Antimicrobial treatment of Corynebacterium striatum invasive infections: a systematic review

Abstract

The aim of this study was to establish an evidence-based guideline for the antibiotic treatment of Corynebacterium striatum infections. Several electronic databases were systematically searched for clinical trials, observational studies or individual cases on patients of any age and gender with systemic inflammatory response syndrome, harboring C. striatum isolated from body fluids or tissues in which it is not normally present. C. striatum had to be identified as the only causative agent of the invasive infection, and its isolation from blood, body fluids or tissues had to be confirmed by one of the more advanced diagnostic methods (biochemical methods, mass spectrometry and/or gene sequencing). This systematic review included 42 studies that analyzed 85 individual cases with various invasive infections caused by C. striatum . More than one isolate of C. striatum exhibited 100% susceptibility to vancomycin, linezolid, teicoplanin, piperacillin-tazobactam, amoxicillin-clavulanate and cefuroxime. On the other hand, some strains of this bacterium showed a high degree of resistance to fluoroquinolones, to the majority majority of β-lactams, aminoglycosides, macrolides, lincosamides and cotrimoxazole. Despite the antibiotic treatment, fatal outcomes were reported in almost 20% of the patients included in this study. Gene sequencing methods should be the gold standard for the identification of C. striatum , while MALDI-TOF and the Vitek system can be used as alternative methods. Vancomycin should be used as the antibiotic of choice for the treatment of C. striatum infections, in monotherapy or in combination with piperacillin-tazobactam. Alternatively, linezolid, teicoplanin or daptomycin may be used in severe infections, while amoxicillin-clavulanate may be used to treat mild infections caused by C. striatum .

The challenge of antibiotic selection in prosthetic joint infections due to Corynebacterium striatum: a case report

“…A recent systematic review of antimicrobial therapy for C. striatum infections reported 100% susceptibility for included isolates to vancomycin, linezolid, piperacillin/tazobactam, amoxicillin/clavulanate, and cefuroxime. However, the review included a total of 85 individual cases from the literature and reported susceptibilities for only 8 organisms for piperacillin/tazobactam, 3 organisms for amoxicillin/clavulanate, and 2 organisms for cefuroxime [ 15 ]. Reports on C. striatum not included in this review indicate that resistance to these agents may be higher, such as in the above study by Noussair and colleagues [ 14 ] that reported a resistance rate of 66% for piperacillin/tazobactam.…”

Corynebacterium striatum Bacteremia during SARS-CoV2 Infection: Case Report, Literature Review, and Clinical Considerations

“…C. striatum is the causative agent of various illnesses, including skin infections such as cellulitis [ 12 ], osteomyelitis [ 13 ], meningitis [ 14 ], pneumonia [ 15 ], bacteremia [ 9 , 16 , 17 , 18 , 19 , 20 ], and infective endocarditis [ 21 ]. Over the past few years, the number of reported cases has been rising due to the increase in the life expectancy of immunosuppressed patients and the improvement in microbiological techniques that are suitable for accurately identifying this microorganism [ 3 ].…”

“…The isolation of C. striatum from culture is often considered as being contamination unless repeated cultures reveal the same result [ 22 ]. In a recent systematic review, Milosavljevic et al stated the reliability of the Vitek 2 system in the identification of C. striatum after the inclusion of this pathogen in the database [ 3 ], despite the fact that the scientific literature has reported misidentifications when using biochemical methods [ 23 , 24 ]. However, the gold standard technique for C. striatum identification is 16S RNA gene sequencing or, alternatively, matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF), due to its simplicity and cost efficiency [ 3 ].…”

“…Corynebacterium (C.) striatum is a non-diphtheric Gram-positive, facultative anaerobic, catalase negative, asporogenous, non-motile actinobacterium [ 3 ]. Despite the fact that it is a skin and mucosal-commensal microorganism [ 4 ], in the last few decades, it has been increasingly reported as being the causative agent of a variety of infections in both immunocompromised patients, such as those in critical conditions, and in immunocompetent hosts.…”

“…Despite the fact that it is a skin and mucosal-commensal microorganism [ 4 ], in the last few decades, it has been increasingly reported as being the causative agent of a variety of infections in both immunocompromised patients, such as those in critical conditions, and in immunocompetent hosts. Although several issues subsist regarding its microbiological isolation and antimicrobial testing, as well as the differentiation between infection and contamination, C. striatum has been recognized as being a nosocomial emerging pathogen that is associated with several diseases, including cases of bacteremia, endocarditis, and pneumonia [ 3 ]. Extended hospitalization, invasive procedures, and the prolonged use of antibiotics represent the major risk factors that correlate with C. striatum infections [ 5 ].…”