TY - JOUR
T1 - Clinical characteristics and predictive factors for mortality in coryneform bacteria bloodstream infection in hematological patients
AU - Kimura, Shun ichi
AU - Gomyo, Ayumi
AU - Hayakawa, Jin
AU - Akahoshi, Yu
AU - Harada, Naonori
AU - Ugai, Tomotaka
AU - Komiya, Yusuke
AU - Kameda, Kazuaki
AU - Wada, Hidenori
AU - Ishihara, Yuko
AU - Kawamura, Koji
AU - Sakamoto, Kana
AU - Sato, Miki
AU - Terasako-Saito, Kiriko
AU - Kikuchi, Misato
AU - Nakasone, Hideki
AU - Kanda, Junya
AU - Kako, Shinichi
AU - Tanihara, Aki
AU - Kanda, Yoshinobu
N1 - Publisher Copyright:
© 2016 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases
PY - 2017/3/1
Y1 - 2017/3/1
N2 - Background We examined the clinical characteristics and predictive factors for mortality in coryneform bacteria bloodstream infection in hematological patients. Methods We searched for hematological patients who had positive blood cultures for coryneform bacteria at our center between April 2007 and January 2016. Patients with definite bloodstream infections were included. We started species identification in April 2014. Results Twenty of twenty-eight cases with a positive blood culture for coryneform bacteria were regarded as definite infections. Sixteen and two patients were allogeneic and autologous hematopoietic stem cell transplantation (HSCT) recipients, respectively. Corynebacterium striatum was identified in all nine of the cases tested and one patient was co-infected with Corynebacterium amycolatum. None of the patients died directly due to coryneform bacteria infection. The survival rates at 30, 60 and 180 days were 100%, 73.7% and 51.3%, respectively. Causes of mortality included progression of the underlying disease (n = 6), other infections (n = 4) and HSCT complications (n = 2). Mixed infection (hazard ratio (HR) 5.47, 95% confidence interval (CI) 1.30–23.0), renal impairment (HR 6.31, 95% CI 1.06–37.4) and absence of a central venous (CV) catheter at the onset (HR 6.39, 95% CI 1.04–39.45) were identified as predictive factors for mortality. Conclusion Most of the coryneform bacteria bloodstream infections occurred in HSCT recipients. Contamination seemed to be less common when coryneform bacteria were detected in blood in hematological patients. Although coryneform bacteria bloodstream infection seemed to mostly be manageable, the prognosis was not desirable, particularly in patients with mixed infection, renal impairment and absence of a CV catheter.
AB - Background We examined the clinical characteristics and predictive factors for mortality in coryneform bacteria bloodstream infection in hematological patients. Methods We searched for hematological patients who had positive blood cultures for coryneform bacteria at our center between April 2007 and January 2016. Patients with definite bloodstream infections were included. We started species identification in April 2014. Results Twenty of twenty-eight cases with a positive blood culture for coryneform bacteria were regarded as definite infections. Sixteen and two patients were allogeneic and autologous hematopoietic stem cell transplantation (HSCT) recipients, respectively. Corynebacterium striatum was identified in all nine of the cases tested and one patient was co-infected with Corynebacterium amycolatum. None of the patients died directly due to coryneform bacteria infection. The survival rates at 30, 60 and 180 days were 100%, 73.7% and 51.3%, respectively. Causes of mortality included progression of the underlying disease (n = 6), other infections (n = 4) and HSCT complications (n = 2). Mixed infection (hazard ratio (HR) 5.47, 95% confidence interval (CI) 1.30–23.0), renal impairment (HR 6.31, 95% CI 1.06–37.4) and absence of a central venous (CV) catheter at the onset (HR 6.39, 95% CI 1.04–39.45) were identified as predictive factors for mortality. Conclusion Most of the coryneform bacteria bloodstream infections occurred in HSCT recipients. Contamination seemed to be less common when coryneform bacteria were detected in blood in hematological patients. Although coryneform bacteria bloodstream infection seemed to mostly be manageable, the prognosis was not desirable, particularly in patients with mixed infection, renal impairment and absence of a CV catheter.
KW - Bloodstream infection
KW - Corynebacterium striatum
KW - Coryneform bacteria
KW - Hematopoietic stem cell transplantation
KW - Mortality
UR - https://www.scopus.com/pages/publications/85008225275
U2 - 10.1016/j.jiac.2016.11.007
DO - 10.1016/j.jiac.2016.11.007
M3 - Article
C2 - 28011352
AN - SCOPUS:85008225275
SN - 1341-321X
VL - 23
SP - 148
EP - 153
JO - Journal of Infection and Chemotherapy
JF - Journal of Infection and Chemotherapy
IS - 3
ER -