Table 1.
Microbiological and clinical findings on patients from whom C. tuberculostearicum was isolated
| Patient no. | Age/sexa | Specimen type | Gram stain (amt)b | Culture (amt)b | Other materials (amt)b | Clinical presentation and underlying disease | Pre-existing antimicrobial therapy | Clinical relevance of C. tuberculostearicume |
|---|---|---|---|---|---|---|---|---|
| 1 | 52/M | Biopsy specimen (chest wall) | Cell debris (++), Gram-positive diplococci (+), Gram-negative rods (+) | C. tuberculostearicum (++), CNSc (+) | C. tuberculostearicum in two other biopsy specimens (++) and one aspirate (++) | Osteomyelitis of chest wall and ribs following polytrauma with multiple rib fractures and empyema with Enterobacter cloacae | Cefepime | Relevant/relevant |
| 2 | 81/M | Bone biopsy specimen (sternum) | Not done | C. tuberculostearicum detected | C. tuberculostearicum detected in VACd sponge and in one bone biopsy specimen from the sternum | Deep sternal wound infection with osteomyelitis 3 weeks after aortocoronary bypass operation | None | Relevant/relevant |
| 3 | 63/M | Urine from extended-dwell catheter | Not done | C. tuberculostearicum 105 CFU/ml | No other materials analyzed | Persistent fever without clinical focus 3 weeks after meningoencephalitis with Streptococcus pneumoniae | Meropenem, ceftriaxone | Not considered relevant/relevant |
| 4 | 64/M | Biopsy specimen (wound) | Erythrocytes (++), cell debris (+), no bacteria | C. tuberculostearicum (++), CNSc (++) | C. tuberculostearicum in two other biopsy specimens (+ and ++) together with CNSc (+ and ++, respectively) | Superinfection of sternum and sternoclavicular joint after Staphylococcus aureus sepsis with infective endocarditis of mitral valve and septic sternoclavicular arthritis | Flucloxacillin, penicillin | Relevant/relevant |
| 5 | 43/F | Biopsy specimen (pericostal) | Erythrocytes (+++), cell debris (++), no bacteria | C. tuberculostearicum (+++) | C. tuberculostearicum in two other biopsy specimens (+), pleura aspirate (++), and bone biopsy specimen (detected) | Superinfection of empyema of chest wall after pneumococcal pneumonia and recurrent empyema with detection of Aspergillus fumigatus | Piperacillin-tazobactam, voriconazole | Relevant/relevant |
| 6 | 75/M | Deep-wound swab (sternum) | Leukocytes (+), cell debris (+), Gram-positive cocci (+), Gram-positive coryneform rods (++) | C. tuberculostearicum (+++) | No other materials analyzed | Persistent secretion of sternal wound in patient treated until recently for deep sternal wound infection with coagulase-negative staphylococci after aortocoronary bypass and mitral valve replacement | None | Not considered relevant/relevant |
| 7 | 61/F | Aspirate (abdomen) | Not known | C. tuberculostearicum (from enrichment broth), Candida albicans (quantity not known) | Not known | Perforated gastric ulcer with polymicrobial peritonitis and sepsis with Candida albicans | Not known | Not considered relevant/not considered relevant |
| 8 | 72/M | Hematoma aspirate (knee) | Not known | C. tuberculostearicum from enrichment broth, Staphylococcus epidermidis (quantity not known) | Not known | Infected hematoma and wound healing disorder following total knee prosthesis | Not known | Not considered relevant/not considered relevant |
| 9 | 18/F | Biopsy specimen (toe tissue) | Cell debris (+), epithelial cells (+), Gram-positive cocci (+) | C. tuberculostearicum (+) | No other materials with C. tuberculostearicum | Not known | Not known | Not known |
