as an emerging pathogen in nephrostomy catheter-related infection: evaluation of traits associated with bacterial virulence Free

Abstract

still represents a global medical challenge, particularly due to the significant number of individuals susceptible to diphtheria and the emergence of non-toxigenic strains as the causative agents of invasive infections. In this study, we characterized the clinical and microbiological features of what we believe to be the first case of infection of a percutaneous nephrostomy catheter insertion site in an elderly patient with a fatal bladder cancer. Moreover, we demonstrated the potential role of adherence, biofilm formation and fibrin deposition traits in from the catheter-related infection. Non-toxigenic isolated from the purulent discharge (named strain BR-CAT5003748) was identified by the API Coryne system (code 1 010 324) and a multiplex PCR for detection of and genes. Strain BR-CAT5003748 showed resistance to oxacillin, ceftazidime and ciprofloxacin. In experiments performed , the catheter isolate was classified as moderately hydrophobic and as moderately adherent to polystyrene surfaces. Glass provided a more effective surface for biofilm formation than polystyrene. Micro-organisms adhered to (>1.5×10 c.f.u.) and multiplied on surfaces of polyurethane catheters. Microcolony formation (a hallmark of biofilm formation) and amorphous accretions were observed by scanning electron microscopy on both external and luminal catheter surfaces. Micro-organisms yielded simultaneous expression of localized adherence-like and aggregative-like (LAL/AAL) adherence patterns to HEp-2 cells. Interestingly, the coagulase tube test resulted in the formation of a thin layer of fibrin embedded in rabbit plasma by the non-toxigenic BR-CAT5003748 strain. In conclusion, should be recognized as a potential cause of catheter-related infections in at-risk populations such as elderly and cancer patients. LAL/AAL strains may be associated with virulence traits that enable to effectively produce biofilms on catheter surfaces. Biofilm formation and fibrin deposition could have contributed to the persistence of at the infected insertion site and the obstruction of the nephrostomy catheter.

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2009-11-01
2024-03-29
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References

  1. Aranha H., Strachan R. C., Arceneaux J. E. L., Byers B. R. 1982; Effect of trace metals on growth of Streptococcus mutans in a teflon chemostat. Infect Immun 35:456–460
    [Google Scholar]
  2. Bousquet-Rouaud R., Castex F., Costalat G., Bastide M., Hedon B., Bouanani M., Jouvert S., Mirouze J. 1993; Factors involved in catheter obstruction during long-term peritoneal insulin infusion. Diabetes Care 16:801–805 [CrossRef]
    [Google Scholar]
  3. Bouzari S., Jafari A., Farhoudi-Moghaddam A. A., Shokouhi F., Parsi M. 1994; Adherence of non-enteropathogenic Escherichia coli to HeLa cells. J Med Microbiol 40:95–97 [CrossRef]
    [Google Scholar]
  4. Cavendish J., Cole J. B., Ohl C. A. 1994; Polymicrobial central venous catheter sepsis involving a multiantibiotic-resistant strain of Corynebacterium minutissimum . Clin Infect Dis 19:204–205 [CrossRef]
    [Google Scholar]
  5. Chan R., Lam J. S., Lam K., Costerton J. W. 1984; Influence of culture conditions on expression of the mucoid mode of growth of Pseudomonas aeruginosa . J Clin Microbiol 19:8–16
    [Google Scholar]
  6. Christensen G. D., Simpson W. A., Bisno A. L., Beachey E. H. 1982; Adherence of slime-producing strains of Staphylococcus epidermidis to smooth surfaces. Infect Immun 37:318–326
    [Google Scholar]
