PATIENT-TO-PATIENT SPREAD OF A SINGLE STRAIN OF CORYNEBACTERIUM-STRIATUM CAUSING INFECTIONS IN A SURGICAL INTENSIVE-CARE UNIT

Over a 12-month period, Corynebacterium striatum strains were isolated from clinical specimens from 14 patients admitted to a surgical inten sive care unit. These isolates were identical by morphology and biotyp e and displayed the same antibiogram. Ten isolates were found to be th e sole possible pathogen, These 10 isolates were from six patients, th ree of whom had signs of infection at the time of positive culture, Fu rther typing was performed by random amplification of polymorphic DNA analysis, by which all strains were identical and were found to differ to various degrees from reference strains and from isolates found in clinical samples from other wards, In a case-control study the only in dependent risk factor for acquiring the strain was intubation for long er than 24 h (odds ratio, 20.09; 95% confidence interval, 2.29 to 176. 09). The same strain was isolated from surfaces and from air sampled i n the direct vicinity of infected patients but never from surfaces or air in other places of the ward. The strain was not isolated from the ventilators, The strain was cultured from the hands of personnel atten ding to infected patients, but no long-term carriers were found among members of the hospital personnel, suggesting transient carriage only. We conclude that C. striatum can cause serious nosocomial infections in surgical intensive care unit patients and may spread from patient t o patient via the hands of attending personnel.