Background: Determination of antibiotic resistance of opportunistic Corynebacterium colonizing the nose that cause infections and evaluation of the applicability of a simple method for detecting the most common constitutive-type resistance to macrolides, lincosamides and streptogramin B (MLSB). Methods: 70 isolates colonizing the nose and 70 clinical isolates of various infection sites were used and identified using APICoryne and 16S rRNA. Minimal inhibitory concentrations (MICs) were determined (Etest) for 12 antibiotics. MLSB was defined based on MIC, a simple method using two disks (erythromycin/clindamycin) and detection of the gene erm X (PCR). Results: There was a high percentage - in both groups at the same level - of strains with MLSB (88.5% colonizing the nose and 87.1% causing infections). Detection with the phenotypic method MLSB was confirmed genetically (erm X) in all cases. In both groups, a high percentage of resistance was found to trimethoprim/sulfamethoxazole (in both groups 71.4%), chloramphenicol (nose 44.2%/infections 37.1%), tetracycline (28 and 45.7%) and β-lactam antibiotics (18.5 and up to 32.8%). Conclusion: Differences in antibiotic resistance were found between strains colonizing the respiratory tract and various infections. Isolates from infections more frequently exhibited multidrug resistance. The possibility of using a simple method was confirmed for MLSB detection, which can be applied to determine drug resistance in routine microbiological diagnostics of infections caused by opportunistic Corynebacterium.

1.
Mookadam F, Cikes M, Baddour LM, Tleyjeh IM, Mookadam M: Corynebacterium jeikeium endocarditis: a systematic overview spanning four decades. Eur J Clin Microbiol Infect Dis 2006;25:349-353.
[PubMed]
2.
Schoen C, Unzicker C, Stuhler G, Elias J, Einsele H, Grigoleil GU, Abele-Horn M, Mielke S: Life-threatening infection caused by daptomycin-resistant Corynebacterium jeikeium in a neutropenic patient. J Clin Microbiol 2009;47:2328-2331.
[PubMed]
3.
Garcia-Bravo M, Aguado JM, Morale JM, Norwega AR: Influence of external factors in resistance of Corynebacterium urealyticum to antimicrobial agents. Antimicrob Agents Chemother 1996;40:497-499.
[PubMed]
4.
Dalal A, Urban C, Segal-Maurer S: Endocarditis due to Corynebacterium amycolatum. J Med Microbiol 2008;10:1299-1302.
5.
Campanile F, Carretto E, Barbarini D, Grigis A, Falcone M, Goglio A, Venditti M, Stefani S: Clonal multidrug-resistant Corynebacterium striatum strains, Italy. Emerg Infect Dis 2009;15:75-78.
[PubMed]
6.
Otsuka Y, Ohkusu K, Kawamura Y, Baba S, Azeki T, Kimura S: Emergence of multidrug-resistant Corynebacterium striatum as a nosocomial pathogen in long-term hospitalized patients with underlying diseases. Diagn Microbiol Infect Dis 2006;54:109-114.
[PubMed]
7.
Boltin D, Katzir MM, Bugoslavsky V, Yalashvili I, Brosh-Nissimov T, Fried, Elkayam O: Corynebacterium striatum - a classic pathogen eluding diagnosis. Eur J Inter Med 2009;20:e49-e52.
[PubMed]
8.
Camello TC, Souza MC, Martins CA, Damasco PV, Marques EA, Pimenta FP, Pereira GA, Hirata R Jr, Mattos-Guarldi AL: Corynebacterium pseudodiphtheriticum isolated from relevant clinical sites of infection: a human pathogen overlooked in emerging countries. Lett Appl Microbiol 2009;48:458-464.
[PubMed]
9.
Manzella JP, Kellogg JA, Parsey KS: Corynebacterium pseudodiphtheriticum: a respiratory tract pathogen in adults. Clin Infect Dis 1995;20:37-40.
[PubMed]
10.
Joussen AM, Funke G, Joussen F, Herbertz G: Corynebacterium macginleyi: a conjunctiva specific pathogen. Br J Ophthalmol 2000;84:1420-1422.
[PubMed]
11.
