Catheter-related Corynebacterium bacteremia: should the catheter be removed and vancomycin administered?
The purpose of this study was to determine the need for central venous catheter removal in patients with corynebacterial catheter-related bloodstream infections and the impact of central venous catheter retention on response to systemic antibiotic therapy and relapse. We searched the microbiology laboratory database and patients’ medical records at our institution between January 2000 and December 2006. We identified 98 patients with corynebacteria infection. Most of the episodes (94%) were catheter-related. Removing the catheter did not affect the outcome of treatment, particularly when an active non-glycopeptide antibiotic was used. All Corynebacterium species isolates were susceptible to vancomycin, 54/55 (98%) to linezolid, 80/95 (84%) to rifampin, and 69/85 (81%) to tetracycline. The median duration of antibiotic therapy was 12 days (range, 0–28), and vancomycin was the most commonly used antibiotic (64%). There was a trend toward earlier fever resolution in patients treated with non-glycopeptide antibiotics compared to vancomycin, particularly if the catheter was not removed. Central venous catheter removal might not be necessary in patients with corynebacterial catheter related bloodstream infection, particularly if systemic therapy consists of non-glycopeptide antibiotics. Treatment with a systemic active antibiotic over a 7-day period appears to be adequate for resolution of the infection.
KeywordsVancomycin Central Venous Catheter Infective Endocarditis Linezolid Corynebacterium Species
- 2.Van Der Lelie H, Leverstein-Van Hall M, Mertens M, van Zaanen HC, van Oers RH, Thomas BL et al (1995) Corynebacterium CDC group JK (Corynebacterium jeikeium) sepsis in haematological patients: a report of three cases and a systemic literature review. Scand J Infect Dis 27:581–584CrossRefPubMedGoogle Scholar
- 3.Marrie TJ, Costerton WJ (1984) Scanning and transmission electron microscopy of in situ bacterial colonization of intravenous and intraarterial catheters. J Clin Microbio 19:687–693Google Scholar
- 7.Mermel LA, Farr BM, Sherertz RJ, Raad II, O'Grady N, Harris JS et al (2001) Infectious Diseases Society of America; American College of Critical Care Medicine; Society for Healthcare Epidemiology of America. Guidelines for the management of intravascular catheter-related infections. Clin Infect Dis 32:1249–1272CrossRefPubMedGoogle Scholar
- 8.Chatzinikolaou I, Hanna H, Darouiche R, Samonis G, Tarrand J, Raad I (2006) Prospective study of the value of quantitative culture of organisms from blood collected through central venous catheters in differentiating between contamination and bloodstream infection. J Clin Microbiol 44:1834–1835CrossRefPubMedGoogle Scholar