Screening for Corynebacterium diphtheriae and Corynebacterium ulcerans in patients with upper respiratory tract infections 2007–2008: a multicentre European study

Abstract

Diphtheria is now rare in most European countries but, when cases do arise, the case fatality rate is high (5-10%). Because few countries continue to routinely screen for the causative organisms of diphtheria, the extent to which they are circulating amongst different European populations is largely unknown. During 2007-2008, ten European countries each screened between 968 and 8551 throat swabs from patients with upper respiratory tract infections. Six toxigenic strains of Corynebacterium diphtheriae were identified: two from symptomatic patients in Latvia (the country with the highest reported incidence of diphtheria in the European Union) and four from Lithuania (two cases, two carriers); the last reported case of diphtheria in Lithuania was in 2002. Carriage rates of non-toxigenic organisms ranged from 0 (Bulgaria, Finland, Greece, Ireland, Italy) to 4.0 per 1000 (95% CI 2.0-7.1) in Turkey. A total of 28 non-toxigenic strains were identified during the study (26 C. diphtheriae, one Corynebacterium ulcerans, one Corynebacterium pseudotuberculosis). The non-toxigenic C. ulcerans strain was isolated from the UK, the country with the highest reported incidence of cases due to C. ulcerans. Of the eleven ribotypes detected, Cluj was seen most frequently in the non-toxigenic isolates and, amongst toxigenic isolates, the major epidemic clone, Sankt-Petersburg, is still in circulation. Isolation of toxigenic C. diphtheriae and non-toxigenic C. diphtheriae and C. ulcerans in highly-vaccinated populations highlights the need to maintain microbiological surveillance, laboratory expertise and an awareness of these organisms amongst public health specialists, microbiologists and clinicians.

Mechanisms of Antibiotic Resistance in Corynebacterium spp. Causing Infections in People

“…It is a large and very diverse group of microorganisms, in which Corynebacterium diphtheriae is the most important species, with the most important human-pathogenic significance (Gomes et al, 2009;Wagner et al, 2011;Wilson, 1995). Strains of this species produce a strong exotoxine and are responsible for causing diphtheria.…”

Multilocus sequence types of invasive Corynebacterium diphtheriae isolated in the Rio de Janeiro urban area, Brazil

“…Although the global incidence of this disease has reduced dramatically as a result of increased vaccine coverage, infections by the different biotypes of C. diphtheriae continue to be reported in many countries [2,3]. Moreover, the emergence in recent years of non-toxigenic strains of this bacterium as causative agents of severe invasive infections in vaccinated and non-vaccinated individuals has raised major concerns [3,4].…”

DNA Sequence Analysis of dtxR Gene (Partial) of Corynebacterium diphtheriae Causing Diphtheria in Jawa and Kalimantan Islands, Indonesia

“…Further analysis using more reliable genotyping method, such as multilocus sequences typing (MLST) and ribotyping should be performed for more sample. (38)(39)(40) Conclusion DNA sequences of partial dtxR genes in this study verify the accuracy of in-house multiplex PCR used to identify the bacteria causing diphtheria. In addition, these results illustrate the genetic diversity of C. diphtheriae strains circulating in Jawa and Kalimantan Islands, Indonesia.…”