Summary
During a six-year period 23 patients with isolation ofCorynebacterium jeikeium (formerly known asCorynebacterium group JK) from one or more blood cultures at a university hospital were identified. Cases occurred sporadically without time- or ward-related clustering. Review of the cases showed that most infections were nosocomial, that most of the patients had underlying malignant disease, had a chronic intravascular catheter implanted, had been pretreated with antibiotics, and were neutropenic at the time the blood cultures were drawn. Patients with only one versus those with more than one positive blood culture differed in some important aspects. Patients with only one positive blood culture were less likely to have acute leukemia, had significantly higher neutrophil counts and a shorter duration of preceding antibiotic treatment, and all had other probable causes of infection and fever. The mortality also appeared to be lower in these patients. Despite the possibility of increasing frequency of blood cultures positive forC. jeikeium, severe infections due to this organism continue to be largely confined to neutropenic patients with hematologic malignancy.
Zusammenfassung
In einer Universitätsklinik wurde während eines Zeitraumes von sechs Jahren bei 23 PatientenCorynebacterium jeikeium aus Blutkulturen isoliert.C. jeikeium-Bakteriämien traten weder zeitlich noch örtlich gehäuft auf. Die retrospektive Analyse der Patientendaten zeigte, daß in den meisten Fällen eine maligne hämatologische Grunderkrankung mit Neutropenie vorlag, ein zentral-venöser Katheter implantiert und eine antibiotische Therapie vorausgegangen war. Die Patientenpopulation mit nur einer positiven Blutkultur unterschied sich in wichtigen Aspekten von derjenigen mit mehreren positiven Blutkulturen. So waren Patienten mit nur einer positiven Blutkultur seltener an akuter Leukämie erkrankt, hatten signifikant höhere neutrophile Granulozytenkonzentrationen im peripheren Blut und waren zuvor über einen kürzeren Zeitraum antibiotisch behandelt worden. Weiterhin fanden sich in dieser Patientengruppe in allen Fällen andere mögliche Ursachen der Fieberepisoden. Auch die Mortalität war deutlich geringer. Trotz des zunehmend häufigeren Nachweises vonCorynebacterium jeikeium in Blutkulturen bleiben schwere Infektionen durch diesen Erreger weiterhin meist auf die Patientenpopulation mit hämatologischer Grunderkrankung und Neutropenie beschränkt.
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Rozdzinski, E., Kern, W., Schmeiser, T. et al. Corynebacterium jeikeium bacteremia at a tertiary care center. Infection 19, 201–204 (1991). https://doi.org/10.1007/BF01644945
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DOI: https://doi.org/10.1007/BF01644945