Funke G, Punter V, von Graevenitz A: Antimicrobial susceptibility patterns of some recently established coryneform bacteria. Antimicrob Agents Chemother 1996;40:2874-2878.
[PubMed]
12.
Funke G, von Graevenitz A, Clarridge JE 3rd, Bernard KA: Clinical microbiology of coryneform bacteria. Clin Micrbiol Rev 1997;1:125-159.
13.
Gómez-Garcés JL, Alos JI, Tamayo J: In vitro activity of linezolid and 12 other antimicrobials against coryneform bacteria. Int J Antimicrob Agents 2007;29:688-692.
[PubMed]
14.
Roberts MC, Leonard RB, Briselden A, Schoenknecht FD, Coyle MB: Characterization of antibiotic-resistant Corynebacterium striatum strains. J Antimicrob Chemother 1992;30:463-474.
[PubMed]
15.
Tauch A, Krieft S, Pühler A, Kalinowski J: The tetAB of the Corynebacterium striatum R-plasmid pTP10 encode an ABC transporter and confer tetracycline, oxytetracycline and oxacillin resistance in Corynebacterium glutamicum. FEMS Microbiol Lett 1999;173:203-209.
[PubMed]
16.
Eguchi H, Kuwahara T, Miyamoto T, Nakayama-Imaohji H, Ichimura M, Hayashi T, Shiota H: High-level fluoroquinolone resistance in ophthalmic clinical isolates belonging to the species Corynebacterium macginleyi. J Clin Microbiol 2008;46:527-532.
[PubMed]
17.
Sierra JM, Martinez-Martinez L, Vazquez F, Giralt E, Vila J: Relationship between mutations in the gyrA gene and quinolone resistance in clinical isolates of Corynebacterium striatum and Corynebacterium amycolatum. Antimicrob Agents Chemother 2005;5:1714-1719.
18.
Roberts MC, Sutcliffe J, Courvalin P, Jensen LB, Rood J, Seppala H: Nomenclature for macrolide and macrolide-lincosamide-streptogramin B resistance determinants. Antimicrob Agents Chemother 1999;43:2823-2830.
[PubMed]
19.
Rosato AE, Lee BS, Nash KA: Inducible macrolide resistance in Corynebacterium jeikeium. Antimicrob Agents Chemother 2001;7:1982-1989.
20.
Bernard KA, Munro C, Wiebe D, Ongsansoy E: Characteristics of rare or recently described corynebacterium species recovered from human clinical material in Canada. J Clin Microbiol 2002;40:4375-4381.
[PubMed]
21.
Drancourt M, Bollet C, Carlioz A, Martelin R, Gayral JP, Raoult D: 16S ribosomal DNA sequence analysis of a large collection of environmental and clinical unidentifiable bacterial isolates. J Clin Microbiol 2000;38:3623-3630.
[PubMed]
22.
Fernández-Natal MI, Sáez-Nieto JA, Fernández-Roblas R, Asencio M, Valdezate S, Lapeña S, Rodríquez-Pollán RH, Guerra JM, Blanco J, Cachón F, Soriano F: The isolation of Corynebacterium coyleae from clinical samples: clinical and microbiological data. Eur J Clin Microbiol Infect Dis 2008;27:177-184.
[PubMed]
23.
CLSI: Method for Antimicrobial Dilution and Disk Susceptibility Testing of Infrequently Isolated or Fastidious Bacteria. Approved Standard M45-A, vol 26, No 19. Wayne, Clinical and Laboratory Standards Institute, 2009.
24.
Etest Application Sheet EAS021: Fastidious Gram Positive Bacilli http://www.ilexmedical.com/files/Etest-ApplicationSheets/fastidiousgrampositivebacilli.pdf (accessed June 2, 2013).
25.
CLSI: Performance Standards for Antimicrobial Susceptibility Testing; Twenty-First Informational Supplement. M100-S21, vol 31, No 1. Wayne, Clinical and Laboratory Standards Institute, 2011.
26.
Fiebelkorn KR, Crawford SA, McElmeed ML, Jorgensen JH: Practical disk diffusion method for detection of inducible clindamycin resistance in Staphylococcus aureus and coagulase-negative staphylococci. J Clin Microbiol 2003;41:4740-4744.