  7. Christensen G. D., Parisi J. T., Bisno A. L., Simpson W. A., Beachey E. H. 1983; Characterization of clinically significant strains of coagulase-negative staphylococci. J Clin Microbiol 18:258–269
    [Google Scholar]
  8. CLSI 2007 Methods for Antimicrobial Dilution and Disk Susceptibility Testing of Infrequently Isolated or Fastidious Bacteria , pp. 4–6. Approved Guideline. CLSI document M45-A Wayne, PA: Clinical and Laboratory Standards Institute;
    [Google Scholar]
  9. Costerton J. W., Stewart P. S., Greenberg E. P. 1999; Bacterial biofilms: a common cause of persistent infections. Science 284:1318–1322 [CrossRef]
    [Google Scholar]
  10. Dalal A., Likhi R. 2008; Corynebacterium minutissimum bacteremia and meningitis: a case report and review of literature. J Infect 56:77–79 [CrossRef]
    [Google Scholar]
  11. Dobler G., Braveny I. 2003; Highly resistant Corynebacterium macginleyi as cause of intravenous catheter-related infection. Eur J Clin Microbiol Infect Dis 22:72–73
    [Google Scholar]
  12. Donlan R. M. 2001; Biofilms and device-associated infections. Emerg Infect Dis 7:277–281 [CrossRef]
    [Google Scholar]
  13. Dooley D. P., Garcia A., Kelly J. W., Longfield R. N., Harrison L. 1996; Validation of catheter semiquantitative culture technique for non staphylococcal organisms. J Clin Microbiol 34:409–412
    [Google Scholar]
  14. Efstratiou A., George R. C. 1999; Laboratory guidelines for the diagnosis of infections caused by Corynebacterium diphtheriae and Corynebacterium ulcerans . Commun Dis Public Health 2:250–257
    [Google Scholar]
  15. Elting L. S., Bodey G. P., Fainstein V. 1986; Polymicrobial septicemia in the cancer patient. Medicine 65:218–225
    [Google Scholar]
  16. Esteban J., Nieto E., Calvo R., Fernandez-Robals R., Valero-Guillen P. L., Soriano F. 1999; Microbiological characterization and clinical significance of Corynebacterium amycolatum strains. Eur J Clin Microbiol Infect Dis 18:518–521 [CrossRef]
    [Google Scholar]
  17. Farley M. M. 2001; Group B streptococcal disease in nonpregnant adults. Clin Infect Dis 33:556–561 [CrossRef]
    [Google Scholar]
  18. Franson T. R., Sheth N. K., Rose H. D., Sohnle P. G. 1984; Scanning electron microscopy of bacteria adherent to intravascular catheters. J Clin Microbiol 20:500–505
    [Google Scholar]
  19. Funke G., Bernard A. K. 2007; Coryneform Gram-positive rods. In Manual of Clinical Microbiology pp 485–514 Edited by Murray P. R., Baron E. J., Pfaller M. A., Jorgensen J. H., Yolken R. H. Washington, DC: American Society for Microbiology;
    [Google Scholar]
  20. Hirata R. Jr, Souza S. M., Rocha-de-Souza C. M., Andrade A. F., Monteiro-Leal L. H., Formiga L. C., Mattos-Guaraldi A. L. 2004; Patterns of adherence to HEp-2 cells and actin polymerisation by toxigenic Corynebacterium diphtheriae strains. Microb Pathog 36:125–130 [CrossRef]
    [Google Scholar]
  21. Hirata R. Jr, Pereira G. A., Filardy A. A., Gomes D. L. R., Damasco P. V., Rosa A. C. P., Nagao P. E., Pimenta F. P., Mattos-Guaraldi A. L. 2008; Potential pathogenic role of aggregative adhering Corynebacterium diphtheriae of different clonal groups in endocarditis. Braz J Med Biol Res 41:986–991 [CrossRef]
    [Google Scholar]
  22. Klastersky J., Aoun M. 2004; Opportunistic infections in patients with cancer. Ann Oncol 15:iv329–iv335
    [Google Scholar]
  23. Kwaszewska A. K., Brewczynska A., Szewczyk E. M. 2006; Hydrophobicity and biofilm formation of lipophilic skin corynebacteria. Pol J Microbiol 55:189–193 [CrossRef]
    [Google Scholar]
  24. Lee P. P., Ferguson D. A. Jr, Sarubbi F. A. 2005; Corynebacterium striatum : an underappreciated community and nosocomial pathogen. J Infect 50:338–343 [CrossRef]
    [Google Scholar]
