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From contamination to infective endocarditis—a population-based retrospective study of Corynebacterium isolated from blood cultures

Rasmussen, Magnus LU ; Mohlin, Anna Wramneby and Nilson, Bo LU (2019) In European Journal of Clinical Microbiology and Infectious Diseases
Abstract

Corynebacterium is a genus that can contaminate blood cultures and also cause severe infections like infective endocarditis (IE). Our purpose was to investigate microbiological and clinical features associated with contamination and true infection. A retrospective population-based study of Corynebacterium bacteremia 2012–2017 in southern Sweden was performed. Corynebacterium isolates were species determined using a matrix-assisted laser desorption/ionization-time-of-flight mass spectrometry (MALDI-TOF MS). Patient were, from the medical records, classified as having true infection or contamination caused by Corynebacterium through a scheme considering both bacteriological and clinical features and the groups were compared. Three hundred... (More)

Corynebacterium is a genus that can contaminate blood cultures and also cause severe infections like infective endocarditis (IE). Our purpose was to investigate microbiological and clinical features associated with contamination and true infection. A retrospective population-based study of Corynebacterium bacteremia 2012–2017 in southern Sweden was performed. Corynebacterium isolates were species determined using a matrix-assisted laser desorption/ionization-time-of-flight mass spectrometry (MALDI-TOF MS). Patient were, from the medical records, classified as having true infection or contamination caused by Corynebacterium through a scheme considering both bacteriological and clinical features and the groups were compared. Three hundred thirty-nine episodes of bacteremia with Corynebacterium were identified in 335 patients of which 30 (8.8%) episodes were classified as true infection. Thirteen patients with true bacteremia had only one positive blood culture. Infections were typically community acquired and affected mostly older males with comorbidities. The focus of infection was most often unknown, and in-hospital mortality was around 10% in both the groups with true infection and contamination. Corynebacterium jeikeium and Corynebacterium striatum were significantly overrepresented in the group with true infection, whereas Corynebacterium afermentans was significantly more common in the contamination group. Eight episodes of IE were identified, all of which in patients with heart valve prosthesis. Six of the IE cases affected the aortic valve and six of seven patients were male. The species of Corynebacterium in blood cultures can help to determine if a finding represent true infection or contamination. The finding of a single blood culture with Corynebacterium does not exclude true infection such as IE.

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author
organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
Bacteremia, Blood culture, Contamination, Corynebacterium, Infective endocarditis
in
European Journal of Clinical Microbiology and Infectious Diseases
publisher
Springer
external identifiers
  • scopus:85072176085
ISSN
0934-9723
DOI
10.1007/s10096-019-03698-6
language
English
LU publication?
yes
id
8f3fbcae-ab38-427d-a15f-30f3becf10a2
date added to LUP
2019-10-11 14:29:10
date last changed
2019-10-15 07:18:42
@article{8f3fbcae-ab38-427d-a15f-30f3becf10a2,
  abstract     = {<p>Corynebacterium is a genus that can contaminate blood cultures and also cause severe infections like infective endocarditis (IE). Our purpose was to investigate microbiological and clinical features associated with contamination and true infection. A retrospective population-based study of Corynebacterium bacteremia 2012–2017 in southern Sweden was performed. Corynebacterium isolates were species determined using a matrix-assisted laser desorption/ionization-time-of-flight mass spectrometry (MALDI-TOF MS). Patient were, from the medical records, classified as having true infection or contamination caused by Corynebacterium through a scheme considering both bacteriological and clinical features and the groups were compared. Three hundred thirty-nine episodes of bacteremia with Corynebacterium were identified in 335 patients of which 30 (8.8%) episodes were classified as true infection. Thirteen patients with true bacteremia had only one positive blood culture. Infections were typically community acquired and affected mostly older males with comorbidities. The focus of infection was most often unknown, and in-hospital mortality was around 10% in both the groups with true infection and contamination. Corynebacterium jeikeium and Corynebacterium striatum were significantly overrepresented in the group with true infection, whereas Corynebacterium afermentans was significantly more common in the contamination group. Eight episodes of IE were identified, all of which in patients with heart valve prosthesis. Six of the IE cases affected the aortic valve and six of seven patients were male. The species of Corynebacterium in blood cultures can help to determine if a finding represent true infection or contamination. The finding of a single blood culture with Corynebacterium does not exclude true infection such as IE.</p>},
  author       = {Rasmussen, Magnus and Mohlin, Anna Wramneby and Nilson, Bo},
  issn         = {0934-9723},
  keyword      = {Bacteremia,Blood culture,Contamination,Corynebacterium,Infective endocarditis},
  language     = {eng},
  publisher    = {Springer},
  series       = {European Journal of Clinical Microbiology and Infectious Diseases},
  title        = {From contamination to infective endocarditis—a population-based retrospective study of Corynebacterium isolated from blood cultures},
  url          = {http://dx.doi.org/10.1007/s10096-019-03698-6},
  year         = {2019},
}