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Corynebacterium propinquum Keratitis Identified Using MALDI-TOF

Paul R Badenoch1, Lisa J OʼDaniel, Rolf P Wise

  • 1*Department of Ophthalmology, Flinders Medical Centre and Flinders University, Bedford Park, South Australia, Australia;†Department of Microbiology and Infectious Diseases, SA Pathology at Flinders Medical Centre, Bedford Park, South Australia, Australia; and‡Department of Microbiology and Infectious Diseases, SA Pathology at the Royal Adelaide Hospital, Adelaide, South Australia, Australia.

Cornea
|March 4, 2016
PubMed
Abstract

Insights

Matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) accurately identified Corynebacterium propinquum, a rare cause of infectious keratitis. This rapid method enhances laboratory diagnosis of difficult ocular infections.

Area of Science:

  • Ophthalmology
  • Medical Microbiology
  • Infectious Diseases

Background:

  • Ocular infections require accurate and rapid microbial identification for effective treatment.
  • Distinguishing between similar bacterial species is crucial for diagnosing and managing infectious keratitis.
  • The matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry method offers a rapid and cost-effective approach to bacterial identification.

Observation:

  • A 94-year-old female patient presented with suppurative keratitis, a severe corneal infection.
  • Her medical history included Fuchs corneal dystrophy, corneal transplantation, and glaucoma, complicating the clinical picture.
  • Gram staining revealed coryneform bacteria, prompting further identification.

Findings:

  • MALDI-TOF successfully identified the causative agent as Corynebacterium propinquum.
  • This identification was further confirmed using RNA polymerase beta subunit (rpoB) gene sequencing.
  • The patient's vision improved after treatment with topical antibiotics (cefazolin, gentamicin) and fluorometholone.

Implications:

  • MALDI-TOF is a valuable tool for identifying uncommon and difficult-to-distinguish bacterial isolates in clinical microbiology.
  • The method's efficiency and low cost can significantly improve the laboratory diagnosis of ocular infections.
  • Accurate identification of pathogens like C. propinquum is essential for guiding appropriate therapeutic interventions in ophthalmology.

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