Further observations on the types of Corynebacterium diphtheriæ

The Types Mitis, Intermedius and Gravis of Corynebacterium Diphtheriae

“…The existence of these types has been so widely recognized and accepted that it cannot be considered to be any longer in doubt. It has been suggested from time to time, however, (a) that forms diverging from the three chief types described are sufficiently numerous and important in clinical diphtheria to make a wider classification desirable (18,23,24,50,51,105,106,196,202,206).…”

“…Such observations come from northern Germany: Henneberg and Pels Leusden (75) who met only three out of 544 strains which were difficult to classify, and Grossmann (62) who met only five such strains out of 594 (also 26, 64); from Poland (209); from Khartoum (81); from Australia (4, 57, 58); and in England, from Hull (98), from Manchester (150), from Dundee (115), from London (104), and from Liverpool (204), where the most extensive of all recorded investigations of this kind has been carried out. There are a considerable number of observers who while accepting the existence of these types prefer to have them indicated by letters or numbers, as Wright and Christison (202) in England and Hammerschmidt (72) in Germany, who had already (in 1924) described types of the diphtheria bacillus corresponding to mitis, gravis and intermedius in some respects but had not suggested any differences in their pathological significance. This aspect of the question will, however, be more appropriately discussed under the section on the significance of the types.…”

“…This wide survey of the work on the types of diphtheria bacilli reveals one or two points of considerable interest. All over the world observers have for the most part found little difficulty in recognizing these types; but in areas where diphtheria is mild and infrequent there may be a rather large number of irregular or atypical forms as in Edinburgh (202); Stafford (106), Capetown (206), Baltimore (50), and New York City (159); whereas in areas visited by severe and epidemic diphtheria the bacterial types are easily and sharply defined: e.g., Berlin (64), Kharkoff (211), and Leeds (3).…”

Corynebacterium Diphtheriae

“…In no other species of micro6rganisms have colony forms been named according to the quantitative variations in clinical manifestations which they produce, and, from the number of discordant reports, this does not appear to be the most satisfactory basis for nomenclature for the diphtherial species. The inadequacy of the classification is exemplified by the necessity for the creation of sub-groups, as was done by Wright, Christison, Rankin, Pearson, and Cuthbert (1935), and Stuart (1938), who found no correlation between virulence, colony form, and the ability of a strain to ferment starch. It is surprising that earlier students of types gravis and mitis did not attempt to associate the various colony forms with S-R variation, a system of variation and nomenclature which has been found applicable and useful for hundreds of other bacterial species.…”

Polyacrylamide Gel Electrophoresis of Corynebacterium diphtheriae: a Possible Epidemiological Aid

“…Many investigators have established their own serological typing system (4,9,11,15,19,21,23,24). Hewitt (9) described 13 gravis types, 40 mitis types, and 2 distinct intermedius types.…”