rifampin and Corynebacterium-Infections

Corynebacterium striatum is a ubiquitous colonizer of human skin and mucous membranes. It is increasingly involved in infections, especially with prosthetic devices or in immunocompromised individuals. Microbiological diagnosis is challenging and bacterial resistance is a major concern. We performed a retrospective study of monomicrobial bone and joint infections (BJI) due to C. striatum in two referral centers from April 2012 to July 2017. We collected the patients' clinical and microbiological characteristics and outcomes. We also performed a literature review of BJI due to C. striatum. We identified 12 cases (nine prosthetic joint infections, one osteosynthetic device infection, one non-union, and one arthritis) in 11 patients, five of which were immunocompromised. Microbiological diagnosis was performed with prolonged culture media. Ten out of 12 strains were susceptible to aminopenicillin, a drug class not recommended for testing by the EUCAST/CASFM guidelines, and 8/12 patients were treated with amoxicillin-rifampicin. The cure rate was 8/12, after a median follow-up period of 487.5 days (IQR 140.3-1348.5). Twelve cases of BJI due to C. striatum were previously reported. Among them, 5/12 patients were immunocompromised, 3/12 cases were acute BJI, and 2/12 were device-related infections. The diagnosis was performed by PCR in one case, and 10/12 patients were treated with glycolipopeptides, with a cure rate of 11/12. We report the largest cohort of monomicrobial BJI with C. striatum. Determination of aminopenicillin susceptibility is essential since it is frequently active in our experience, even in BJI. The cure rate of this infection seems high.

Topics: Aged; Aged, 80 and over; Amoxicillin; Anti-Bacterial Agents; Arthritis, Infectious; Bone Diseases, Infectious; Corynebacterium; Corynebacterium Infections; Drug Resistance, Multiple, Bacterial; Female; Humans; Immunocompromised Host; Joints; Male; Middle Aged; Prosthesis-Related Infections; Retrospective Studies; Rifampin

Although the clinical presentation of Hidradenitis Suppurativa (HS) is strongly reminiscent of bacterial infection, the role of bacteria remains controversial. Studies have isolated an array of different bacterial specimens as well as biofilm formation in lesional HS skin. Consistent findings of Gram-positive cocci and -rods including Staphylococus aureus, Coagulase-negative staphylococci (CoNS) and Corynebacterium species (spp) in deep tissue samples have been demonstrated in HS. Although efficacy of antibiotics, i.e., rifampicin, clindamycin or tetracycline may support a microbial role in disease pathogenesis, the most often isolated bacterial specimens are commensal bacteria (CoNS).

Topics: Anti-Bacterial Agents; Biofilms; Clindamycin; Corynebacterium Infections; Hidradenitis Suppurativa; Humans; Rifampin; Skin; Staphylococcal Skin Infections; Staphylococcus aureus; Staphylococcus epidermidis; Tetracycline

Combinations of rifampin and clindamycin or rifampin, metronidazole, and moxifloxcin have been reported as effective treatments for hidradenitis suppurativa (HS) Hurley Stage 1 and Hurley Stage 2.  Clinical trials suggest that for stage 1 and mild stage 2 HS, clindamycin 300 mg twice daily and rifampin 300 mg twice daily for 10 weeks can substantially abate HS in ~80% of cases and remit HS in ~50% of cases.  Another study notes use of rifampin-moxifloxacin-metronidazole given for 6 weeks, dosed as rifampin (10 mg/kg once daily), moxifloxacin (400 mg daily), and metronidazole (500 mg thrice daily) with the metronidazole stopped at week 6.   Rifampin and moxifloxacin were continued if the HS improved and side effects did not occur.  Using this triple antibiotic regimen remission occurred in 100% Hurley Stage 1, 80% Hurly Stage 2, and 16.7 % of Hurley Stage 3 HS.   The author typically gives HS clindamycin 300 mg and rifampin 300 mg, each twice daily, for 10 weeks and assesses if remission has occurred.  If the patient has not achieved remission the author continues the regimen as long as the patient's clinical status continues to improve without side effects.  The reasons why rifampin is so effective against HS have not been fully defined and might involve rifampin's (1) antibacterial effects (2) effects on bacterial biofilms (3) anti-inflammatory effects (4) effects against granulomas (5) and immunomodulatory effects on neutrophils.  It is notable that rifampin, although not first line, is an effective treatment for Clostridium difficile, a pathogen that arises during treatment with clindamycin.  Thus, rifampin enhances safety when rifampin and clindamycin are combined for the treatment of HS.

