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Infection and colonization by Corynebacterium pseudodiphtheriticum: a 9-year observational study in a university central hospital

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Abstract

Despite constituting part of the human commensal flora, Corynebacterium pseudodiphtheriticum has been recognized as a potentially infectious agent, most frequently in immunocompromised patients or individuals with other morbidity factors, but significant association to comorbid states remains unproven. This study’s purpose was to assess clinical significance, risk factors for infection and antimicrobial susceptibility of C. pseudodiphtheriticum isolates. A retrospective observational study was conducted. Relevance of isolation was determined by clinical, laboratory, and imaging criteria. Forty-nine isolates occurred in 47 episodes. Colonization was assumed in 12% and infection in 78%, of which 51% were nosocomial. Patients with infection were older, with male predominance; both age and gender were statistically significant (p < 0.05) between infection and colonization groups. Although dyslipidemia (58%), arterial hypertension (58%), invasive procedures (56%), and chronic lung disease (50%) were prevalent in the infection group, no comorbidity was a significant risk factor for infection compared with colonization. Charlson comorbidity index showed no statistically difference between groups. Mortality rate was 14% in infection. Respiratory samples were the main isolation product; all tested strains were susceptible to amoxicillin/clavulanate and vancomycin. Resistant strains were observed for clindamycin (77%) and erythromycin (48%). C. pseudodiphtheriticum isolation was associated with infection in most cases. Despite the high prevalence of comorbidities and invasive procedures, no factors other than age and gender were significantly associated with infection. Although C. pseudodiphtheriticum may constitute a contaminant or colonizer in clinical samples, positive cultures in patients with signs and symptoms consistent with infection should not be neglected.

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  1. Sofia R. Valdoleiros, Catarina Sousa Neves and João Abranches Carvalho contributed equally to this work.

Authors and Affiliations

  1. Department of Infectious Diseases, Centro Hospitalar Universitário do Porto, Largo Prof. Abel Salazar, 4099-001, Porto, Portugal

    Sofia R. Valdoleiros, Celina Gonçalves & Olga Vasconcelos

  2. Division of Microbiology, Department of Pathology, Centro Hospitalar Universitário do Porto, Largo Prof. Abel Salazar, 4099-001, Porto, Portugal

    Catarina Sousa Neves, Paulo Pereira, Ana Paula Castro & Maria Helena Ramos

  3. Department of Internal Medicine, Centro Hospitalar de Entre o Douro e Vouga, R. Dr. Cândido Pinho 5, 4520-211, Santa Maria da Feira, Portugal

    João Abranches Carvalho

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  1. Sofia R. Valdoleiros
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Sofia R. Valdoleiros, Catarina Sousa Neves, and João Abranches Carvalho. The first draft of the manuscript was written by Sofia R. Valdoleiros, Catarina Sousa Neves, and João Abranches Carvalho and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Valdoleiros, S.R., Sousa Neves, C., Abranches Carvalho, J. et al. Infection and colonization by Corynebacterium pseudodiphtheriticum: a 9-year observational study in a university central hospital. Eur J Clin Microbiol Infect Dis 39, 1745–1752 (2020). https://doi.org/10.1007/s10096-020-03891-y

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