Multidrug-resistant Corynebacterium striatum pneumonia in a heart transplant recipient

Details

Serval ID
serval:BIB_5AE0A77D1532
Type
Article: article from journal or magazin.
Publication sub-type
Case report (case report): feedback on an observation with a short commentary.
Collection
Publications
Institution
Title
Multidrug-resistant Corynebacterium striatum pneumonia in a heart transplant recipient
Journal
Transplant Infectious Disease
Author(s)
Tarr  P. E., Stock  F., Cooke  R. H., Fedorko  D. P., Lucey  D. R.
ISSN
1398-2273
Publication state
Published
Issued date
03/2003
Peer-reviewed
Oui
Volume
5
Number
1
Pages
53-8
Notes
Case Reports
Journal Article --- Old month value: Mar
Abstract
Corynebacterium striatum is a rare, but likely underreported, cause of serious infections in immunocompromised hosts and generally is susceptible to multiple classes of antimicrobial agents. Here we report the first case of C. striatum infection in a solid organ transplant recipient. Three years after heart transplantation, a 58-year-old man developed bilateral pneumonia and pulmonary embolism. He did not improve with levofloxacin, piperacillin/tazobactam, and heparin treatment. A homogeneous population of abundant gram-positive rods was repeatedly demonstrated in sputum and bronchoalveolar lavage fluid, and C. striatum was grown in pure culture. The isolate was unusual for its multidrug-resistant (MDR) antimicrobial susceptibility pattern. The pneumonia resolved with 4 weeks of vancomycin therapy, in combination with rifampin given only during the first 2 weeks of treatment. The isolation of coryneforms ("diphtheroids") is often attributed to contamination. Their abundant presence on direct examination of specimens and/or their growth in pure culture suggest a pathogenic role, however, and indicate the need for accurate microbiological identification, particularly in immunocompromised hosts who have been hospitalized and previously treated with antibiotics. Combination therapy that includes vancomycin may be the most prudent treatment for MDR C. striatum infections.
Keywords
Amphotericin B/therapeutic use Ciprofloxacin/therapeutic use Corynebacterium/classification/isolation & purification Corynebacterium Infections/diagnosis/drug therapy/*etiology *Drug Resistance, Multiple, Bacterial Drug Therapy, Combination/therapeutic use Heart/microbiology Heart Transplantation/*adverse effects Humans Male Pneumonia, Bacterial/diagnosis/drug therapy/*etiology/radiography
Pubmed
Create date
20/01/2008 16:55
Last modification date
20/08/2019 14:13
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