You are leaving Medscape Education
Cancel Continue
Log in to save activities Your saved activities will show here so that you can easily access them whenever you're ready. Log in here CME & Education Log in to keep track of your credits.
 

Table 1.  

Corynebacterium species Total, n = 115 True bacteremia, n = 60 Contamination, n = 55
C. striatum 67 47 20
C. jeikeium 14 10 4
Other, total 34 3 31
   C. accolens 1 0 1
   C. afermentans 6 0 6
   C. amycolatum 4 1 3
   C. aurimucosum 4 0 4
   C. coyleae 1 0 1
   C. glucuronolyticum 1 0 1
   C. minutissimum 4 0 4
   C. mucifaciens 1 0 1
   C. pseudodiphtheriticum 1 0 1
   C. resistens 2 0 2
   C. riegelii 1 1 0
   C. simulans 3 0 3
   C. singulare 2 0 2
   C. tuberculostearicum 2 0 2
   C. urealyticum 1 1 0

Table 1. Patients with Corynebacterium species detected in blood cultures, Japan, 2014–2020

Table 2.  

Variable All, n = 115 C. striatum, %, n = 67 C. jeikeium, %, n = 14 Other species, %, n = 34 p values
C. striatum vs. other species C. jeikeium vs. other species
Age, y 71 71 66 77 0.055 <0.001
Sex
   M 80 (70) 51 (76) 13 (93) 16 (47) <0.01 <0.001
   F 35 (30) 16 (24) 1 (7) 18 (53) <0.01 <0.001
Underlying disease, no. (%)
   Diabetes mellitus 27 (23) 14 (20) 2 (14) 11 (32) 0.309 0.292
   Chronic kidney disease 16 (14) 9 (13) 2 (14) 5 (15) 1 1
   Liver disease 4 (4) 4 (6) 0 (0) 0 (0) 0.299 NA
   Solid tumor 27 (24) 13 (19) 4 (29) 10 (29) 0.378 1
   Leukemia† 20 (17) 11 (16) 8 (57) 1 (3) 0.056 <0.001
   Malignant lymphoma‡ 14 (12) 8 (12) 3 (21) 3 (9) 0.537 0.171
   Hematologic malignancy§ 38 (33) 24 (36) 9 (64) 5 (15) 0.036 <0.01
Underlying condition, no. (%)
  Neutropenia, <500 cells/mm3 29 (25) 19 (28) 8 (57) 2 (6) <0.01 <0.001
   Corticosteroid 8 (7) 5 (8) 2 (14) 1 (3) 0.661 0.2
   Chemotherapy, within 3 mo 41 (36) 23(34) 10 (71) 8 (24) 0.377 <0.01
Clinical diagnosis, no. (%)
   True bacteremia 60 (52) 47 (70) 10 (71) 3 (9) <0.001 <0.001
      No focus 25 (22) 19 (29) 6 (43) 0 ND ND
      CRBSI 17 (15) 13 (19) 3 (21) 1 (3) ND ND
      Other focus¶ 18 (16) 15 (22) 1 (7) 2 (6) ND ND
   Contamination 55 (48) 20 (30) 4 (29) 31 (91) <0.001 <0.001

Table 2. Clinical diagnosis and characteristics of patients with Corynebacterium species detected in blood culture, Japan, 2014–2020*

*ALL, acute lymphoid leukemia; AML, acute myeloid leukemia; CRBSI: catheter-related blood stream infection; DLBCL, diffuse large B cell lymphoma; MDS, myelodysplastic syndrome; MM, multiple myeloma; NA, not applicable; ND, not done; IVLBCL, intravascular large B cell lymphoma.; PTCL, peripheral T-cell lymphoma.

†No. cases: AML, 17; ALL, 3,

‡No.cases: DLBCL, n = 8: PCTL, n =3; IVLBCL, n = 1; lymphoplasmacytic lymphoma, n= 1,: Burkitt lymphoma, n = 1.

§No. cases: leukemia, n = 20; lymphoma, n = 14; MM, n = 3; MDS, n = 1; myelofibrosis, n = 2.

¶No. cases: pyelonephritis, n = 5; skin and soft tissue infection, n = 4; empyema, n = 2; pneumonia, n = 1; prostatitis, n = 1; infective endocarditis, n = 1; osteomyelitis, n = 1; vascular graft infection, n = 1; central venous port infection, n = 1; spontaneous bacterial peritonitis, n = 1.

Table 3.  

