Corynebacterium amycolatum

Corynebacterium amycolatum is a Gram-positive, non-spore-forming, aerobic or facultatively anaerobic bacillus capable of fermentation [1] with propionic acid as the major end product of its glucose metabolism. One of its best known relatives is Corynebacterium diphtheriae, the causative agent of diphtheria. C. amycolatum is a common component of the natural flora found on human skin and mucous membranes, and as such, is often disregarded by physicians as a contaminant when found in blood cultures.[2] However, C. amycolatum is actually an opportunistic pathogen capable of causing serious human disease such as endocarditis and sepsis.

Corynebacterium amycolatum
Scientific classification
Domain:
Bacteria
Phylum:
Actinobacteria
Class:
Actinobacteria
Order:
Actinomycetales
Suborder:
Corynebacterineae
Family:
Corynebacteriaceae
Genus:
Corynebacterium
Species:
C. amycolatum
Binomial name
Corynebacterium amycolatum
Collins et al 1988

Identification

First described in 1988, C. amycolatum is one of the diphtheroids most often isolated from clinical samples. However, it is often difficult to differentiate from other fermentative corynebacteria such as C. minutissimum and C. xerosis, both of which are known human pathogens. One method of differentiation, however, is by observing the cell wall. Unlike other members of this genus, C. amycolatum lacks mycolic acid, long fatty acids usually found in the cell wall. C. amycolatum also differs in its colony morphology; the species characteristically produces flat, whitish-gray, matte or waxy colonies on Schaedler blood agar. Its antibiotic sensitivity may also aid in its identification; the organism is generally resistant to multiple antibiotics. Because of its relatively new status as a pathogen, however, no standard laboratory tests yet identify C. amycolatum.[1]

Disease

C. amycolatum has been shown to cause pneumonia, peritonitis, empyema, infectious endocarditis, and fatal sepsis, most of which occur as nosocomial infections. As an opportunistic pathogen, the bacterium is pathogenic in immunocompromised patients, mostly infecting those with underlying heart defects or intravascular devices. Corynebacterium endocarditis usually infects the left side of the heart in males, though C. amycolatum has shown a predilection for women.[3] While cases of disease have been small in number, this underreporting could be due to misdiagnosis of C. amycolatum as C. xerosis, which is a known human pathogen.[2][4]

Treatment

For the few cases thus far, vancomycin or daptomycin has been used in tandem with rifampicin for a duration ranging from four weeks to six months.[1] Valve replacement was also required in some cases of infectious endocarditis. Due to its recent pathogenic status, however, few treatments have been tested, and an optimal treatment regimen has yet to be established.

Antibiotic resistance

One of C. amycolatum's characteristic traits is its resistance to a wide range of antibiotics. Various strains tested have shown resistance to beta lactam antibiotics, lincosamides, macrolides, and quinolones. Multiple drug-resistant strains were mainly isolated from wounds of patients treated in departments of general surgery and vascular surgery. However, the bacterium was shown to be particularly sensitive to glycopeptide and lipopeptide antibiotics.[5]

References
  1. Dalal, Aman; Urban, Segal-Maurer (October 2008). "Endocarditis due to Corynebacterium amycolatum". Journal of Medical Microbiology. 57 (10): 1299–1302. doi:10.1099/jmm.0.2008/003343-0. Retrieved 30 October 2012.
  2. Knox, Karen. "Nosocomial Endocarditis Caused by Corynebacterium amycolatum and Other Nondiphtheriae Corynebacteria". Centers for Disease Control and Prevention. Retrieved 30 October 2012.
  3. Belmares, Jaime; Stephanie Detterline; Janet B Pak; Jorge P Parada (2007). "Corynebacterium endocarditis species-specific risk factors and outcomes". BMC Infectious Diseases. 7: 4. doi:10.1186/1471-2334-7-4. PMC 1804271.
  4. Berner, R; K Pelz; C Wilhelm; A Funke; J U Leititis; M Brandis (April 1997). "Fatal sepsis caused by Corynebacterium amycolatum in premature infant". Journal of Clinical Microbiology. 35 (4): 1011–1012. PMC 229725. PMID 9157120.
  5. Koneman, Elmer (2006). Koneman's Color Atlas and Textbook of Diagnostic Microbiology, 6 ed. Lippincott Williams & Wilkins. p. 798. ISBN 9780781730143.
This article is issued from Wikipedia. The text is licensed under Creative Commons - Attribution - Sharealike. Additional terms may apply for the media files.