Table 1 Laboratory data on admission resistant Staphylococcus aureus (MRSA), Enterococcus faecalis 106 <CFU/ml Fig. 1 Clinical course
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1 Key words: Corynebacterium jeikeium, septicemia
2 Table 1 Laboratory data on admission resistant Staphylococcus aureus (MRSA), Enterococcus faecalis 106 <CFU/ml Fig. 1 Clinical course
3 1529 Corynebacterium jeikeium に よ る敗血 症 の1例 Fig. 2 in The lung colonies tissue and of in C. the iirrloin small were Fig. 3 observed pulmonary Hight form vessels. magnification was of Fig. 2. Typical seen. conryne H. E ~100 キ ノ ロ ン 剤 等 多 剤 に 耐 性 で あ っ た が,MINO, 48時 間 で 非 運 動 性 のGram陽 羊 血 液 寒 天 培 地(好 性 桿 菌 を 認 め た 為, 気 性 培 養)に て 分 離,同 VCMの 考 時 に C. 直 接 薬 剤 感 受 性 検 査 を 実 施 し た 時 が1976年 同 定 はAPI-Coryne(ビ ド: オ メ リ ュ ー)に て,コ (Corynebacterium jeikeium あ り, ID-テ ス ト NF-18(ニ び 従 来 法 の 成 績 もJackmalnら1)が に 一 致 し た.そ 剤 と そ の 他 の 薬 剤9剤 ー 3)は ミ ノ グ リ コ シ ド剤,マ Table 2 来20例 報告 されてお 邦 で は これ ま で に報 告 日本 感 染 症 学 会 総 会(1994年4月) C. jeikeiumに が 男 性,3例 性 に 有 意 で あ っ た.一 歳 で 平 均 は43歳 クタム 方,年 characteristics 齢 的 に は11歳 か ら80 で あ っ た. 基 礎 疾 患 は23例 中20例 ュー が 女 性 で あ り男 of Corynebacterium が 急 性 リ ン パ 性 白血 病 jeikeium a o-nitrophenyl-ƒà-d-galactopyranoside Table 3 Minimum 平成6年12月20日 inhibitory concentration (ƒêg/mi) が本 よ る敗 血 症 例 は 自験 例 を 含 め 男 女 比 で は23例 中20例 β-ラ ク タ ム 剤9 Biochemical に 初 報 告 が あ り,以 邦 で の 初 報 告 と な っ た. 2に 示 し た. ク ロ ラ イ ド剤,ニ 対 し て の 敗 血 症8) 12) に て 報 告 し た 本 例 と 山 口 ら'6)が報 告 し た2例 ッ ス イ)15)及 に つ い て 行 い,β-ラ hostに は な く,第68回 %id= 本 化 学 療 法 学 会 標 準 法)に よ る 薬 剤 感 受 性 検 査(Table 察 よ る 敗 血 症 例 は 欧 米 で はim- り既 に 注 目 さ れ て き た.本 報 告 した性 状 の 主 な 性 状 をTable 微 量 液 体 希 釈 法(日 剤,ア jeikeiumに munocompromised 間 後 真 珠 様 光 沢 を持 っ 微 小 集 落 を形 成 し た. 98.4)で み に は感 受 性 を 示 し た. of Corynebacteraum jeikeium obtained from the patient
4 (acute lymphocytic leukemia), (chronicmyelogenous leukemia) Table 4 Patients with Corynebacteriurn bacteremia A) Chronic myelogenous leukemia B) Acute lymphocytic leukemia C) Acute myelogenous leukemia
5 Corynebacterium jeikeium Chemother., 3: , ) Gerry, J. L. & Greenogh, W. B. III: Diphtheroid endocarditis. Report of nine cases and review of literature. Johns Hopkins Med. J., 139: 61-68, ) Van Scoy, R. E., Cohen, S. N., Geraci, J. E., et al.: Coryneform bacterial endocarditis, Difficulties in diagnosis and treatment, Presentation of three cases, and review of literatire. Mayo Clin. Proc., 52: , ) Murray, B. E., Karchmer, A. W., Moellering, R. C.: Diphtheroid prosthetic valve endocarditis, a study of clinical features and infecting organ- Am. J. Med., 69: , isms ) Hande, K. R., Witebsky, F. G., Levine, A. S., et al.: Sepsis with a new species of Corynebacterium. Ann. Intern. Med., 85: , ) Pearson, T. A., Brain, H. G. & Rathbun, H. K.: Corynebacterium sepsis in oncology patients, predisposing factors, diagnosis and treatment. J. A. M. A., 238: , ) Wirsing von Konig, C. H., Wichmann, S. & Finger, H.: Corynebakterien der JKgruppeals Sepsiserreger. Klin. Wochenschr., 