| 10 | 50/F | Biopsy specimen (phalanx) | Cell debris (+), no bacteria | C. tuberculostearicum (+), CNSc (++) | No other materials with C. tuberculostearicum | Pseudoarthrosis 7 months after a fracture of proximal phalanx IV of left foot with posttraumatic plegia of the foot | None | Possibly relevant/possibly relevant |
| 11 | 47/F | Deep-wound swab (abdomen) | Leukocytes (++), erythrocytes (++), no bacteria | C. tuberculostearicum (+), Klebsiella pneumoniae (from enrichment broth) | No other materials analyzed | Tertiary peritonitis after septic shock due to abdominal perforation and peritonitis with Clostridium perfringens, Klebsiella pneumoniae, and Escherichia coli following resection of sigma cancer | Imipenem, amoxicillin-clavulanic acid | Not considered relevant/possibly relevant |
| 12 | 32/M | Wound swab (genital ulcus) | Epithelial cells (+), cell debris (+), Gram-positive cocci (+) | C. tuberculostearicum (++), Staphylococcus epidermidis (++) | No other materials analyzed | Recurrent genital ulcerations | Not known | Not known |
| 13 | 24/M | Urethral swab | Leukocytes (+), cell debris (+), Gram-positive cocci (+) | C. tuberculostearicum (++), Corynebacterium glucuronolyticum (++), Ureaplasma urealyticum (+) | No other materials analyzed | Urethritis caused by Chlamydia trachomatis | Not known | Not considered relevant/not considered relevant |
| 14 | 72/M | Bone biopsy specimen (fibula) | Not done | C. tuberculostearicum detected, Micrococcus group detected | No other materials with C. tuberculostearicum | Diabetes mellitus with Charcot foot deformation and chronic polymicrobial osteomyelitis with Staphylococcus aureus, Enterobacter cloacae, Pseudomonas aeruginosa, Streptococcus agalactiae, Enterococcus faecalis, Achromobacter xylosoxidans | Ciprofloxacin, trimethoprim-sulfamethoxazole, amoxicillin | Not considered relevant/not considered relevant |
| 15 | 67/F | Midstream urine | Not done | C. tuberculostearicum at 104 CFU/ml | C. tuberculostearicum at 104 CFU/ml in urine sample together with yeast at 103 CFU/ml | Febrile episode without clinical focus in patient treated with chemotherapy and antibiotics for poststenotic pneumonia due to small cell lung cancer | Piperacillin-tazobactam, amoxicillin-clavulanic acid | Not considered relevant/relevant |
| 16 | 54/F | Aspirate (pleura) | Leukocytes (+), erythrocytes (+++), no bacteria | C. tuberculostearicum (++) | C. tuberculostearicum in one aspirate from pleura (+) and one pleura biopsy specimen (+) | Superinfection of empyema with Streptococcus pneumoniae 2 weeks after initial operation | Piperacillin-tazobactam, vancomycin | Relevant/relevant |
| 17 | 75/M | Deep-wound swab (pericardium) | Leukocytes (++), erythrocytes (++), no bacteria | C. tuberculostearicum (+) | C. tuberculostearicum in two other biopsy specimens from pleura and sternum (+ and ++) and deep-wound swab from sternum (+) | Complicated course after aortic valve replacement with prolonged duration of heart-lung machine, multiple operative revisions, extracorporeal membrane oxygenation | Piperacillin-tazobactam | Relevant/relevant |
| 18 | 51/M | Biopsy specimen (rib cartilage) | Leukocytes (+), erythrocytes (+), no bacteria | C. tuberculostearicum (++) | C. tuberculostearicum in five other biopsy specimens from thorax (+) | Osteomyelitis of chest wall and ribs following empyema with unknown pathogen 1 month after pneumonectomy for non-small-cell lung cancer | Piperacillin-tazobactam | Relevant/relevant |
a
M, male; F, female.
b
Amounts: +, detached; ++, moderate; +++, numerous. CFU, colony-forming units.
c
CNS, coagulase-negative staphylococci.
d
VAC, vacuum-assisted closure.
e
CDC criteria/criteria of Funke and Bernard.