462. An Increase in Invasive Infections due to Corynebacterium striatum at an Academic Medical Center
Session: Poster Abstract Session: HAI: Outbreaks
Thursday, October 5, 2017
Room: Poster Hall CD
Posters
  • IDSA 2017 C striatum Poster 092917.pdf (967.2 kB)
  • Background:

    After identifying an increase in invasive infections due to Corynebacterium striatum (CS) in 2016, we evaluated the epidemiology of C. striatum (CS) infections in our system.

    Methods:

    We reviewed microbiology records to determine the number of patients with cultures growing CS from 1/1/14 - 12/31/16.  Prior to 11/2015, diphtheroids identified from sterile body sites were sent to a reference lab for identification (ID); beginning in 11/2015, MALDI-TOF was used by the microbiology lab for CS ID.  Two infectious diseases physicians reviewed charts of all 2016 cases using a standardized data collection tool and determined whether patients had infection versus colonization. 

    Results:

    We identified 3,6, and 50 patients with cultures growing CS in 2014, 2015, and 2016, respectively.  Thirty-six (72%) of the patients in 2016 were felt to have true infection.  Skin and soft tissue infections and osteomyelitis were the most common sites (Figure).  The majority of infected patients were immunocompetent, had community-acquired (CA) infections, received antibiotics in the prior 60 days, and required prolonged courses of antimicrobial treatment (Table). No epidemiologic link was identified for nosocomial or CA infections.

    Conclusion:   

    The notable increase in clinically significant CS infections at our institution warrants further investigation.  Whole genome sequencing may offer insight into whether a specific clone is responsible for more invasive disease.

    Table: Case characteristics of patients with C. striatum infections in 2016

    Characteristic 

    n=36

    Age, years (mean, std dev)

    59 + 18.1

    Sex (% Female)

    16 (44%)

    Immunocompromised status

    9 (25%)

    Transplant Recipient

    5 (14%)

    Medication

    3 (8%)

    Cancer

    1 (3%)

    Vascular device present

    5 (14%)

    Central Venous Catheter

    2 (6%)

    Left Ventricular Assist Device

    3 (8%)

    Classification of infection

     

    Hospital-Acquired

    7 (19%)

    Healthcare-Associated

    10 (28%)

    Community-Acquired

    19 (53%)

    Antimicrobial exposure in the last 60 days

    30 (83%)

    Pure growth of Corynebacterium striatum in culture

    23 (64%)

    Gram-Positive Rods present on Gram stain

    14 (39%)

    Blood culture (n=8)

    8 (100%)

    Non-blood culture (n=28)

    6 (21%)

    Duration of antimicrobial treatment, days (mean, std dev)

    28 + 16.9

    Mortality related to infection

    3 (8.3%)

     

    Becky Smith, MD1,2, Kirk Huslage, MSPH, BSN, RN, CIC1,2, Barbara D. Alexander, MD, MHS, FIDSA3, Julia Messina, MD3, Daniel Sexton, MD, FIDSA, FSHEA2,3 and Sarah S. Lewis, MD MPH2,3, (1)Infection Prevention and Hospital Epidemiology, Duke University Medical Center, Durham, NC, (2)Duke Center for Antimicrobial Stewardship and Infection Prevention, Durham, NC, (3)Division of Infectious Diseases, Duke University Medical Center, Durham, NC

    Disclosures:

    B. Smith, None

    K. Huslage, None

    B. D. Alexander, None

    J. Messina, None

    D. Sexton, Centers for Disease Control and Prevention: Grant Investigator , Grant recipient
    Centers for Disease Control and Prevention Foundation: Grant Investigator , Grant recipient
    UpToDate: Collaborator , Royalty Recipient

    S. S. Lewis, None

    See more of: HAI: Outbreaks
    See more of: Poster Abstract Session

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 4th with the exception of research findings presented at the IDWeek press conferences.