Clinical relevance and impact of Corynebacterium isolation in lower respiratory tract of critically ill patients requiri
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ORIGINAL PAPER
Clinical relevance and impact of Corynebacterium isolation in lower respiratory tract of critically ill patients requiring mechanical ventilation Simon Clariot1 · Ophélie Constant1 · Raphaël Lepeule2 · Vincent Fihman3,7 · Keyvan Razazi4 · Fabrice Cook1 · Arié Attias1 · Jean‑Claude Merle1 · François Hemery5 · Eric Levesque1,6,7 · Jean‑Winoc Decousser3,6,7 · Olivier Langeron1,6 · Nicolas Mongardon1,6,8 Received: 22 December 2019 / Accepted: 6 March 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose Corynebacterium spp. (C. spp.) is commonly considered as a contaminant in respiratory specimens. No study has ever focused on its clinical relevance in the lower respiratory tract of patients admitted to the intensive care unit (ICU) and requiring mechanical ventilation. The aims were to describe the characteristics of ICU patients with a C. spp. positive deep respiratory specimen, to investigate the impact of C. spp. on the occurrence of pneumonia, and to evaluate the outcomes of these pneumonia. Methods We retrospectively included all adult patients admitted to ICU in a 1000-bed University Hospital (2007–2017) who had a C. spp. positive lower respiratory tract specimen at a significant quantitative level. We used clinical, radiological, and microbiological criteria to classify the likelihood of such pneumonia. Results Among the 31 patients included, acute respiratory failure and postoperative care after major surgery were the main reasons of admission. SAPS II was 47 [34–60]. C. spp. pneumonia was considered as probable, possible and unlikely in 10, 14, and 7 patients, respectively. Fifty-two and 94% of C. spp. strains were sensitive to amoxicillin, and vancomycin/linezolid, respectively. Seventeen patients had a complete course of antibiotic against C. spp. The overall ICU mortality was 58%. Conclusion Corynebacterium spp seems to be responsible for authentic pneumonia in mechanically ventilated patients. It should be considered as clinically relevant when predominantly present in respiratory specimen from patients suspected with pneumonia in ICU, and empirically treated. Keywords Pneumonia · Nosocomial infection · Sepsis · Corynebacterium · Infection · Colonization * Nicolas Mongardon [email protected] 1
Service d’Anesthésie‑Réanimation Chirurgicale, DMU CARE, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, CHU Henri Mondor, 51 avenue du Maréchal de Lattre de Tassigny, 94000 Créteil, France
2
Unité Transversale de Traitement Des Infections (UT2I), Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, 94010 Créteil, France
3
Unité de Bactériologie‑Hygiène, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor Henri Mondor, 94010 Créteil, France
4
Service de Réanimation Médicale, Groupe de Recherche Clinique CARMAS, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, 94010 Créteil, France
5
Département d’Inf
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