Non-Urinary Tract Infections Caused by Multiply Antibiotic-Resistant Corynebacterium urealyticum

Soriano, Francisco; Ponte, Carmen; Ruiz, Paloma Gallar; Zapardiel, Javier

doi:10.1093/clinids/17.5.890

Cited by 29 publications

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“…Although Corynebacterium urealyticum has been recorded only rarely as a cause of nonurinary infection in humans, it has been isolated from cases of pneumonia, peritonitis, cardiac valve infection, osteomyelitis, infection of postoperative wounds, and soft tissue necrosis [5]. We present here six cases of bacteremia caused by multiply resistant Corynebacterium urealyticum, four of which occurred in patients who had no evidence of pathology in the urinary tract.…”

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Bacteremia Caused by Multiply Resistant Corynebacterium urealyticum: Six Case Reports and Review

Fernández-Natal¹,

Guerra²,

Alcoba

et al. 2001

EJCMID

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“…Unlike some members of the genus Corynebacterium, especially Corynebacterium jeikeium, Corynebacterium urealyticum is an infrequent cause of bacteremia [4,5]. Corynebacterium jeikeium, a diphtheromorph, has arisen as a major human pathogen together with Corynebacterium urealyticum.…”

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Bacteremia Caused by Multiply Resistant Corynebacterium urealyticum: Six Case Reports and Review

Fernández-Natal¹,

Guerra²,

Alcoba

et al. 2001

EJCMID

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“…1), nonmotile, catalase-positive, multiresistant, urease-positive microorganism with filamentous morphology (Corynebacteria are often pleomorphic). This bacterium has been involved in endocarditis, (4) pericarditis (5), bacteriemia (6), peritonitis (7), osteomyelitis (8), necrotic infections of soft-tissue(3), and wound infections (9). Since 1985 it has been known as a cause of alkaline encrusted cystitis and other urinary tract infections (UTI) (I), occurring mainly in debilitated or transplanted patients subjected to urological manipulation (10).…”

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Encrusted Cystitis in an Immunocompromised Patient: Possible Coinfection by Corynebacterium Urealyticum and E. Coli

Penta

Fioriti

Chinazzi

et al. 2006

Int J Immunopathol Pharmacol

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Encrusted cystitis is a severe chronic inflammatory disease of the bladder characterized by excessively alkaline urine and calcifications within the bladder wall. A case of a 60 year-old man affected by systemic lupus erythematosus (SLE), which developed encrusted cystitis due to Corynebacterium urealyticum with E. coli coinfection, shows that the treatment of encrusted cystitis with a endoscopic debulking of the encrusted stones and an antimicrobial therapy specific for C. urealyticum often is not sufficient for the complete resolution of symptoms.C. urealyticum is a Gram-positive, slow-growing, multiresistant, urease-positive microorganism with diphtheroid morphology. Since 1985 it has been known as a cause of alkaline encrusted cystitis and other urinary tract infections (1), occurring mainly in patients subjected to urological manipulation. Alkaline encrusted cystitis is a condition characterized by the deposition of inorganic salts on a damaged urothelium. The patient presents symptoms of cystitis (2). Moreover C. urealyticum has been involved in endocarditis, pneumonia, peritonitis, osteomyelitis and soft-tissue infections (3). We report a case of encrusted cystitis due to Corynebacterium urealyticum in a patient with SLE. MATERIALS AND METHODSA 60 year-old man, affected by SLE and in treatment with steroid therapy, presents with persistent symptoms of urinary tract infection including dysuria, pollakiuria, and intermittent hematuria with urinary gravel. He had undergone cystoscopy, which showed stone deposits in the bladder wall. Analysis of the urinary stone deposits on the bladder mucosa revealed the presence of ammonium magnesium phosphate (struvite) and calcium hydroxy phosphate (apatite).The urine sample was plated onto modified MacConkey agar (Oxoid) and CLED (cystine-Iactoseelectrolyte-deficient) agar and incubated at 37°C for 48 h. The identification and the antibiotic sensitivity testing for common pathogen germs were performed with the Phoenyx identification system (Becton Dickinson, USA). The urine and pus culture for Corynebacterium spp. on 7% sheep blood agar (Oxoid, England) was performed with incubation at 37°C in air for 24 h. The microbiological criteria for identification of C. urealyticum were the presence of gram-positive bacteria with diphtheroid morphology catalase-positive and strongly urease-positive. For identification the APICoryne identification strip (API Laboratory' Products; bio-Merieux, France) and the Phoenyx identification system (Becton Dickinson, USA) were utilised. The

