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Factors affecting the clinical relevance of Corynebacterium striatum isolated from blood cultures

机译:从血液培养物中分离出纹状棒状杆菌的临床相关性的因素

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摘要

This study aimed to identify clinical or microbiological factors affecting the clinical relevance of Corynebacterium striatum isolated from blood cultures. A total of 64 isolates from 51 patients identified as C. striatum by matrix assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) and 16S rRNA gene sequencing were assessed. More than two blood cultures were positive in 25 (48.1%) patients. Diabetes, solid tumor, and a history of previous exposure to antibiotics were more common in patients with multiple positive blood cultures. Charlson comorbidity scores were also higher, and more isolates were recovered after 48 hours of hospital stay in patients with multiple positive blood cultures. Strains recovered from patients with multiple positive blood cultures produced significantly more biofilm. Based on multilocus sequence typing (MLST), sequence type (ST) 20 (31.3%) was the most dominant, followed by ST2 (20.3%) and ST23 (10.9%). There was no relationship between the number of positive blood culture sets and sequence typing. In multivariate analyses, Carlson comorbidity score (odds ratio [OR], 1.91; 95% confidence interval [CI], 1.09–3.36; P = 0.03) and biofilm formation were associated with multiple positive blood cultures (OR, 17.43; 95% CI, 3.71–81.91; P = 0.03). This study provides evidence that the biofilm phenotype could contribute to determining the clinical significance of C. striatum in patients with severe underlying conditions. The predominance of certain STs suggests the relatedness of C. striatum infection and the nosocomial environment.
机译:这项研究旨在确定影响从血液培养物中分离出的纹状棒状杆菌的临床相关性的临床或微生物因素。评估了通过基质辅助激光解吸/电离飞行时间质谱(MALDI-TOF MS)和16S rRNA基因测序被鉴定为纹状体梭状芽胞杆菌的51例患者的64种分离株。 25名患者(48.1%)中有两种以上的血培养阳性。在具有多种阳性血液培养的患者中,糖尿病,实体瘤和以前曾接触过抗生素的历史更为普遍。 Charlson合并症评分也更高,血液培养呈多种阳性的患者在住院48小时后可发现更多分离株。从具有多种阳性血液培养物的患者中回收的菌株产生的生物膜明显更多。根据多基因座序列类型(MLST),序列类型(ST)20(31.3%)是最主要的,其次是ST2(20.3%)和ST23(10.9%)。阳性血液培养物组数与序列分型之间没有关系。在多元分析中,卡尔森合并症评分(优势比[OR]为1.91; 95%置信区间[CI]为1.09–3.36; P = 0.03)和生物膜形成与多种阳性血液培养物相关(OR为17.43; 95%CI ,3.71-81.91; P = 0.03)。这项研究提供了证据,表明生物膜表型可能有助于确定患有严重潜在疾病的患者纹状体的临床意义。某些ST的优势表明纹状体梭状芽胞杆菌感染与医院环境之间的相关性。

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