), sendo Corynebacterium amycolatum (29,55%)> Corynebacterium minutissimum (20,45%)> Corynebacterium pseudodiphtheriticum (13,63%) as espécies mais frequentemente encontradas. Corynebacterium minutissimum (24,14%)> Corynebacterium propinquum (17,24%) em cirurgias e/ou pele feridas e abscessos; Corynebacterium xerosis (25%)> Corynebacterium amycolatum (21,87%)> Corynebacterium pseudodiphtheriticum (18,75%) nos sítios intravenosos; Corynebacterium pseudodiphtheriticum (33,33%) e Corynebacterium propinquum (33,33 %) no trato respiratório inferior. Em relação aos testes de sensibilidade aos antimicrobianos testados rotineiramente, observamos que todos os microrganismos apresentaram sensibilidade à vancomicina e teicoplanina, enquanto a maioria das espécies foi predominantemente resistente aos b-lactâmicos. No período de 1993 a 2006, 113 amostras de C. pseudodiphtheriticum foram isoladas em ambiente hospitalar, principalmente em urina, trato respiratório baixo, sítios intravenosos e sangue, além de líquido peritoneal e abscesso, entre outros...

Various species belonging to the genus Corynebacterium spp. have been frequently associated with serious infection (sepsis, endocarditis, surgical infections, prostheses and infections related to venous catheter, among others), paticularly in nosocomial environment. Such infections are frequently difficult to treat when caused by multiresistant strains. Reports dealing with the descreption of infections process caused by corynebacteria in both public and private institutions in Brazil are scarce. In the present study, 163 corynebacterium strains were isolated from clinical specimens from patients in HUPE-UERJ. Most of the strains were isolated from genitourinary tract and intravenous sites (46,62%). Corynebacterium amycolatum (29,55%)> Corynebacterium minutissimum (20,45%)> Corynebacterium pseudodiphtheriticum (13,63%) the most often isolated species in genitourinary tract. Corynebacterium minutissimum (24,14%)> Corynebacterium propinquum (17,24%), in surgery, and/or skin and abscesses; Corynebacterium xerosis (25%)> Corynebacterium amycolatum (21,87%)> Corynebacterium pseudodiphtheriticum (18,75%) were isolated from intravenous sites. Corynebacterium pseudodiphtheriticum (33,33%) and Corynebacterium propinquum (33,33%) were the most frequently species from lower respiratory tract. In relation to the sensibility to antibiotics routinely used clinically, it was observed that all microorganisms showed sensitivity to vancomycin and teicoplanin, while the majority of strains were predominantly resistant to b-lactam. From 1993 to 2006, 113 C. pseudodiphtheriticum strians were isolated predominantly from nosocomial environment from urine, lower respiratory tract, blood and intravenous sites, peritoneal fluid and abscess. The predominantly underlying conditions were renal failure, hemodialysis and/or transplant; and HIV infection...