INFECTION DUE TO CORYNEBACTERIUM SPECIES IN MARROW TRANSPLANT PATIENTS

A Corynebacterium species consistently resistant to all antibiotic therapy except vancomycin caused bacteremia in 32 of 284 (11%) marrow transplant patients. Twenty-one patients had colonization or infection before bacteremia. Twenty-six of the 32 patients were males, and males older than 16 years were infected significantly more often than females over 16, or than all patients under 16. A case-control study showed that infected patients had greater exposure to antibiotics; more often had failure of engraftment and persistent granulocytopenia; were in laminar air-flow rooms less often; and had greater inhospital mortality. Cultural surveillance showed that 17 of 42 marrow transplant patients were colonized with Corynebacterium species. Likelihood of colonization appeared related to age, sex, and duration of hospitalization. Prevalence of colonization in other populations was 1% in nonhospitalized healthy adults and 13% in adults in a general hospital. Corynebacterium species infections occur primarily in adult males with granulocytopenia, mucocutaneous defects, and receiving intensive antibiotic therapy.