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Corynebacterium Group JK pathogen in cerebrospinal fluid shunt infection. Report of two cases
G Keren1, T Geva, B Bogokovsky
1Pediatric Infectious Diseases Unit, Chaim Sheba Medical Center, Tel-Hashomer, Israel.
Abstract:
The clinical and laboratory findings in two cases of aerobic Corynebacterium Group JK infection of cerebrospinal fluid (CSF) shunts are described. These organisms have occasionally been reported as a cause of serious infections in man but have not been reported as a cause of shunt infection. In both cases, CSF pleocytosis was limited to 20 or 60 cells with variable protein and sugar values. Fever was a constant finding, frequently accompanied by signs of central nervous system dysfunction. Corynebacterium Group JK organisms are common contaminants of the normal skin flora. When isolated from the blood and/or the CSF of a patient with a CSF shunt who has symptoms and signs compatible with infection, the organism should not be dismissed as a contaminant. A significant feature of this group is its resistance to almost all presently available antibiotics including penicillin, the cephalosporins, and the aminoglycosides. These organisms are, however, sensitive to vancomycin.
Insights
Aerobic Corynebacterium Group JK can cause serious cerebrospinal fluid (CSF) shunt infections. These resistant bacteria are treatable with vancomycin, not typical antibiotics.
Area of Science:
- Infectious Diseases
- Clinical Microbiology
- Neurosurgery
Background:
- Cerebrospinal fluid (CSF) shunts are crucial for managing hydrocephalus.
- Aerobic Corynebacterium Group JK is a known pathogen but rarely implicated in shunt infections.
Observation:
- Two cases of CSF shunt infection caused by aerobic Corynebacterium Group JK are presented.
- Patients exhibited fever and central nervous system dysfunction.
- Laboratory findings included limited CSF pleocytosis and variable protein/sugar levels.
Findings:
- Aerobic Corynebacterium Group JK, a common skin flora contaminant, can cause significant shunt infections.
- The organism demonstrated resistance to penicillin, cephalosporins, and aminoglycosides.
- Vancomycin proved effective against the isolated Corynebacterium Group JK strains.
Implications:
- Clinical and laboratory staff should avoid dismissing Corynebacterium Group JK as mere contaminants in shunt infection cases.
- Vancomycin is the recommended antibiotic for treating these infections.
- This highlights the importance of accurate pathogen identification and susceptibility testing in neurosurgical infections.