RESUMO
We report here a rare case of cutaneous infection due to Corynebacterium pseudodiphtheriticum. The patient presented to the clinical laboratory with a skin ulcer on his left leg. Gram-stained preparation of the purulent secretion revealed the presence of numerous rod-shaped Gram-positive organisms in the absence of any other species. The organism was grown in pure culture on sheep blood agar and was further identified as C. pseudodiphtheriticum using a commercial identification system (API-Coryne, BioMérieux, France). The infection was successfully treated with ciprofloxacin. This case emphasizes the importance of the clinical microbiology laboratory in correctly identifying Gram-positive organisms obtained in pure culture from skin ulcers.
Assuntos
Infecções por Corynebacterium/microbiologia , Corynebacterium/isolamento & purificação , Dermatopatias Bacterianas/microbiologia , Úlcera Cutânea/microbiologia , Anti-Infecciosos/uso terapêutico , Ciprofloxacina/uso terapêutico , Corynebacterium/classificação , Humanos , Hospedeiro Imunocomprometido , Masculino , Dermatopatias Bacterianas/diagnóstico , Dermatopatias Bacterianas/tratamento farmacológico , Úlcera Cutânea/diagnóstico , Úlcera Cutânea/tratamento farmacológicoRESUMO
Detection of AmpC beta-lactamase production by enterobacteria has been problematic. Contrary to ESBLs, no specific guidelines are available for detection and confirmation of AmpC production by clinical relevant microorganisms. Moreover, some bacterial species may produce inducible AmpC beta-lactamases that can be easily overlooked by routine susceptibility tests. We reported here a new test based on the strong inducible effect of imipenem on AmpC genes and the consequent antagonism with ceftazidime. This test is very simple and proved to be helpful in detecting AmpC-inducible enzymes among several species of clinical isolates.
Assuntos
Antibacterianos/farmacologia , Proteínas de Bactérias/efeitos dos fármacos , Ceftazidima/farmacologia , Enterobacteriaceae/efeitos dos fármacos , Imipenem/farmacologia , beta-Lactamases/efeitos dos fármacos , Proteínas de Bactérias/biossíntese , Proteínas de Bactérias/genética , Enterobacteriaceae/enzimologia , Humanos , Fenótipo , beta-Lactamases/biossíntese , beta-Lactamases/genéticaRESUMO
Corynebacterium species have often been considered normal skin flora or contaminants; however, in recent years they have been increasingly implicated in serious infections. Moreover, many new species have been discovered and old species renamed, especially after molecular biology techniques were introduced. Corynebacterium mucifaciens is mainly isolated from blood and from other normally-sterile body fluids; it forms slightly yellow, mucoid colonies on blood agar. We report a fatal case of bacteremia due to an atypical strain of C. mucifaciens. This strain had atypical colony morphology; analysis of the 16S rRNA gene was used to define the species.
Assuntos
Bacteriemia/microbiologia , Infecções por Corynebacterium/microbiologia , Corynebacterium/isolamento & purificação , Idoso de 80 Anos ou mais , Bacteriemia/diagnóstico , Corynebacterium/classificação , Corynebacterium/genética , Infecções por Corynebacterium/diagnóstico , DNA Bacteriano/análise , Evolução Fatal , Feminino , Humanos , RNA Ribossômico 16S/análiseRESUMO
We report here a rare case of cutaneous infection due to Corynebacterium pseudodiphtheriticum. The patient presented to the clinical laboratory with a skin ulcer on his left leg. Gram-stained preparation of the purulent secretion revealed the presence of numerous rod-shaped Gram-positive organisms in the absence of any other species. The organism was grown in pure culture on sheep blood agar and was further identified as C. pseudodiphtheriticum using a commercial identification system (API-Coryne, BioMérieux, France). The infection was successfully treated with ciprofloxacin. This case emphasizes the importance of the clinical microbiology laboratory in correctly identifying Gram-positive organisms obtained in pure culture from skin ulcers.
Reportamos o isolamento de Corynebacterium pseudodiphtheriticum de um caso de infecção cutânea. O paciente apresentou-se ao laboratório clínico com uma úlcera na perna esquerda. A coloração de Gram do material revelou a presença de bacilos Gram-positivos e ausência de outras espécies bacterianas. O organismo foi isolado em cultura pura no ágar sangue de carneiro e foi identificado como C. pseudodiphtheriticum através de um sistema de identificação comercial (API-Coryne, BioMérieux, França). A infecção foi tratada com sucesso através do uso de ciprofloxacina. Este caso reforça a importância do laboratório de microbiologia clínica na identificação de organismos Gram-positivos isolados de cultura pura de amostras de úlceras cutâneas.
Assuntos
Humanos , Masculino , Infecções por Corynebacterium/microbiologia , Corynebacterium/isolamento & purificação , Dermatopatias Bacterianas/microbiologia , Úlcera Cutânea/microbiologia , Anti-Infecciosos/uso terapêutico , Ciprofloxacina/uso terapêutico , Corynebacterium/classificação , Hospedeiro Imunocomprometido , Dermatopatias Bacterianas/diagnóstico , Dermatopatias Bacterianas/tratamento farmacológico , Úlcera Cutânea/diagnóstico , Úlcera Cutânea/tratamento farmacológicoRESUMO
Detection of AmpC beta-lactamase production by enterobacteria has been problematic. Contrary to ESBLs, no specific guidelines are available for detection and confirmation of AmpC production by clinical relevant microorganisms. Moreover, some bacterial species may produce inducible AmpC beta-lactamases that can be easily overlooked by routine susceptibility tests. We reported here a new test based on the strong inducible effect of imipenem on AmpC genes and the consequent antagonism with ceftazidime. This test is very simple and proved to be helpful in detecting AmpC-inducible enzymes among several species of clinical isolates.
Assuntos
Humanos , Antibacterianos/farmacologia , Proteínas de Bactérias/efeitos dos fármacos , Ceftazidima/farmacologia , Enterobacteriaceae/efeitos dos fármacos , Imipenem/farmacologia , beta-Lactamases/efeitos dos fármacos , Proteínas de Bactérias/biossíntese , Proteínas de Bactérias/genética , Enterobacteriaceae/enzimologia , Fenótipo , beta-Lactamases/biossíntese , beta-Lactamases/genéticaRESUMO
Corynebacterium species have often been considered normal skin flora or contaminants; however, in recent years they have been increasingly implicated in serious infections. Moreover, many new species have been discovered and old species renamed, especially after molecular biology techniques were introduced. Corynebacterium mucifaciens is mainly isolated from blood and from other normally-sterile body fluids; it forms slightly yellow, mucoid colonies on blood agar. We report a fatal case of bacteremia due to an atypical strain of C. mucifaciens. This strain had atypical colony morphology; analysis of the 16S rRNA gene was used to define the species.