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Bacillus cereus is a facultative aerobic gram positive bacilli which is abundantly found in air, water and soil. It is usually interpreted as contamination when it is isolated from clinical specimens. Recently, it has been, reported as health-care associated infectious agent (HAIA) in patients with immune deficiency, receiving chemotherapy, with prolonged hospitalization and who had been performed invasive procedures. This case was reported in order to increase the awareness of clinicians for the pathogenicity of Bacillus cereus. Piperacillin-tazobactam was started for noil-neutropenic fever to an 18-month old girl with acute lymphocytic leukemia. Her catheter-drawn blood sample revealed Bacillus cereus growth. Teicoplanin was added to therapy for unremitting fever, since Bacillus species are resistant to penicillin. Echocardiography did not reveal any sign of infective endocarditis. Her catheter was withdrawn since repeated peripheric and catheter drawn blood samples yielded Bacillus cereus growth on alternate days. Her fever dropped after the catheter was withdrawn. In conclusion, it must be remembered that Bacillus cereus can be a HAIA and should not be always interpereted as contamination. Besides, since Bacillus species are resistant to penicilline derivatives, therapy should be held as vancomycine and/or amikacin. [ABSTRACT FROM AUTHOR]

Corynebacterium striatum, is a gram positive bacterium that can cause opportunistic infections in immunocompromised host and it is among the members of the normal flora of skin and mucous membranes, In this case, a 88 years-old Non-Hodgkin lymphoma patient admitted to intensive care unit with pneumonia and bacteriemia due to C. striatum which was isolated from both blood and respiratory specimens sent simultaneously, is presented. Isolates are diagnosed as C. striatum with conventional biochemical tests and VITEK2 automated diagnostic system. Diagnosis is also confirmed by VITEKMS. Isolate was susceptible to vancomycin, teicoplanin, linezolid, erythromycin and gentamicin; resistant to trimethoprim/sulfamethoxazole, ciprofloxacin, ceftriaxone, imipenem, meropenem, tetracycline and penicillin. Initial emperical meropenem treatment subsituted with linezolid and control samples, taken after a week period, were negative for C. striatum. Isolation of coryneform bacteria from clinical samples usually considered as contamination or colonization. In this case presentation, C. striatum, a member of coryneform bacteria, was isolated as causative agent in a patient with immunosupression, prolonged hospital stay and antibiotherapy. We believe effective coordination between laboratory and clinician is much more important in such cases. [ABSTRACT FROM AUTHOR]