  25. Maki D. G., Weise C. E., Sarafin H. W. 1977; A semi-quantitative culture method for identifying intravenous-catheter-related infection. N Engl J Med 296:1305–1309 [CrossRef]
    [Google Scholar]
  26. Marrie T. J., Costerton J. W. 1984; Scanning and transmission electron microscopy of in situ bacterial colonization of intravenous and intra-arterial catheters. J Clin Microbiol 19:687–693
    [Google Scholar]
  27. Mattos-Guaraldi A. L., Formiga L. C. D. 1991; Relationship of biotype and source to the hemagglutination and adhesive properties of Corynebacterium diphtheriae . Braz J Med Biol Res 24:399–406
    [Google Scholar]
  28. Mattos-Guaraldi A. L., Formiga L. C. D. 1998; Bacteriological properties of a sucrose-fermenting Corynebacterium diphtheriae strain isolated from a case of endocarditis. Curr Microbiol 37:156–158 [CrossRef]
    [Google Scholar]
  29. Mattos-Guaraldi A. L., Cappelli E. A., Previato J. O., Formiga L. C. D., Andrade A. F. B. 1999a; Characterization of surface saccharides in two Corynebacterium diphtheriae strains. FEMS Microbiol Lett 170:159–166 [CrossRef]
    [Google Scholar]
  30. Mattos-Guaraldi A. L., Formiga L. C. D., Andrade A. F. B. 1999b; Cell surface hydrophobicity of sucrose fermenting and nonfermenting Corynebacterium diphtheriae strains evaluated by different methods. Curr Microbiol 38:37–42 [CrossRef]
    [Google Scholar]
  31. Mattos-Guaraldi A. L., Formiga L. C. D., Camello T. C. F., Pereira G. A., Hirata R. Jr, Halpern M. 2001; Corynebacterium diphtheriae threats in cancer patients. Rev Argent Microbiol 33:96–100
    [Google Scholar]
  32. Mohamed J. A., Huang D. B., Jiang Z. D., DuPont H. L., Nataro J. P., Belkind-Gerson J., Okhuysen P. C. 2007; Association of putative enteroaggregative Escherichia coli virulence genes and biofilm production in isolates from travelers to developing countries. J Clin Microbiol 45:121–126 [CrossRef]
    [Google Scholar]
  33. Moreira L. de O., Andrade A. F. B., Vale M. D., Souza S. M. S., Hirata R. Jr, Asad L. M. O. B., Asad N. R., Monteiro-Leal L. H., Previato J. O., Mattos-Guaraldi A. L. 2003; Effects of iron limitation on adherence and cell surface carbohydrates of Corynebacterium diphtheriae strains. Appl Environ Microbiol 69:5907–5913 [CrossRef]
    [Google Scholar]
  34. Olson M. E., Ceri H., Morck D. W., Buret A. G., Read R. R. 2002; Biofilm bacteria: formation and comparative susceptibility to antibiotics. Can J Vet Res 66:86–92
    [Google Scholar]
  35. O'Toole G., Kaplan H. B., Kolter R. 2000; Biofilm formation as microbial development. Annu Rev Microbiol 54:49–79 [CrossRef]
    [Google Scholar]
  36. Oudiz R. J., Widlitz A., Beckmann X. J., Camanga D., Alfie J., Brundage B. H., Barst R. J. 2004; Micrococcus-associated central venous catheter infection in patients with pulmonary arterial hypertension. Chest 126:90–94 [CrossRef]
    [Google Scholar]
  37. Pereira G. A., Pimenta F. P., Santos F. R., Damasco P. V., Hirata R. Jr, Mattos-Guaraldi A. L. 2008; Antimicrobial resistance among Brazilian Corynebacterium diphtheriae strains. Mem Inst Oswaldo Cruz 103:507–510 [CrossRef]
    [Google Scholar]
  38. Pimenta F. P., Hirata R. Jr, Rosa A. C. P., Milagres L. G., Mattos-Guaraldi A. L. 2008a; A multiplex PCR assay for simultaneous detection of Corynebacterium diphtheriae and differentiation between non-toxigenic and toxigenic isolates. J Med Microbiol 57:1438–1439 [CrossRef]
    [Google Scholar]
  39. Pimenta F. P., Souza M. C., Pereira G. A., Hirata R. Jr, Camello T. C. F., Mattos-Guaraldi A. L. 2008b; DNase test as a novel approach for the routine screening of Corynebacterium diphtheriae . Lett Appl Microbiol 46:307–311 [CrossRef]
    [Google Scholar]
