title: Clinical characteristics and predictive factors for mortality in coryneform bacteria bloodstream infection in hematological patients.
abstract: BACKGROUND
  We examined the clinical characteristics and predictive factors for mortality in coryneform bacteria bloodstream infection in hematological patients.
  
  
  METHODS
  We searched for hematological patients who had positive blood cultures for coryneform bacteria at our center between April 2007 and January 2016. Patients with definite bloodstream infections were included. We started species identification in April 2014.
  
  
  RESULTS
  Twenty of twenty-eight cases with a positive blood culture for coryneform bacteria were regarded as definite infections. Sixteen and two patients were allogeneic and autologous hematopoietic stem cell transplantation (HSCT) recipients, respectively. Corynebacterium striatum was identified in all nine of the cases tested and one patient was co-infected with Corynebacterium amycolatum. None of the patients died directly due to coryneform bacteria infection. The survival rates at 30, 60 and 180 days were 100%, 73.7% and 51.3%, respectively. Causes of mortality included progression of the underlying disease (n = 6), other infections (n = 4) and HSCT complications (n = 2). Mixed infection (hazard ratio (HR) 5.47, 95% confidence interval (CI) 1.30-23.0), renal impairment (HR 6.31, 95% CI 1.06-37.4) and absence of a central venous (CV) catheter at the onset (HR 6.39, 95% CI 1.04-39.45) were identified as predictive factors for mortality.
  
  
  CONCLUSIONS
  Most of the coryneform bacteria bloodstream infections occurred in HSCT recipients. Contamination seemed to be less common when coryneform bacteria were detected in blood in hematological patients. Although coryneform bacteria bloodstream infection seemed to mostly be manageable, the prognosis was not desirable, particularly in patients with mixed infection, renal impairment and absence of a CV catheter.
authors.affiliation: Division of Hematology, Saitama Medical Center, Jichi Medical University, Japan.
authors.forename: Shun-Ichi
authors.initials: SI
authors.lastname: Kimura
authors.affiliation: Division of Hematology, Saitama Medical Center, Jichi Medical University, Japan.
authors.forename: Ayumi
authors.initials: A
authors.lastname: Gomyo
authors.affiliation: Division of Hematology, Saitama Medical Center, Jichi Medical University, Japan.
authors.forename: Jin
authors.initials: J
authors.lastname: Hayakawa
authors.affiliation: Division of Hematology, Saitama Medical Center, Jichi Medical University, Japan.
authors.forename: Yu
authors.initials: Y
authors.lastname: Akahoshi
authors.affiliation: Division of Hematology, Saitama Medical Center, Jichi Medical University, Japan.
authors.forename: Naonori
authors.initials: N
authors.lastname: Harada
authors.affiliation: Division of Hematology, Saitama Medical Center, Jichi Medical University, Japan.
authors.forename: Tomotaka
authors.initials: T
authors.lastname: Ugai
authors.affiliation: Division of Hematology, Saitama Medical Center, Jichi Medical University, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Komiya
authors.affiliation: Division of Hematology, Saitama Medical Center, Jichi Medical University, Japan.
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Kameda
authors.affiliation: Division of Hematology, Saitama Medical Center, Jichi Medical University, Japan.
authors.forename: Hidenori
authors.initials: H
authors.lastname: Wada
authors.affiliation: Division of Hematology, Saitama Medical Center, Jichi Medical University, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Ishihara
authors.affiliation: Division of Hematology, Saitama Medical Center, Jichi Medical University, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Kawamura
authors.affiliation: Division of Hematology, Saitama Medical Center, Jichi Medical University, Japan.
authors.forename: Kana
authors.initials: K
authors.lastname: Sakamoto
authors.affiliation: Division of Hematology, Saitama Medical Center, Jichi Medical University, Japan.
authors.forename: Miki
authors.initials: M
authors.lastname: Sato
authors.affiliation: Division of Hematology, Saitama Medical Center, Jichi Medical University, Japan.
authors.forename: Kiriko
authors.initials: K
authors.lastname: Terasako-Saito
authors.affiliation: Division of Hematology, Saitama Medical Center, Jichi Medical University, Japan.
authors.forename: Misato
authors.initials: M
authors.lastname: Kikuchi
authors.affiliation: Division of Hematology, Saitama Medical Center, Jichi Medical University, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Nakasone
authors.affiliation: Division of Hematology, Saitama Medical Center, Jichi Medical University, Japan.
authors.forename: Junya
authors.initials: J
authors.lastname: Kanda
authors.affiliation: Division of Hematology, Saitama Medical Center, Jichi Medical University, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Kako
authors.affiliation: Division of Hematology, Saitama Medical Center, Jichi Medical University, Japan.
authors.forename: Aki
authors.initials: A
authors.lastname: Tanihara
authors.affiliation: Division of Hematology, Saitama Medical Center, Jichi Medical University, Japan. Electronic address: ycanda-tky@umin.ac.jp.
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Kanda
mesh_terms: D000328:Adult; D000368:Aged; D016470:Bacteremia / Q000382:microbiology*; D003141:Communicable Diseases / Q000382:microbiology*; D003352:Corynebacterium / Q000302:isolation & purification*; D003354:Corynebacterium Infections / Q000382:microbiology*; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests / Q000379:methods; D008875:Middle Aged; D012307:Risk Factors; D055815:Young Adult
keywords: Bloodstream infection; Corynebacterium striatum; Coryneform bacteria; Hematopoietic stem cell transplantation; Mortality