[PubMed]
27.
Otsuka Y, Kawamura Y, Koyama T, Iihara H, Ohkusu K, Azeki T: Corynebacterium resistens sp.nov, a new multi-resistant coryneform bacterium isolated from human infection. J Clin Microbiol 2005;8:3713-3717.
28.
Ahmed K, Kawakami K, Watanabe K, Mitsushima H, Nagatake T, Matsumoto K: Corynebacterium pseudodiphtheriticum: a respiratory tract pathogen. Clin Infect Dis 1995;20:41-46.
[PubMed]
29.
Colt HG, Morris JF, Marston BJ, Sewell DL: Necrotizing tracheitis caused by Corynebacterium pseudodiphtheriticum: unique case and review. Rev Infect Dis 1991;13:73-76.
[PubMed]
30.
Bittar F, Cassagne C, Bosdure E, Stremler N, Dubus JC, Sarles J, Reynaud-Gaubert M, Raoult D, Rolain JM: Outbreak of Corynebacterium pseudodiphtheriticum infection in cystic fibrosis patients, France. Emerg Infect Dis 2010;16:1231-1236.
[PubMed]
31.
Ang LM, Brown H: Corynebacterium accolens isolated from breast abscess: possible association with granulomatous mastitis. J Clin Microbiol 2007;45:1666-1668.
[PubMed]
32.
Claeys G, Vanhouteghem H, Riegel P, Wauters G, Hamerlynck R, Dierick J, de Witte J, Verschraegen G, Vaneechoutte M: Endocarditis of native aortic and mitral valves due to Corynebacterium accolens: report of a case and application of phenotypic and genotypic techniques for identification. J Clin Microbiol 1996;34:1290-1292.
[PubMed]
33.
Wong JS, Seaward LM, Ho CP, Anderson TP, Lau EO, Amodeo MR, Metcalf SC, Pithie AD, Murdoch DR: Corynebacterium accolens-associated pelvic osteomyelitis. J Clin Microbiol 2010;48:654-655.
[PubMed]
34.
Motomura K, Masaki H, Terada M, Onizuka T, Shimogama S, Furumoto A, Asoh N, Watanabe K, Oishi K, Nagatake T: Three adult cases with Corynebacterium propinquum respiratory infections in a community hospital (in Japanese). Kansenshogaku Zasshi 2004;78:277-282.
[PubMed]
35.
Superti SV, Martins Dde S, Caierão J, Soares F, Prochnow T, Cantarelli VV, Zavascki AP: Corynebacterium striatum infecting a malignant cutaneous lesion: the emergence of an opportunistic pathogen. Rev Inst Med Trop São Paulo 2009;51:115-116.
36.
Tibrewala AV, Woods CJ, Pyrgos VJ, Ruiz ME: Native valve endocarditis caused by C. striatum. Scand J Infect Dis 2006;38:805-807.
[PubMed]
37.
Martins C, Faria L, Souza M, Camello T, Velasco E, Hirata R Jr, Thuler L, Mattos-Guaraldi A: Microbiological and host features associated with corynebacteriosis in cancer patients: a five-year study. Mem Inst Oswaldo Cruz 2009;104:905-913.
[PubMed]
38.
Martínez-Martínez L, Suárez AI, Winstanley J, Ortega MC, Bernard K: Phenotypic characteristics of 31 strains of Corynebacterium striatum isolated from clinical samples. J Clin Microbiol 1995;9:2458-2461.
39.
Fernandez-Roblas R, Adames H, Martín-de-Hijas NZ, Almeida DG, Gadea I, Esteban J: In vitro activity of tigecycline and 10 other antimicrobials against clinical isolatesof the genus Corynebacterium. Int J Antimicrob Agents 2009;33:453-455.
[PubMed]
40.
Espínola M, Somodevilla A, Domingo D, Alarcón T, López-Brea M: Antibiotic susceptibility of Corynebacterium macginleyi strains causing conjunctivitis (in Spanish). Rev Esp Quimioter 2010;23:196-200.
[PubMed]
41.
