Targeted Antibiotics for Lower Respiratory Tract Infection with Corynebacterium striatum

Abstract

Huan Zhang,1,2 Xiaojiao Tan,1 Zhen Zhang,1 Xuewei Yang,1 Lijie Wang,1 Meiqian Li,1 Dan Shi,1 Yao Li,1 Jianbo Li,1 Zhen Li,3 Xuelian Liao1,4 1Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, People’s Republic of China; 2Department of Critical Care Medicine, The Third People’s Hospital of Chengdu, Chengdu, People’s Republic of China; 3Clinical Research Unit, First Maternity and Infant Hospital of Shanghai, Shanghai, People’s Republic of China; 4Department of Critical Care Medicine, West China Tianfu Hospital of Sichuan University, Chengdu, People’s Republic of ChinaCorrespondence: Xuelian Liao, Department of Critical Care Medicine, West China Hospital, Sichuan University, No. 37, Guoxue Lane, Wuhou district, Chengdu, People’s Republic of China, Tel [phone], Email [email protected]: To assess the impact of targeted antibiotic therapy on clinical outcomes of patients with lower respiratory tract (LRT) infection with Corynebacterium striatum (C. striatum).Methods: A new propensity score-inverse probability of treatment weighting (IPTW) cohort study was conducted by using 10-year data. The study included LRT infection patients with respiratory secretions cultured positive for C. striatum simultaneously. The primary outcome was all-cause hospital mortality; the secondary outcomes included hospital stay, ICU stay and ventilation time. The safety outcomes were drug-related serum creatinine (Cr) increase and thrombocytopenia.Results: A total of 339 patients were included in the cohort, and 84 (24.78%) initiated vancomycin or linezolid therapy. In the new IPTW cohort, targeted antibiotic therapy did not improve all-cause hospital mortality (P=0.632), and the OR (95% CI) was 0.879 (0.519– 1.488). Moreover, targeted antibiotic therapy was not associated with hospital stay (P=0.415), ICU stay (P=0.945) or ventilation time (P=0.885). The side effects of drug-related higher serum Cr (P=0.044) and thrombocytopenic levels (P=0.038) cannot be ignored.Conclusion: Clinical benefits by vancomycin or linezolid targeted against LRT infection with C. striatum were limited and with drug-related side effects. A prospectively designed study is needed to further confirm the results.Keywords: Corynebacterium striatum, lower respiratory tract infection, vancomycin, linezolid, all-cause mortality

Keywords

• corynebacteritum striatum
• lower respiratory tract infection
• vancomycin
• linezolid
• all-cause mortality.