Comparison of bloodstream infections due to Corynebacterium striatum, MRSA, and MRSE

BMC Infect Dis. 2024 Sep 17;24(1):988. doi: 10.1186/s12879-024-09883-z.

Abstract

Background: Corynebacterium striatum (C. striatum), a common skin and mucosal colonizer, is increasingly considered as an opportunistic pathogen causing bloodstream infections (BSIs). This study aims to investigate the clinical features and outcomes of C. striatum-BSI.

Methods: We included hospitalized cases with C. striatum-positive blood cultures from January 2014 to June 2022 and classified them into C. striatum-BSI group and contamination group; Clinical characteristics, treatments, and outcomes were compared between the C. striatum-BSI group and contamination group, Methicillin-resistant Staphylococcus aureus (MRSA)-BSI and Methicillin-resistant Staphylococcus epidermidis (MRSE)-BSI.

Results: Fifty-three patients with positive C. striatum blood cultures were identified. Among them, 25 patients were classified as C. striatum-BSI, with 21 as contamination cases. And 62 cases of MRSA-BSI and 44 cases of MRSE-BSI were identified. Compared to the contaminated group, the C. striatum-BSI group had a shorter time to positivity of blood cultures (27.0 h vs. 42.5 h, P = 0.011). C. striatum-BSI group had a longer time to positivity (27 h) when compared to both the MRSA (20 h) and MRSE groups (19 h) (p < 0.05). Appropriate therapy within 24 h of BSI onset was significantly lower in the C. striatum group (28%) compared to the MRSA (64.5%) and MRSE (65.9%) groups (p < 0.005). The 28-day mortality was higher in the C. striatum group (52.0%) compared to the MRSA (25.8%) and MRSE (18.2%) groups. CONCLUSIONS: Given the distinct characteristics of C. striatum-BSI, including a longer time to positivity than other Gram-positive bacteria and higher mortality rates, we suggest prescribing early appropriate antibiotics if C. striatum-BSI is suspected.

Keywords: Corynebacterium striatum; Bloodstream infection; Early appropriate antibiotics; MRSA; MRSE.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use
  • Bacteremia* / drug therapy
  • Bacteremia* / microbiology
  • Bacteremia* / mortality
  • Corynebacterium Infections* / drug therapy
  • Corynebacterium Infections* / microbiology
  • Corynebacterium* / classification
  • Corynebacterium* / genetics
  • Corynebacterium* / isolation & purification
  • Female
  • Humans
  • Male
  • Methicillin-Resistant Staphylococcus aureus* / drug effects
  • Methicillin-Resistant Staphylococcus aureus* / isolation & purification
  • Middle Aged
  • Retrospective Studies
  • Staphylococcal Infections / drug therapy
  • Staphylococcal Infections / microbiology
  • Staphylococcal Infections / mortality
  • Staphylococcus epidermidis / isolation & purification

Substances

  • Anti-Bacterial Agents

Supplementary concepts

  • Corynebacterium striatum