Species Susceptible/tested (%)
PEN CRO MEM GEN CIP MIN CLI ERY VAN LZD†
C. striatum, n = 67 14/67 (21) 5/67 (7) 17/67 (25) 59/67 (88) 3/67 (4) 67/67 (100) 8/67 (12) 13/67 (19) 67/67 (100) 4/4 (100)
C. jeikeium, n = 14 0/14 (0) 0/14 (0) 5/14 (36) 5/14 (36) 0/14 (0) 14/14 (100) 0/14 (0) 0/14 (0) 14/14 (100) 3/3 (100)
Other species, n = 34 27/34 (79) 22/34 (65) 31/34 (91) 30/34 (88) 10/34 (29) 34/34 (100) 6/34 (18) 16/34 (47) 34/34 (100) 2/2 (100)
All, n = 115 41/115 (36) 27/115 (23) 53/115 (46) 94/115 (82) 13/115 (11) 115/115 (100) 14/115 (12) 29/115 (25) 115/115 (100) 9/9 (100)

Table 3. Antimicrobial susceptibility testing of Corynebacterium species isolated from blood culture, Japan, 2014–2020*

*CIP, ciprofloxacin; CLI, clindamycin; CRO, ceftriaxone; ERY, erythromycin; GEN, gentamicin; LZD, linezolid; MEM, meropenem; MIN, minocycline; PEN, penicillin; VAN, vancomycin.

†Antimicrobial susceptibility testing for linezolid was only performed if requested by physicians.

CME / ABIM MOC

Clinical Characteristics of Corynebacterium Bacteremia Caused by Different Species, Japan, 2014–2020

  • Authors: Ryosuke Yamamuro, MD; Naoto Hosokawa, MD, PhD; Yoshihito Otsuka, PhD; Ryosuke Osawa, MD
  • CME / ABIM MOC Released: 11/17/2021
  • THIS ACTIVITY HAS EXPIRED
  • Valid for credit through: 11/17/2022
Start Activity


Target Audience and Goal Statement

This activity is intended for infectious disease clinicians, hematologists/oncologists, internists, intensivists, and other clinicians caring for patients with Corynebacterium bacteremia.

The goal of this activity is to describe differences in clinical characteristics of patients with bacteremia from C striatum, C jeikeium, and other Corynebacterium species, based on a single-center, retrospective medical record review of 115 patients with Corynebacterium bacteremia between January 2014 and May 2020 in Japan.

Upon completion of this activity, participants will:

  1. Describe the proportion of true bacteremia and differences in clinical characteristics of patients with bacteremia from C striatum, C jeikeium, and other Corynebacterium species, based on a retrospective medical record review
  2. Describe differences in mortality and antimicrobial susceptibility in patients with bacteremia from C striatum, C jeikeium, and other Corynebacterium species, based on a retrospective medical record review
  3. Describe clinical implications of differences in clinical characteristics of patients with bacteremia from C striatum, C jeikeium, and other Corynebacterium species, based on a retrospective medical record review


Disclosures

As an organization accredited by the ACCME, Medscape, LLC requires everyone who is in a position to control the content of an education activity to disclose all relevant financial relationships with any commercial interest. The ACCME defines "relevant financial relationships" as financial relationships in any amount, occurring within the past 12 months, including financial relationships of a spouse or life partner, that could create a conflict of interest.

Medscape, LLC encourages Authors to identify investigational products or off-label uses of products regulated by the US Food and Drug Administration, at first mention and where appropriate in the content.


Faculty

  • Ryosuke Yamamuro, MD

    Kameda Medical Center, Department of Infectious Diseases, Chiba, Japan

    Disclosures

    Disclosure: Ryosuke Yamamuro, MD, has disclosed no relevant financial relationships.

  • Naoto Hosokawa, MD, PhD

    Kameda Medical Center, Department of Infectious Diseases, Chiba, Japan

    Disclosures

    Disclosure: Naoto Hosokawa, MD, PhD, has disclosed no relevant financial relationships.

  • Yoshihito Otsuka, PhD

    Kameda Medical Center, Department of Laboratory Medicine, Chiba, Japan

    Disclosures

    Disclosure: Yoshihito Otsuka, PhD, has disclosed no relevant financial relationships.

  • Ryosuke Osawa, MD

    Kameda Medical Center, Department of Infectious Diseases, Chiba, Japan

    Disclosures

    Disclosure: Ryosuke Osawa, MD, has disclosed no relevant financial relationships.

CME Author

  • Laurie Barclay, MD

    Freelance writer and reviewer
    Medscape, LLC

    Disclosures

    Disclosure: Laurie Barclay, MD, has disclosed no relevant financial relationships.

Editor

  • P. Lynne Stockton Taylor, VMD, MS, ELS(D)

    Copyeditor
    Emerging Infectious Diseases

    Disclosures

    Disclosure: P. Lynne Stockton Taylor, VMD, MS, ELS(D), has disclosed no relevant financial relationships.

