Corynebacterium striatum: An unusual pathogen of nosocomial meningitis

Özet

Elli beş yaşındaki kadın hasta subaraknoidal kanama nedeniyle acil servise başvurdu. Hastaya eksternal ventriküler drenaj takıldı. İki gün sonra hastada Acinetobacter baumannii menenjiti gelişti. Kolistin temin edilemediği için intravenöz tigesiklin (200 mg/gün) ve intratekal netilmisin (9 mg/gün) verildi. Kolistin 10 gün sonra başlanabildi. Kolistin intravenöz (240 mg/gün) ve intratekal (10 mg/gün) olarak, intratekal netilmisin ile birlikte verildi ve tigesiklin kesildi. Eksternal ventriküler drenajdan tekrarlayan işlemler sonrası, hastada Corynebacterium striatum menenjiti gelişti. Vankomisin (2 g/gün) ve intratekal gentamisin (8 mg/gün) tedavisi başlandı. Ancak hasta bu tedavinin ikinci günü kaybedildi.

Abstract

A 55-year-old woman was admitted due to subarachnoidal hemorrhage, and external ventricular drainage catheter was inserted. Two days after the procedure, carbapenem-resistant Acinetobacter baumannii meningitis developed. After 10 days of treatment with intravenous tigecycline (200 mg/day) and intrathecal netilmicin (9 mg/day), colistin was obtained, and the antimicrobial therapy was changed to intravenous and intrathecal colistin, together with intrathecal netilmicin; tigecycline was stopped. Cerebrospinal fluid sterility could not be achieved under this therapy, and after repeated manipulation of the external ventricular drainage catheter, Corynebacterium striatum was isolated from two cultures of cerebrospinal fluid, which were performed on consecutive days. Vancomycin (2 g/day) and intrathecal gentamicin (8 mg/day) were initiated; however, the patient died on the second day of this therapy.