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Corynebacteria as a cause of pulmonary infection: a case series and literature review

机译：棒杆菌作为肺部感染的原因：一个病例系列和文献综述

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Background In most cases of community-acquired pneumonia (CAP), an etiologic agent is not determined; the most common report from the microbiological evaluation of sputum cites “normal respiratory flora.” Non-diphtheria Corynebacterium spp. , a component of this flora, is?commonly viewed as a?contaminant, but it may be the cause of pneumonia and the frequency with which it?causes CAP may be underestimated. Case presentations This report present 3 cases of CAP in which Corynebacterium spp. was clearly the predominant isolate; identification was confirmed by matrix-assisted laser desorption ionization time of flight (MALDI-TOF) mass spectrometry. Two cases were caused by C. propinquum and one by C. striatum. Two patients had a tracheostomy and one was on hemodialysis. Patients who received an appropriate antibiotic responded well. Conclusion When identified as the predominant isolate in sputum from a patient with CAP, Corynebacterium spp. should be considered as a potential cause of the infection. In cases with patients who have compromised airway clearance or who are immunocompromised, microaspiration may be responsible. While some Corynebacterium spp. are suspectible to antibiotics usually prescribed for?CAP, others are susceptible only to vancomycin or aminoglycosides. Vancomycin is thus?the appropriate empiric antibiotic, pending speciation and susceptibility test results. The number of reported cases with result of antibiotic susceptibility testing, however, remains limited, and further investigation is needed.?Non-diphtheria Corynebacterium spp. represent a noteworthy clinical cause of pneumonia.?Identification by Gram stain and as a predominant organism on culture demands careful consideration for management.
机译：背景在大多数社区获得性肺炎（CAP）病例中，未确定病因。痰液微生物学评估中最常见的报告称“正常呼吸道菌群”。非白喉棒状杆菌属。这种菌群的一个组成部分通常被视为污染物，但它可能是肺炎的病因，其引起CAP的频率可能被低估了。病例介绍该报告介绍了3例棒杆菌属CAP的病例。显然是主要的隔离群;通过基质辅助激光解吸电离飞行时间（MALDI-TOF）质谱法确认了鉴定。丙种梭菌引起两例，纹状体梭菌引起一例。两名患者进行了气管切开术，一名接受血液透析。接受适当抗生素治疗的患者反应良好。结论当被确定为CAP患者痰中主要的分离株，即棒状杆菌。应该被认为是感染的潜在原因。对于气道间隙受损或免疫功能低下的患者，可能需要微量抽吸。而一些棒杆菌属。通常可用于CAP的抗生素可疑，其他仅对万古霉素或氨基糖苷敏感。因此，万古霉素是合适的经验性抗生素，有待物种和药敏试验结果。然而，通过抗生素药敏试验结果报告的病例数量仍然有限，需要进一步的研究。非白喉棒状杆菌属。代表着值得注意的肺炎临床病因。通过革兰氏染色鉴定以及作为培养中的主要生物，需要仔细考虑管理。

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