60: , ) Dib, W. L. & von der Lippe, E.: Septisemia in granulocytopenic patients caused by multiresistant diphtheroid rods. Acta Pathol. Microbiol. Immunol. Scand. Sect. B, 92: , ) Guarino, M. J., Qazi, R. & Woll, J. E.: Se- pticemia, rash, and pulmonary infiltrates secondary to Corynebacterium Group JK infection. Am. J. Med., 82: , ) Hoffman, S., Ersgaard, H., Justesen, T., et al.: Fatal meningitis with Group JK for ynebacterium 1) Jackman, P. J. H., Pitcher, D. G., Pelczynska, S., in a leukopenic patient. Eur. J. Clin. Mi- et al.: Classification of corynebacteria associated crobiol., 2: , with endocarditis (Group JK) as Corcrobiol., 14) Yoshitomi, Y., Kohno, S., Koga, H., et al.: ynebacterium jeikeium. sp. nov. Syst. Appi. Fatal pneumonia caused by Corynebacterium Microbiol., 9: 83-90, Group JK after treatment of Staphylococcus 2) Stamm, W. E., Tompkins, L. S., Wagner, K. F., et aureus pneumonia. Internal. Medicine, 31: 930 al.: Infection due to Corynebacterium species 32, in marrow transplant patients. Ann. Intern. Med., 91: , ) Gill, V. J., et al.: Antibiotic-resistant Group JK bacteria in hospitals. J. Clin. Microbiol., 13: , ) Davis, A., Binder, M.J., Burroughs, J. T., et al.: Diphtheroid endocarditis after Cardiopulmonary bypass surgery for the repair of cardiac valvular defects. Antimicrob. Agents 15) Sako, H., Tanaka, M., Watanabe, S., et al.: Application of ID-test NF-18 to identification of the genus Corynebacterium. 35: , Media Circle.,
6 19) Wichmann, S., Wirsing, C. H., Becker-Boost, von Koenig, E.& Finger, H.: Group JK corynebacteria in skin flora of healthy persons and patients. Eur. J. Clin. Microbiol., 4: , A Case of Corynebaeterium jeikeium Septicemia Yoshihito OTSUKA1), Shigehiro KITAMURA2), Takashi ARIMURA3), Shigeki MISAWA4), Toyoko OGURI4) & Kaoru SHIMADA3) Clinical Laboratories, Social Health Insurance Medical Center ) D epartment of Pathology, Social Health Insrurance Medical Center Department of Internal Medicine, Social Health Insurance Medical Center 4) Clinical Laboratories, Juntendo University Hospital We report a case of Corynebacterium jeikeium septicemia associated with malignant lymphoma. The patient is a 58-year-old male who was diagnosed as malignant lymphoma on August May 15, 1993, he was admitted to our hospital because of oliguria, abdominal flatulence and vomiting which developed a few days before admission. Anticancer regimen were started. In the middle of July, white blood cell (WBC) count dropped to 100/mm3 and body temperature rose to 39 Ž. He was been treated with Ceftazidime and Piperacillin. C. jeikeium was recovered from blood culture. Antibiotics were switched to minocycline and vancomycin. He died of septic shock and pneumonia. Autopsy revealed the presence of the colonies of Rods. Which were morphologically compatible with C. jeikeium were observed in lung tissue and in the small pulmonary vessels.
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