The acquired spectra of three out of the five unrelated tested C.?striatum external strains showed a distinct spectrum pattern. All 10 outbreak-related C.?striatum isolates had the same repPCR patterns and had ��97.7% similarity level between each other while the five epidemiologically non-related strains displayed different strain patterns, with similarity levels <97% between each other (Fig.?3). PFGE delineated the 10 C.?striatum patient strains into three distinct PFGE types (Fig.?3). Type A comprised the outbreak-related C.?striatum isolates from patients 1 to 7 and C.?striatum external isolate 5. Type F comprised the C.?striatum isolates from patients 8 and 9. Finally Type H was a singleton only including the C.?striatum patient <a href="http://www.selleckchem.com/products/midostaurin-pkc412.html
">Midostaurin cell line 10 strain. The analysis of the four leftover C.?striatum epidemiologically non related strains led to four singleton PFGE types (B, C, D and G). Over recent years Corynebacteria have been recognized as opportunistic pathogens able to cause various types of healthcare-associated infections in immunocompromised hosts . It is therefore essential for each clinical microbiology laboratory to use techniques that identify correctly and rapidly these bacteria. Identification of Corynebacteria by conventional methods is suboptimal and it is likely that their true prevalence in clinical specimens either as colonizers or as pathogens is largely underestimated. MALDI-TOF MS has proven accuracy for rapid identification of toxigenic Corynebacterium species and non-diphtheria Corynebacterium, including C.?striatum [15-17]. In our setting, the repeated identification of C.?striatum in clinical respiratory samples of several hospitalized PRDX5 MCC950 mouse
patients over a limited period of time raised the suspicion of an ongoing outbreak. While only one C.?striatum isolate had been recovered from a hospitalized patient in the preceding 8-month baseline period, we identified 24 clinical C.?striatum isolates in 10 distinct hospitalized patients over the 8 following months, corresponding to an attack rate of 10 to 1. Following this observation, we established the ��outbreak case definition�� as each hospitalized patient with a clinical sample growing mainly or exclusively C.?striatum colonies. A retrospective investigation of the patients' medical records was carried out to describe the outbreak population. Several risk factors were identified in our patients. The most frequently found underlying co-morbidity in our series was chronic obstructive pulmonary disease for eight of the ten patients. It is very likely that such long-lasting chronic disease along with the frequent use of respiratory equipment did contribute to the respiratory tract colonization and the infectious potential of this organism in immunocompromised patients. Previous exposure to antibiotic treatment observed in eight patients also most likely contributed to the overgrowth of this multidrug-resistant organism through selective pressure.