Molecular epidemiology and clinical significance of Corynebacterium striatum isolated from clinical specimens
Received 19 August 2018
Accepted for publication 19 November 2018
Published 4 January 2019 Volume 2019:12 Pages 161—171
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Amy Norman
Peer reviewer comments 3
Editor who approved publication: Professor Suresh Antony
Jin Woong Suh,1 Yongguk Ju,2 Chang Kyu Lee,3 Jang Wook Sohn,1,2 Min Ja Kim,1,2 Young Kyung Yoon1,2
1Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea; 2Institute of Emerging Infectious Diseases, Korea University College of Medicine, Seoul, Republic of Korea; 3Department of Laboratory Medicine, Korea University College of Medicine, Seoul, Republic of Korea
Purpose: This study investigated the clinical epidemiology, antimicrobial susceptibility, and molecular epidemiology of Corynebacterium striatum isolates.
Patients and methods: An observational study was conducted at a university hospital in the Republic of Korea from August to December 2016. All subjects were patients who tested positive for C. striatum clinically. Clinical data were analyzed to evaluate the microbiological and genotypic characteristics of C. striatum strains.
Results: Sixty-seven C. striatum isolates recovered from non-duplicated patients were characterized. Patients were classified into three groups according to the infection type: nosocomial infection (71.6%), health care-associated infection (8.7%), and community-acquired infection (18.8%). The most common clinical specimens were urine (35.8%) and skin abscesses (32.8%). Fifty-two (77.6%) isolates showed multidrug resistance, defined as resistance to ≥3 different antibiotic families. All strains were susceptible to vancomycin and linezolid. Resistance to other antibiotics varied: penicillin (n=65; 97.0%), ampicillin (n=63; 94.0%), cefotaxime (n=64; 95.5%), and levofloxacin (n=61; 91.0%). Phylogenetic analysis identified all 16 S rRNA gene sequences of the 67 isolates as those of C. striatum, where 98%–99% were homologous to C. striatum ATCC 6940. In multilocus sequence typing for internal transcribed spacer region, gyrA, and rpoB sequencing, the most predominant sequence types (STs) were ST2, ST3, ST6, and ST5.
Conclusion: C. striatum isolates may cause opportunistic infections associated with nosocomial infections through horizontal transmission. The presence of multidrug resistance and intra-hospital dissemination implicate C. striatum isolates as a potential target pathogen for infection control and antimicrobial stewardship programs.
Keywords: Corynebacterium striatum, multidrug resistant, multilocus sequence typing, opportunistic infections, nosocomial infections
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