Non-Toxigenic Corynebacterium Diphtheriæ in a Boarding School

Jephcott, A. E.; Gillespie, E. H.; Davenport, C.; Emerson, Julie; Moroney, P.J.

doi:10.1016/s0140-6736(75)91962-5

Cited by 13 publications

(4 citation statements)

References 5 publications

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“…However, studies in France have found that biotype mitis is more prevalent (Patey et al, 1997), suggesting that our understanding of how biotypes are distributed within the population is lacking. Carriage rates in healthy individuals are poorly studied, with one study indicating that a high proportion of individuals may be asymptomatic carriers (Jephcott et al, 1975) whilst another suggests that asymptomatic carriage is low (Larsson et al, 1987). Such conflicting data make it difficult to determine the importance of carriage and the potential conversion from asymptomatic carriage to disease states.…”

Section: Discussionmentioning

confidence: 99%

Recent cases of non-toxigenic Corynebacterium diphtheriae in Scotland: justification for continued surveillance

Edwards

Hunt

Hoskisson

2011

Journal of Medical Microbiology

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Recent cases of non-toxigenic Corynebacterium diphtheriae in Scotland: justification for continued surveillance In recent years, there has been an increase in incidences of non-toxigenic Corynebacterium diphtheriae causing disease. Non-toxigenic strains generally cause persistent sore throats and severe pharyngitis/tonsillitis although complications of invasive disease such as endocarditis, septic arthritis, splenic abscesses and osteomyelitis are not uncommon (Wilson, 1995; Belko et al., 2000; von Hunolstein et al., 2002). Currently there is an overall lack of information on the prevalence of nontoxigenic C. diphtheriae colonization, prevalence and disease in the population due to a reduction in routine screening for this organism (Wagner et al., 2010). Here we describe three recent cases of non-toxigenic C. diphtheriae infection in Scotland and review the recent cases in the Grampian area.

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Section: Discussionmentioning

confidence: 99%

Recent cases of non-toxigenic Corynebacterium diphtheriae in Scotland: justification for continued surveillance

Edwards

Hunt

Hoskisson

2011

Journal of Medical Microbiology

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“…Differences in the abilities to bind to and to convert Fbn to fibrin may partially explain differences in the extent of pseudomembrane formation by C. diphtheriae strains, including cases of catarrhal diphtheria. Therefore, the data of the present study may also help to explain why nontoxigenic strains may cause pharyngitis (Jephcott et al 1975, Wilson 1995, Rakhmanova et al 1997, Bonnet & Begg 1999.…”

Section: Discussionmentioning

confidence: 63%

“…However, the association of nontoxigenic strains with localized disease and with cases of invasive infection has become recognized, particularly with endocarditis (Gubler et al 1998, Galazka 2000, Mattos-Guaraldi et al 2000, Kanungo et al 2002, Gomes et al 2009). Various authors share the opinion that nontoxigenic strains may be responsible for pharyngitis and should be treated (Jephcott et al 1975, Wilson 1995, Rakhmanova et al 1997, Bonnet & Begg 1999. However, it is also emphasized that additional studies are still required to obtain more complete information on the pathogenicity or copathogenicity of nontoxigenic C. diphtheriae associated with cases of infection in the respiratory tract (Reacher et al 2000, Gomes et al 2009.…”

mentioning

confidence: 99%

Fibrinogen binds to nontoxigenic and toxigenic Corynebacterium diphtheriae strains

Sabbadini

Genovez

Silva

et al. 2010

Mem. Inst. Oswaldo Cruz

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“…1 Infective endocarditis (IE) because of C. diphtheriae was first described by Howard in the Johns Hopkins Hospital Bulletin in 1893 2 with a non-toxigenic organism. Invasive infection with non-toxigenic C. diphtheriae was described infrequently 3,4 following this case but has become more prolific in the literature since the 1980s. Infective endocarditis is the most commonly reported presentation, usually appearing as isolated sporadic cases.…”

Section: Introductionmentioning

confidence: 83%

Non-toxigenic Corynebacterium diphtheriae endocarditis: A cluster of five cases

Lovelock,

du Plessis,

van der Westhuizen

et al. 2024

Southern African Journal of Infectious Diseases

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Background: Classical toxin-mediated respiratory diphtheria has become less common because of widespread effective vaccination globally but invasive disease as a result of non-toxigenic strains of Corynebacterium diphtheriae is not prevented by vaccination and may result in severe disease, including infective endocarditis (IE).Objectives: To describe the outbreak and subsequent investigation of a cluster of five cases of non-toxigenic C. diphtheriae endocarditis.Method: A retrospective observational case series of five cases of non-toxigenic C. diphtheriae endocarditis identified in the rural West Coast district of the Western Cape province of South Africa between May 2021 and June 2021.Results: Non-toxigenic C. diphtheriae IE had an aggressive clinical course with high mortality in this cohort. Only one of five patients survived to hospital discharge. The surviving patient received a prompt diagnosis with early surgical intervention but still had a complicated clinical course. Notably, only one case had a pre-existing risk factor for IE, namely a prosthetic valve. Whole genome sequencing of clinical isolates confirmed that all isolates were of the same novel sequence type of non-toxigenic C. diphtheriae but despite a thorough investigation no epidemiological link was ever found between the cases.Conclusion: Non-toxigenic strains of C. diphtheriae are less well known but may be highly virulent and cause severe invasive disease.Contribution: This is the largest cluster of non-toxigenic C. diphtheriae IE ever described in South Africa and expands the body of literature on this unusual but possibly emerging infection.

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Non-Toxigenic Corynebacterium Diphtheriæ in a Boarding School

Cited by 13 publications

References 5 publications

Recent cases of non-toxigenic Corynebacterium diphtheriae in Scotland: justification for continued surveillance

Recent cases of non-toxigenic Corynebacterium diphtheriae in Scotland: justification for continued surveillance

Fibrinogen binds to nontoxigenic and toxigenic Corynebacterium diphtheriae strains

Non-toxigenic Corynebacterium diphtheriae endocarditis: A cluster of five cases

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