Topics: Anti-Bacterial Agents; Anti-Inflammatory Agents; Biofilms; Clindamycin; Corynebacterium Infections; Drug Therapy, Combination; Granuloma; Hidradenitis Suppurativa; Humans; Immunologic Factors; Neutrophils; Rifampin; Staphylococcal Infections; Streptococcal Infections

Combined antimicrobial drug treatment was recommended for foals with Corynebacterium equi pneumonia. The preferred combination is orally administered erythromycin estolate (25 mg/kg of body weight, QID) plus rifampin (10 mg/kg, BID). Erythromycin estolate also can be combined for synergistic effect with sodium benzyl penicillin given IV (100,000 IU/kg, QID) or with ampicillin given IV (11 to 15 mg/kg, QID). A third choice is sodium benzyl penicillin IV with gentamicin IM (2.2 mg/kg, TID) or with kanamycin IM (10 mg/kg, QID). Gentamicin should be combined with penicillin G or ampicillin and not used for longer than one week without monitoring for nephrotoxicosis. Rifampin should be used only in combination with erythromycin or penicillin. Erythromycin or rifampin and gentamicin give antagonistic interactions in vitro. Chloramphenicol or trimethoprim-sulfamethoxazole may be effective if given in high doses but are not preferred drugs. Treatment response should be monitored clinically and radiographically and treatment should be continued for 2 weeks after the foal is clinically and radiographically normal.

Topics: Amikacin; Aminoglycosides; Animals; Anti-Bacterial Agents; Bronchopneumonia; Chloramphenicol; Corynebacterium Infections; Drug Combinations; Drug Therapy, Combination; Erythromycin; Horses; Humans; Rifampin; Sulfadiazine; Trimethoprim

Topics: Acute Disease; Anti-Bacterial Agents; Aortic Valve Insufficiency; Corynebacterium Infections; Humans; Male; Middle Aged; Rifampin; Subarachnoid Hemorrhage; Treatment Outcome

Corynebacterium jeikeium, frequently encountered in clinical specimens, is part of the normal skin flora. Nevertheless, a few cases of C. jeikeium bacteremia followed by severe clinical manifestations have been reported. C. jeikeium has been reported to cause endocarditis, septicemia, meningitis, pneumonia and osteomyelitis, along with soft tissue and trauma infections. Herein we describe a case of C. jeikeium bacteremia in Greece. The isolation of a coryneform bacterium from a clinical specimen should not immediately be considered a superinfection by the skin flora. Clinical and laboratory investigations are essential in order to evaluate such cases before applying appropriate treatment. On the other hand, the association of coryneform bacteria and disease should be critically investigated, with a thorough identification of the strain, ideally beyond the classical methods, at a specialized center.

Topics: Aged; Anti-Bacterial Agents; Bacteremia; Corynebacterium; Corynebacterium Infections; Female; Greece; Humans; Microbial Sensitivity Tests; Renal Dialysis; Rifampin; Skin; Vancomycin

To report a case of Corynebacterium striatum endocarditis that was treated successfully with daptomycin plus rifampin following an unsuccessful attempt at vancomycin desensitization and failure of linezolid therapy.. A 46-year-old woman with hemodialysis-dependent chronic renal failure was admitted for a graft-related infection. She presented with C. striatum endocarditis that was treated with daptomycin plus rifampin due to a history of allergies to vancomycin and beta-lactam antibiotics and failure of linezolid therapy. The patient received daptomycin and rifampin for a total of 6 weeks. Three months after completion of treatment, no recurrence of endocarditis was evident.. Daptomycin is a lipopeptide antibiotic, with rapid bactericidal activity. It has demonstrated efficacy in animal models of staphylococcal, streptococcal, and enterococcal endocarditis. Case reports of its activity in methicillin-resistant Staphylococcus aureus endocarditis have also been documented.. Daptomycin, which has shown in vitro activity against C. striatum, may be a viable treatment option for patients with C. striatum endocarditis who are either allergic or refractory to traditional antibiotics.