Ghide S, Jiang Y, Hachem R, Chaftari AM, Raad I: Catheter-related Corynebacterium bacteremia: should the catheter be removed and vancomycin administered? Eur J Clin Microbiol Infect Dis 2010;29:153-156.
[PubMed]
42.
Iroh Tam PY, Fisher MA, Miller NS: Corynebacterium falsenii bacteremia occurring in an infant on vancomycin therapy. J Clin Microbiol 2010;48:3440-3442.
[PubMed]
43.
Suzuki Y, Kawasaki K, Sato Y, Tokimatsu I, Itoh H, Hiramatsu K, Takeyama M, Kadota J: Is peak concentration needed in therapeutic drug monitoring of vancomycin? A pharmacokinetic-pharmacodynamic analysis in patients with methicillin-resistant Staphylococcus aureus pneumonia. Chemotherapy 2012;58:308-312.
[PubMed]
44.
Sánchez Hernández J, Mora Peris B, Yagüe Guirao G, Gutiérrez Zufiaurre N, Muñoz Bellido JL, Segovia Hernández M, García Rodríguez JA: In vitro activity of newer antibiotics against Corynebacterium jeikeium, Corynebacterium amycolatum and Corynebacterium urealyticum. Int J Antimicrob Agents 2003;22:492-496.
[PubMed]
45.
Dinleyici EC, Yargic ZA, Bor O, Kiremitci A, Durmaz G: Tigecycline treatment of multi-drug-resistant Corynebacterium jeikeium infection in a child with relapsing and refractory acute lymphoblastic leukemia. Pediatr Blood Cancer 2010;55:349-351.
[PubMed]
46.
Arthur M, Nolinas C, Mabilat C, Courvalin P: Detection of erythromycin resistance by the polymerase chain reaction using primers in conserved regions of erm rRNA methylase genes. Antimicrob Agents Chemother 1990;10:2024-2026.
47.
Luna VA, Coates P, Eady A, Cove JH, Nguyen TTH, Roberts MC: A variety of Gram-positive bacteria carry mobile mef genes. J Antimicrob Chemother 1999;44:19-25.
[PubMed]
48.
Tauch A, Bischoff N, Brune I, Kalinowski J: Insights into the genetic organization of the Corynebacterium diphtheriae erythromycin resistance plasmid pNG2 deduced from its complete nucleotide sequence. Plasmid 2003;49:63-74.
[PubMed]
49.
Coyle MB, Minshew BH, Bland JA, Hsu PC: Erythromycin and clindamycin resistance in Corynebacterium diphtheriae from skin lesion. Antimicrob Agents Chemother 1979;16:525-527.
[PubMed]
50.
Ross JI, Eady AA, Carnegle E, Cove JH: Detection of transposon Tn5432-mediated macrolide-lincosamide-streptogramin B (MLSB) resistance in cutaneus propionibacterie from six European cities. J Antimicrob Chemother 2002;49:165-168.
[PubMed]
51.
El-Mahdy TS, Abdalla S, El-Domany R, Mohamed MS, Ross JI, Snelling AM: Detection of a new erm(X)-mediated antibiotic resistance in Egyptian cutaneous propionibacteria. Anaerobe 2010;16:376-379.
[PubMed]
52.
Zasada AA, Baczewska-Rej M, Wardak S: An increase in non-toxigenic Corynebacterium diphtheriae infections in Poland - molecular epidemiology and antimicrobial susceptibility of strains isolated from past outbreaks and those currently circulating in Poland. Int J Infect Dis 2010;14:e907-e912.
[PubMed]
53.
Gladin DP, Kozlova NS, Zaĭtseva TK, Cherednichenko AS, Khval SA: Sensitivity of Corynebacterium diphtheriae isolated in Saint-Petersburg to antibacterial drugs (in Russian). Antibiot Khimioter 1999;44:17-21.
[PubMed]
54.
Lavollay M, Arthur M, Fourgeaud M, Dubost L, Marie A, Riegel P, Gutmann L, Mainardi JL: The beta-lactam-sensitive D,D-carboxypeptidase activity of Pbp4 controls the L,D and D,D transpeptidation pathways in Corynebacterium jeikeium. Mol Microbiol 2009;74:650-661.
[PubMed]
You do not currently have access to this content.