  40. Polotsky Y., Nataro J. P., Kotler D., Barrett T. J., Orenstein J. M. 1997; HEp-2 cell adherence patterns, serotyping, and DNA analysis of Escherichia coli isolates from eight patients with AIDS and chronic diarrhea. J Clin Microbiol 35:1952–1958
    [Google Scholar]
  41. Rao R. S., Karthika R. U., Singh S. P., Shashikala P., Kanungo R., Jayachandran S., Prashanth K. 2008; Correlation between biofilm production and multiple drug resistance in imipenem resistant clinical isolates of Acinetobacter baumannii . Indian J Med Microbiol 26:333–337 [CrossRef]
    [Google Scholar]
  42. Rigdon R. H. 1970; Hemolysis associated with plastics – a histopathologic study with polyurethane. J Biomed Mater Res 4:57–71 [CrossRef]
    [Google Scholar]
  43. Rolston K. V. I., Bodey G. P., Safdar A. 2007; Polymicrobial infection in patients with cancer: an underappreciated and underreported entity. Clin Infect Dis 45:228–233 [CrossRef]
    [Google Scholar]
  44. Rosenberg M. 1981; Bacterial adherence to polystyrene: a replica method of screening for bacterial hydrophobicity. Appl Environ Microbiol 42:375–377
    [Google Scholar]
  45. Scaletsky I. C., Pedroso M. Z., Oliva C. A., Carvalho R. L., Morais M. B., Fagundes-Neto U. A. 1999; Localized adherence-like pattern as a second pattern of adherence of classic enteropathogenic Escherichia coli to HEp-2 cells that is associated with infantile diarrhea. Infect Immun 67:3410–3415
    [Google Scholar]
  46. Schiffl H., Mucke C., Lang S. M. 2004; Exit-site infections by non-diphtheria corynebacteria in CAPD. Perit Dial Int 24:454–459
    [Google Scholar]
  47. Silva De Souza S. M., Hirata R. Jr, Moreira L. O., Gomes M. L., Braga De Andrade A. F., Bernardo-Filho M., Mattos-Guaraldi A. L. 2003; Influence of stannous chloride on the adhesive properties of Corynebacterium diphtheriae strains. Int J Mol Med 12:657–661
    [Google Scholar]
  48. Soriano F., Ponte C., Galiano M. J. 1993; Adherence of Corynebacterium urealyticum (CDC group D2) and Corynebacterium jeikeium to intravascular and urinary catheters. Eur J Clin Microbiol Infect Dis 12:453–456 [CrossRef]
    [Google Scholar]
  49. Soriano F., Huelves L., Naves P., Rodriguez-Cerrato V., Del Prado G., Ruiz V., Ponte C. 2008; In vitro activity of ciprofloxacin, moxifloxacin, vancomycin and erythromycin against planktonic and biofilm forms of Corynebacterium urealyticum . J Antimicrob Chemother 63:353–356 [CrossRef]
    [Google Scholar]
  50. Stepanovic S., Vukovic D., Davic I., Savic B., Svabic-Vlahovic M. 2000; A modified microtiter-plate test for quantification of staphylococcal biofilm formation. J Microbiol Methods 40:175–179 [CrossRef]
    [Google Scholar]
  51. Stewart P. S., Costerton J. W. 2001; Antibiotic resistance of bacteria in biofilms. Lancet 358:135–138 [CrossRef]
    [Google Scholar]
  52. Suzuki T., Lihara H., Uno T., Hara Y., Ohkusu K., Hata H., Shudo M., Ohashi Y. 2007; Suture-related keratitis caused by Corynebacterium macginleyi . J Clin Microbiol 45:3833–3836 [CrossRef]
    [Google Scholar]
  53. Teixido J., Arias N., Tarrats L., Romero R. 2007; The microbial pattern of the catheter exit-site infection in peritoneal dialysis: a non-diphtheria corynebacteria emergence?. Nefrologia 27:350–358
    [Google Scholar]
  54. Wakimoto N., Nishi J., Sheikh J., Nataro J. P., Sarantuya J., Iwashita M., Manago K., Tokuda K., Yoshinaga M., Kawano Y. 2004; Quantitative biofilm assay using a microtiter plate to screen for enteroaggregative Escherichia coli . Am J Trop Med Hyg 71:687–690
    [Google Scholar]
  55. Wang C. C., Mattson D., Wald A. 2001; Corynebacterium jeikeium bacteremia in bone marrow transplant patients with Hickman catheters. Bone Marrow Transplant 27:445–449 [CrossRef]
    [Google Scholar]
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