Topics: Anti-Bacterial Agents; Corynebacterium; Corynebacterium Infections; Daptomycin; Drug Administration Schedule; Drug Therapy, Combination; Endocarditis, Bacterial; Female; Humans; Middle Aged; Rifampin; Treatment Outcome

Case report describing spontaneous Corynebacterium diptheria discitis in a patient with chronic renal failure.. To describe this very rare form of discitis and the results of surgical and antibiotic therapy.. University Department of Neurosurgery, Turkey.. A 55-year-old man with chronic renal failure presented with acute low-back pain. Lumbar magnetic resonance imaging (MRI) suggested discitis and osteomyelitis at the L5-S1 level. The L5-S1 disc was operated upon and the discectomy material was sent for pathological and microbiological analysis.. Pathological examination revealed infection and bacterial culture grew C. diptheria. The patient was prescribed combination antibiotic therapy with vancomycin, a third-generation cephalosporin, and rifampicin. Clinical status improved after 8 weeks of therapy. Lumbar MRI revealed remission of the discitis and osteomyelitis after 10 months of follow-up.. Chronic renal failure patients with low-back pain should be investigated for spinal infection. These individuals are prone to low-grade infection in the form of discitis or osteomyelitis. Corynebacterium subspecies rarely cause spontaneous discitis. This case is interesting because of the unusual causal organism and the occurrence of discitis in the setting of chronic renal failure.

Topics: Anti-Bacterial Agents; Cephalosporins; Corynebacterium diphtheriae; Corynebacterium Infections; Diagnosis, Differential; Discitis; Diskectomy; Humans; Kidney Failure, Chronic; Low Back Pain; Lumbosacral Region; Magnetic Resonance Imaging; Male; Middle Aged; Rifampin; Vancomycin

The nondiphtheriae corynebacteria are uncommon but increasingly recognized as agents of endocarditis in patients with underlying structural heart disease or prosthetic-valves. We describe three cases of nosocomial endocarditis caused by nondiphtheriae corynebacteria, including the first reported case of Corynebacterium amycolatum, endocarditis. These all occurred in association with indwelling intravascular devices.

Topics: Aged; Catheters, Indwelling; Corynebacterium; Corynebacterium Infections; Cross Infection; Endocarditis, Bacterial; Fatal Outcome; Female; Heart Valve Prosthesis; Humans; Male; Middle Aged; Prosthesis-Related Infections; Rifampin; Vancomycin

Corynebacterium minutissimum, known as the causative agent of erythrasma, has recently been reported as a clinically significant pathogen in the immunocompromised host. We report for the first time the possible involvement of a multidrug-resistant C. minutissimum strain in a costochondral abscess occurring in an HIV-infected patient.

Topics: Abscess; Adult; AIDS-Related Opportunistic Infections; Amikacin; Amoxicillin; Anti-Bacterial Agents; Anti-Infective Agents; Antibiotics, Antitubercular; Ciprofloxacin; Corynebacterium; Corynebacterium Infections; Drug Resistance, Microbial; Drug Resistance, Multiple; HIV Infections; HIV-1; Humans; Male; Penicillins; Ribs; Rifampin; Tomography, X-Ray Computed; Vancomycin

A case of septic arthritis caused by Corynebacterium amycolatum in a native hip joint occurred in an adult man following contralateral vascular graft sepsis, and was successfully treated with intravenous vancomycin followed by oral doxycycline and rifampicin. To the authors' knowledge, this is the only reported case of septic arthritis due to C. amycolatum.

Topics: Anti-Bacterial Agents; Antibiotics, Antitubercular; Arthritis, Infectious; Arthroplasty, Replacement, Hip; Corynebacterium; Corynebacterium Infections; Doxycycline; Drug Therapy, Combination; Femoral Artery; Hip Joint; Humans; Male; Middle Aged; Osteoarthritis; Rifampin; Vancomycin

Topics: Anti-Bacterial Agents; Corynebacterium; Corynebacterium Infections; Humans; Microbial Sensitivity Tests; Pneumonia, Bacterial; Rifampin; Teicoplanin; Vancomycin

A young goat was presented with a left spastic hemiparesis and general proprioceptive ataxia with postural reaction deficits, a right head tilt and positional nystagmus. Seizure-like activity was elicited by rapid changes in the position of the animal's head. The neurological signs and quality of the seizure activity suggested a lesion involving the medulla and possibly the cerebellum. A focal lesion at the level of the left cerebellar peduncles could explain the left hemiparesis and right paradoxical vestibular signs. A large encapsulated abscess was found at the confluence of the left cerebellar peduncles. The morphology and staining characteristics of the organisms within the abscess were consistent with Corynebacterium pseudotuberculosis.

