Related Experiment Video
Updated: Aug 21, 2026
Growing a Cystic Fibrosis-Relevant Polymicrobial Biofilm to Probe Community Phenotypes
Published on: April 19, 2024
Exit-site infections by non-diphtheria corynebacteria in CAPD
Helmut Schiffl1, Claudia Mücke, Susanne M Lang
1KfH Nierenzentrum München-Laim, Munich, Germany. hschiffl@hotmail.com
Abstract:
Non-diphtheria corynebacteria species cause disease in risk populations such as immunocompromised patients and patients with indwelling medical devices. Despite reports of exit-site infection and peritonitis caused by non-diphtheria corynebacteria, these organisms are frequently dismissed as contaminants. During a 10-year observation period, we prospectively identified 8 cases of exit-site/tunnel infections caused by 2 different species of corynebacteria (Corynebacterium striatum in 5 and C. jeikeium in 3 cases). Four patients experienced a second episode of exit-site infection 3 months (2 cases), 25 months, and 40 months, respectively, after termination of an oral cephalosporin therapy of 4 to 6 weeks' duration. Non-diphtheria corynebacteria accounted for 9% of all exit-site infections during the study period. All catheter-related infections healed; no catheter had to be removed. The diagnosis of catheter-related non-diphtheria corynebacteria infection may be suspected when Gram stain shows gram-positive rods and with colony morphology and commercial biochemical identification systems. Susceptibility of non-diphtheria corynebacteria to antibiotics may vary, especially in C. jeikeium. Virtually all Corynebacterium species are sensitive to vancomycin. Empirical antibiotic therapy with vancomycin should be initiated while antibiotic susceptibility testing is being carried out. Oral cephalosporin may be an alternative treatment regimen for exit-site infections if sensitive. This study highlights the importance of non-diphtheria corynebacteria as emerging nosocomial pathogens in the population of end-stage renal disease patients on on continuous ambulatory peritoneal dialysis.
Insights
Non-diphtheria corynebacteria are emerging nosocomial pathogens causing exit-site infections in dialysis patients. Prompt diagnosis and vancomycin treatment are crucial for successful outcomes, even with recurrent infections.
Area of Science:
- Infectious Diseases
- Microbiology
- Nephrology
Background:
- Non-diphtheria corynebacteria are increasingly recognized as pathogens, particularly in immunocompromised individuals and those with medical devices.
- These bacteria are often misidentified as contaminants, delaying appropriate diagnosis and treatment.
- Patients undergoing continuous ambulatory peritoneal dialysis (CAPD) are at risk for catheter-related infections.
Purpose of the Study:
- To investigate the incidence and characteristics of exit-site and tunnel infections caused by non-diphtheria corynebacteria in CAPD patients.
- To evaluate treatment outcomes and identify effective therapeutic strategies for these infections.
- To highlight the significance of non-diphtheria corynebacteria as nosocomial pathogens in this patient population.
Main Methods:
- Prospective identification of 8 cases of exit-site/tunnel infections caused by Corynebacterium striatum (5 cases) and Corynebacterium jeikeium (3 cases) over a 10-year period.
- Analysis of patient data, including previous treatments, recurrence of infection, and outcomes.
- Review of diagnostic methods, including Gram stain, colony morphology, and biochemical identification.
Main Results:
- Non-diphtheria corynebacteria accounted for 9% of all exit-site infections during the study.
- Four patients experienced recurrent exit-site infections after completing oral cephalosporin therapy.
- All catheter-related infections resolved without the need for catheter removal, with vancomycin being a key component of successful treatment.
Conclusions:
- Non-diphtheria corynebacteria are significant emerging nosocomial pathogens in CAPD patients.
- Early suspicion, accurate diagnosis, and appropriate antibiotic therapy, including vancomycin, are essential for managing these infections.
- Effective treatment can lead to infection resolution without catheter removal, emphasizing the importance of recognizing these pathogens.
Related Concept Videos
01:28Diphtheria
01:29Endocarditis IV: Nursing Management
01:29Staphylococcal Skin Infections
01:26Healthcare Associated Infections I: Iatrogenic, Exogenic and Endogenic
HAIs significantly increase the cost of health care. Extended stays in healthcare institutions, increased disability, increased costs of medications, including specialized antibiotics, and prolonged recovery times add to the patient's expenses and the healthcare institution and funding bodies. Common...
01:27Streptococcal Pharyngitis
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...