Group JK diphtheroid bacteremia. The successive isolation of an antibiotic-susceptible and an antigenically different multi-resistant strain.
A 71-year-old man with a permanent, subcutaneously implanted, intra-cardial pacemaker suffered from prolonged bacteremia with an antibiotic-susceptible group JK diphtheroid rod. He died in spite of the formation of specific serum antibody and parenteral treatment with ampicillin, cephradine and gentamicin. A second multi-resistant, but otherwise similar group JK strain was isolated post-mortem from the aseptically removed pacemaker electrode tip. The susceptible and the multi-resistant strains differed antigenically in crossed immunoelectrophoresis assays, and fatty acid isomer patterns were dissimilar. The theory that a multi-resistant group JK clone emerged by simple mutation in susceptible, indigenous group JK skin flora is rejected. The concept of major structural differences among group JK bacteria, possibly affecting cell-wall permeability, is supported. Crossed immunoelectrophoresis is suggested as a means for strain comparison in epidemiological surveys. Vancomycin is regarded as the antibiotic of choice for the treatment of potentially fatal, deep-seated infections.
D000368:Aged; D000907:Antibodies, Bacterial / Q000032:analysis; D000942:Antigens, Bacterial / Q000032:analysis; D003352:Corynebacterium / Q000145:classification* / Q000187:drug effects / Q000276:immunology / Q000302:isolation & purification; D003354:Corynebacterium Infections / Q000382:microbiology*; D004352:Drug Resistance, Microbial; D006801:Humans; D007123:Immunoelectrophoresis, Two-Dimensional; D010138:Pacemaker, Artificial; D018805:Sepsis / Q000382:microbiology*
D000907:Antibodies, Bacterial; D000942:Antigens, Bacterial