CME Reviewer

  • Leigh A. Schmidt, MSN, RN, CMSRN, CNE, CHCP

    Associate Director, Accreditation and Compliance
    Medscape, LLC

    Disclosures

    Disclosure: Leigh A. Schmidt, MSN, RN, CMSRN, CNE, CHCP, has disclosed no relevant financial relationships.

None of the nonfaculty planners for this educational activity have relevant financial relationship(s) to disclose with ineligible companies whose primary business is producing, marketing, selling, reselling, or distributing healthcare products used by or on patients.


Accreditation Statements



In support of improving patient care, this activity has been planned and implemented by Medscape, LLC and Emerging Infectious Diseases. Medscape, LLC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

    For Physicians

  • Medscape, LLC designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™ . Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.0 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit. Aggregate participant data will be shared with commercial supporters of this activity.

    Contact This Provider

For questions regarding the content of this activity, contact the accredited provider for this CME/CE activity noted above. For technical assistance, contact [email protected]


Instructions for Participation and Credit

There are no fees for participating in or receiving credit for this online educational activity. For information on applicability and acceptance of continuing education credit for this activity, please consult your professional licensing board.

This activity is designed to be completed within the time designated on the title page; physicians should claim only those credits that reflect the time actually spent in the activity. To successfully earn credit, participants must complete the activity online during the valid credit period that is noted on the title page. To receive AMA PRA Category 1 Credit™, you must receive a minimum score of 70% on the post-test.

Follow these steps to earn CME/CE credit*:

  1. Read about the target audience, learning objectives, and author disclosures.
  2. Study the educational content online or print it out.
  3. Online, choose the best answer to each test question. To receive a certificate, you must receive a passing score as designated at the top of the test. We encourage you to complete the Activity Evaluation to provide feedback for future programming.

You may now view or print the certificate from your CME/CE Tracker. You may print the certificate, but you cannot alter it. Credits will be tallied in your CME/CE Tracker and archived for 6 years; at any point within this time period, you can print out the tally as well as the certificates from the CME/CE Tracker.

*The credit that you receive is based on your user profile.

CME / ABIM MOC

Clinical Characteristics of Corynebacterium Bacteremia Caused by Different Species, Japan, 2014–2020

Authors: Ryosuke Yamamuro, MD; Naoto Hosokawa, MD, PhD; Yoshihito Otsuka, PhD; Ryosuke Osawa, MDFaculty and Disclosures
THIS ACTIVITY HAS EXPIRED

CME / ABIM MOC Released: 11/17/2021

Valid for credit through: 11/17/2022

processing....

Abstract and Introduction

Abstract

To determine differences in clinical characteristics of patients with bacteremia caused by Corynebacterium striatum, C. jeikeium, and other species of Corynebacterium, we retrospectively reviewed medical records of patients in Japan who had Corynebacterium bacteremia during January 2014–May 2020. Of the 115 records evaluated, 60 (52%) were cases of true bacteremia and 55 (48%) were cases of contamination. Proportions of true bacteremia cases caused by C. striatum (70%) and by C. jeikeium (71%) were significantly higher than those caused by other species of Corynebacterium (9%). These 2 organisms were commonly detected in blood cultures of patients with hematologic malignancies and neutropenia. The mortality rates at 90 days were 34% (C. striatum), 30% (C. jeikeium), and 0 (other species). Given the high mortality rates, assessing true bacteremia when C. striatum or C. jeikeium is detected in blood cultures, especially in patients with hematologic malignancy, is warranted.

Introduction

Corynebacterium bacteria are club-shaped gram-positive rods that are ubiquitous in the environment. Because Corynebacterium species other than C. diphtheriae colonize skin and mucous membranes in humans, Corynebacterium is typically considered a clinically nonsignificant contaminant in cultures[1]. Recently, the frequency of detecting C. striatum and C. jeikeium as causative agents of severe bloodstream infections[2,3], infective endocarditis, pneumonia, meningitis, and skin and soft tissue infections (SSTIs) has increased[4]. Furthermore, these 2 species have been identified most frequently in cultures of clinical specimens, mainly blood, pus, urine, and pleural effusion[5].

Studies that have identified Corynebacterium infections or bacteremia to the species level are limited, and most are case reports[6]. The largest study to date of Corynebacterium bacteremia investigated 98 cases; however, the species were not identified[7]. The largest study that identified Corynebacterium species included 30 cases of true bacteremia in 339 patients with positive blood cultures[8]. In our study, we aimed to determine the differences in characteristics and clinical presentations for patients with bacteremia caused by C. striatum, C. jeikeium, or other species of Corynebacterium.