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“…However, sepsis due to C. urealyticum is rare, with only few cases reported over the past three decades, but it remains a life-threatening condition with mortality rate up to 20% [1][2][3][4]. Very scarce information is available about infection caused by C. urealyticum acquired while in the hospital.…”

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A case report and literature review of Corynebacterium urealyticum infection acquired in the hospital

et al. 2008

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Corynebacterium urealyticum is a Gram-positive, slowgrowing, and urea-splitting bacterium that frequently colonizes the skin and may occasionally cause a transient bacteremia [1][2][3][4]. However, sepsis due to C. urealyticum is rare, with only few cases reported over the past three decades, but it remains a life-threatening condition with mortality rate up to 20% [1][2][3][4]. Very scarce information is available about infection caused by C. urealyticum acquired while in the hospital. We analyzed the clinical features, management and outcome of one such patient.An 86-year-old man had a sudden onset of fever (40.3°C), dysuria, confusion and lethargy. He had hypertension and diabetes controlled with glyclazide and valsartan; there was no history of alcohol use or toxic habits nor was he taking other medications, including overthe-counter medications and herbal remedies. On admission, the patient appeared unwell and lethargic with a poor dental state, was dehydrated, with tachypnea (28 breaths/ min), blood pressure at 110/80 mmHg, and heart rate at 65 beats/min. Physical and neurological examination was normal except for motor function graded 3/5 throughout. A peripheral intravenous line, which was changed thereafter every fourth day, was inserted in the right arm.Laboratory analyses showed glucose 173 mg/dl (normal 60-110), creatinine 1.4 mg/dL (normal 0.4-1.2), urea 65 mg/dL (normal 10-50), leukocytes 7.4 9 10 9 cells/L (75% of which were neutrophils), and hematocrit 36.1%; amylase, lipase, electrolytes, coagulation, liver function tests, and arterial blood gas analysis were normal. Electrocardiogram revealed an atrial flutter with a 4:1 conduction and chest X-ray was normal. Urine analysis revealed trace proteins and glucose, pH was 5.5 and gravity 1017; microscopic examination showed 50 erythrocytes, 500 leukocytes, and 1074 bacteria per high-power field.After blood and urine samples were taken for culture, the patient was started on intravenous fluids, regular insulin, ciprofloxacin (200 mg i.v. twice daily), enoxaparin (50 IU/kg daily), and on the 5th day of hospital stay he was stable, alert and oriented but still pyrexial; at this time glucose, electrolytes, liver and renal function tests, and hematological variables were all within the normal range. On the 6th day, pyrexia settled and Pseudomonas aeruginosa, which was fully sensitive to amikacin and piperacillin and resistant to cephalosporins, quinolones, and carbapenems, grew from urine samples collected at admission; blood cultures remained sterile. Amikacin (15 mg/kg i.m. daily) and piperacillin/tazobactam (4.5 g i.v. three times daily) were administered in place of ciprofloxacin with a full clinical response; repeated urine and blood cultures grew no pathogens on the 13th day. Antibiotics were stopped while intravenous fluids were continued; an abdominal ultrasonography was unrevealing except for a moderate prostate enlargement, and a transthoracic echocardiography showed a mild left atrial enlargement with concentric left ventricular hypertrophy and...

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Non-Urinary Tract Infections Caused by Multiply Antibiotic-Resistant Corynebacterium urealyticum

Cited by 29 publications

References 0 publications

Bacteremia Caused by Multiply Resistant Corynebacterium urealyticum: Six Case Reports and Review

Bacteremia Caused by Multiply Resistant Corynebacterium urealyticum: Six Case Reports and Review

Encrusted Cystitis in an Immunocompromised Patient: Possible Coinfection by Corynebacterium Urealyticum and E. Coli

A case report and literature review of Corynebacterium urealyticum infection acquired in the hospital

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