The aim of this study was to clarify the clinical and microbiological characteristics of Corynebacterium bacteremia in hematological patients. We retrospectively reviewed the medical records of patients with Corynebacterium bacteremia from April 2013 to June 2018. The causative Corynebacterium species were identified using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Drug susceptibility tests were performed using the broth microdilution method recommended by the Clinical and Laboratory Standards Institute. In total, 147 cases of Corynebacterium bacteremia were identified during the study period. Corynebacterium striatum was the most frequent pathogen. Catheter-related bloodstream infection was diagnosed in 19.7% of all patients, and moderate/severe oral or severe gastrointestinal mucosal impairment was detected in 19.7%. Polymicrobial infection was found in about 20% of cases, with Enterococcus faecium being the most frequent isolate. The overall 30-day mortality was 34.7% (51/147). Multivariate analysis showed that E. faecium co-infection (odds ratio (OR) 9.3; 95% confidence interval (CI) 2.1–40), systemic corticosteroids (OR 3.6; 95% CI 1.4–8.9), other immunosuppressive drugs (OR 0.32; 95% CI 0.13–0.76), and a Pitt bacteremia score ≥4 (OR 12; 95% CI 3.9–40) were significant risk factors for overall 30-day mortality. The drug susceptibility rates for beta-lactam antimicrobial agents were quite low. All isolates were susceptible to glycopeptides and linezolid. However, some C. striatum isolates were resistant to daptomycin. Corynebacterium bacteremia can occur in the presence of several types of mucosal impairment. Our drug susceptibility data indicate that Corynebacterium bacteremia in hematological patients could be treated by glycopeptides or linezolid.

本研究的目的是阐明血液病患者棒状杆菌菌血症的临床和微生物学特征。我们回顾性审查了2013 年 4 月至 2018 年 6 月棒状杆菌菌血症患者的医疗记录。使用基质辅助激光解吸/电离飞行时间质谱法鉴定了致病棒状杆菌属物种。使用临床和实验室标准研究所推荐的肉汤微量稀释方法进行药物敏感性测试。在研究期间，总共发现了 147 例棒状杆菌菌血症病例。棒状杆菌是最常见的病原体。所有患者中有 19.7% 被诊断出与导管相关的血流感染，19.7% 的患者中检测到中度/重度口腔或重度胃肠道黏膜损伤。在大约 20% 的病例中发现了多种微生物感染，其中屎肠球菌是最常见的分离株。30 天的总死亡率为 34.7% (51/147)。多变量分析表明，屎肠球菌合并感染（比值比 (OR) 9.3；95% 置信区间 (CI) 2.1–40）、全身性皮质类固醇（OR 3.6；95% CI 1.4–8.9）、其他免疫抑制药物（OR 0.32；95% CI 0.13–0.76） ) 和 Pitt 菌血症评分 ≥ 4 (OR 12; 95% CI 3.9–40) 是 30 天总死亡率的重要危险因素。β-内酰胺类抗菌剂的药敏率非常低。所有分离株均对糖肽和利奈唑胺敏感。然而，一些纹状体分离株对达托霉素具有抗性。存在多种类型的粘膜损伤时，可能会发生棒状杆菌菌血症。我们的药敏数据表明，血液病患者的棒状杆菌菌血症可用糖肽或利奈唑胺治疗。