Topics: Animals; Ataxia; Brain; Brain Abscess; Cerebellar Diseases; Corynebacterium Infections; Corynebacterium pseudotuberculosis; Diagnosis, Differential; Diazepam; Goat Diseases; Goats; Hemiplegia; Male; Neurologic Examination; Penicillin G Procaine; Rifampin; Seizures

The comparative study of 44 isolates of Corynebacterium group D2, from urine, most frequently, shows the pathogenic role of these bacteria in urinary tract infection, with or without urinary stones. These microorganisms have an opportunistic behaviour in other non-urinary sites, and become pathogen in immunosuppressed conditions. The rapid tests as urease, glucose acidification, nitrate reductase, associated with multiple resistance to antibiotics (beta-lactams and aminosides) identify easily Corynebacterium group D2, from 48 h cultures under CO2 conditions. The results of MIC determination of 10 antibiotics, show the high activity (100% sensitivity) of vancomycin and pristinamycin, with MIC modes, respectively, 0.5 and 0.03 mg/l. These antibiotics are the most useful for the treatment of non-urinary infections. Among quinolones, the most active agents are ciprofloxacin and ofloxacin (MIC modes: 4 and 2 mg/l), so these antimicrobials could be used for the treatment of urinary tract infections caused by Corynebacterium group D2.

Topics: Anti-Bacterial Agents; Ciprofloxacin; Corynebacterium; Corynebacterium Infections; Drug Resistance, Microbial; Enoxacin; Female; Humans; Male; Naphthyridines; Norfloxacin; Ofloxacin; Oxazines; Peptides, Cyclic; Pipemidic Acid; Rifampin; Tetracycline; Tetracycline Resistance; Urinary Tract Infections; Vancomycin; Virginiamycin

Sepsis with a previously undescribed species of Corynebacterium was documented in four patients. All patients had predisposing illness at the time of infection, three patients having leukemia in relapse and one having a porencephalic cyst and a ventriculoatrial shunt. The isolates from blood cultures had a characteristic metallic sheen when grown on blood agar. They were resistant to most antibiotics tested, including the penicillins, but were uniformly sensitive to vancomycin. Common biochemical characteristics, the metallic sheen, and the unusual antibiotic sensitivity pattern suggest that these isolates comprise a new species or group of closely related species of Corynebacterium that is capable of infection in man.

Topics: Adult; Child; Corynebacterium; Corynebacterium Infections; Drug Resistance, Microbial; Female; Humans; Male; Rifampin; Vancomycin

A patient with hydrocephalus and a ventriculojugular shunt presented with acute nephritis, nephrotic syndrome (proteinuria 10 g/24 hours), decreased complement levels, circulating immune complexes and diminished creatinine clearance (41 ml/min). Seven blood cultures grew Corynebacterium bovis. A renal biopsy specimen revealed mesangiocapillary glomerulonephritis by light microscopy, and thickened glomerular basement membranes with areas of increased granular density by electron microscopy. Immunofluorescent examination of the biopsy specimen demonstrated 2+ granular glomerular basement membrane deposits of immunoglobulin M (IgM), with trace third component of complement (C-3), fourth component of complement (C-4) and immunoglobulin G (IgG). Rabbits immunized with C. bovis produced a line of partial identity in agar with patient serum against a sonicate of C. bovis. Indirect fluorescein staining of the biopsy specimen with the rabbit antiserum demonstrated 1+ granular glomerular basement membrane deposits. Potassium thiocyanate microelution of sections prior to examination markedly diminished staining with antihuman antiserum, but did not affect staining with rabbit antiserum. Following initial therapy with intravenous penicillin for six weeks the bacteremia cleared, serum complement levels returned to normal, proteinuria decreased and creatinine clearance increased. A relapse occured four weeks later with decreased complement levels, increased proteinuria and decreased creatinine clearance. Blood cultures were again positive for C. bovis. Following therapy with erythromycin and rifampin, the bacteremia cleared and there was a sustained improvement of all parameters. To our knowledge, this is the first time an association has been noted between C. bovis ventriculojugular shunt infection and glomerulonephritis. These findings support the potential role of C. bovis as an etiologic agent in human renal disease and further define the immune complex nature of shunt nephritis.

Topics: Adult; Animals; Biopsy; Cerebrospinal Fluid Shunts; Complement C3; Complement C4; Corynebacterium Infections; Erythromycin; Glomerulonephritis; Humans; Immunoglobulin G; Immunoglobulin M; Kidney; Male; Microbial Sensitivity Tests; Penicillins; Postoperative Complications; Rabbits; Recurrence; Rifampin