Corynebacterium jeikeium endocarditis: A case report and comprehensive review of an underestimated infection

Introduction Corynebacterium tuberculostearicum (C. t.) is a ubiquitous bacterium that colonizes human skin. In contrast to other members of the genus Corynebacterium, such as toxigenic Corynebacterium diphtheriae or the opportunistic pathogen Corynebacterium jeikeium, several studies suggest that C. t. may play a role in skin health and disease. However, the mechanisms underlying these effects remain poorly understood. Methods To investigate whether C. t. induces inflammatory pathways in primary human epidermal keratinocytes (HEKs) and human cutaneous squamous carcinoma cells (SCCs), cell culture, reverse transcription‐polymerase chain reaction (PCR), enzyme‐linked immunosorbent assay, immunofluorescence microscopy, Western blot, chromatin immunoprecipitation‐PCR, small interfering RNA knockdown and luciferase reporter expression system were used. Results Herein, we demonstrate that C. t. upregulates the messenger RNA (mRNA) and protein levels of inflammatory mediators in two human skin cell lines, HEKs and SCCs. We further show activation of the canonical nuclear factor‐κB (NF‐κB) pathway in response to C. t. infection, including phosphorylation of the inhibitor of κB (IκB), the nuclear translocation of NF‐κB subunit (NF‐κB‐P65) and the recruitment of NF‐κB‐P65 and RNA polymerase to the NF‐κB response elements at the promoter region of the inflammatory genes. Lastly, the data confirm that C. t.‐induced tumor necrosis factor mRNA expression in HEKs is toll‐like receptor 2 (TLR2) dependent. Conclusion Our results offer a mechanistic model for C. t.‐induced inflammation in human keratinocytes via TLR2 and activation of IκB kinase and downstream signaling through the canonical NF‐κB pathway. Relevance to chronic inflammatory diseases of the skin and cutaneous oncology is discussed.

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“…C. j . is an opportunistic human pathogen reported to induce inflammatory cytokines, such as IL17a . S. e .…”

Section: Resultsmentioning

confidence: 99%

Corynebacterium tuberculostearicum, a human skin colonizer, induces the canonical nuclear factor‐κB inflammatory signaling pathway in human skin cells

Altonsy

Kurwa

Lauzon

et al. 2020

Immunity Inflam & Disease

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“…C. jeikeium was recovered from 20% of our Corynebacterium-positive blood cultures but not from any of the orthopedic samples. C. jeikeium has been described to be the cause of endocarditis, bacteremia, cerebrospinal fluid shunt infections, peritoneal dialysis peritonitis, and, rarely, PJI (11,24,25). Biochemical characteristics and cell envelope structure are key factors for the adaptation to a certain habitat or for a predilection for a certain body site.…”

Section: Discussionmentioning

confidence: 99%

Corynebacterium Species Rarely Cause Orthopedic Infections

et al. 2018

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Corynebacteriumspp. are rarely considered pathogens, but data onCorynebacteriumspp. as a cause of orthopedic infections are sparse. Therefore, we asked how oftenCorynebacteriumspp. caused an infection in a defined cohort of orthopedic patients with a positive culture. In addition, we aimed to determine the species variety and the susceptibility of isolated strains to define potential treatment strategies. We retrospectively assessed all bone and joint samples that were collected between 2006 and 2015 from an orthopedic ward and that were positive forCorynebacteriumspp. by culture. The isolates were considered relevant to an infection if the sameCorynebacteriumsp. was present in at least two samples. We found 97 orthopedic cases with isolation ofCorynebacteriumspp. (128 positive samples). These were mainlyCorynebacterium tuberculostearicum(n= 26),Corynebacterium amycolatum(n= 17),Corynebacterium striatum(n= 13), andCorynebacterium afermentans(n= 11). Compared to the species found in a cohort of patients with positive blood cultures hospitalized in nonorthopedic wards, we found significantly moreC. striatum- andC. tuberculostearicum-positive cases but noC. jeikeium-positive cases in our orthopedic cohort. Only 16 out of 66 cases (24.2%) with an available diagnostic set of at least two samples had an infection. Antibiotic susceptibility testing (AST) showed various susceptibility results for all antibiotics except vancomycin and linezolid, to which 100% of the isolates were susceptible. The rates of susceptibility of corynebacteria isolated from orthopedic samples and of isolates from blood cultures were comparable. In conclusion, our study results confirmed that aCorynebacteriumsp. is most often isolated as a contaminant in a cohort of orthopedic patients. AST is necessary to define the optimal treatment in orthopedic infections.

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“…Wang et al (2001) "retrospectively reviewed 53 cases of C. jeikeium bacteremia in bone marrow transplant recipients who had a Hickman catheter without signs of local catheter site infection. The results showed that salvage of catheter with vancomycin therapy is successful in most patients (93%)" (Bookani et al, 2018). However, 7% of patients that underwent catheter salvage were affected by recurrent bacteremia.…”

Section: Discussionmentioning

confidence: 99%

Corynebacterium jeikeium Dormant Cell Formation and Photodynamic Inactivation

2020

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Pathogenic non-spore forming bacteria enter a dormant state under stressful conditions, which likely allows them to acquire resistance to various antibiotics. This work revealed the efficient formation of dormant “non-culturable” (NC) Corynebacterium jeikeium cells in stationary phase upon gradual acidification of the growth medium. Such cells were unable to form colonies and existed in a prolonged stationary phase. At an early stage of dormancy (approximately 14 days post-inoculation), dormant cells are able for resuscitation in liquid medium. However, those stored for long time in dormant state needed addition of supernatant taking from active C. jeikeium cultures for successful resuscitation. NC cells possessed low RNA synthesis and significant tolerance to antibiotics (rifampicin and vancomycin). They also accumulated free porphyrins, and 5-aminolevulinic acid addition enhanced free porphyrin accumulation which makes them potentially sensitive to photodynamic inactivation (PDI). PDI of dormant bacteria was accomplished by exposing cells to a 565 nm wavelength of light using a SOLIS-4C light-emitting diode for 60 min. This revealed that increased porphyrin concentrations were correlated with elevated PDI sensitivity. Results shown here demonstrate the potential utility of employing PDI to minimize levels of dormant, persistent corynebacteria and the C. jeikeium dormancy model developed here may be useful for finding new drugs and techniques for combatting persistent corynebacteria.

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Corynebacterium jeikeium endocarditis: A case report and comprehensive review of an underestimated infection

Cited by 22 publications

References 32 publications

Corynebacterium tuberculostearicum, a human skin colonizer, induces the canonical nuclear factor‐κB inflammatory signaling pathway in human skin cells

Corynebacterium tuberculostearicum, a human skin colonizer, induces the canonical nuclear factor‐κB inflammatory signaling pathway in human skin cells

Corynebacterium Species Rarely Cause Orthopedic Infections

Corynebacterium jeikeium Dormant Cell Formation and Photodynamic Inactivation

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