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Khalid Z, Shamim A, Saadh MJ, Alafnan A, Alaraj M, Butt MH, Ashraf T. Identification of potential inhibitors against Corynebacterium diphtheriae MtrA response regulator protein; an in-silico drug discovery approach. J Mol Graph Model 2024; 133:108858. [PMID: 39232488 DOI: 10.1016/j.jmgm.2024.108858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 08/02/2024] [Accepted: 08/28/2024] [Indexed: 09/06/2024]
Abstract
Corynebacterium diphtheriae is a multi-drug resistant bacteria responsible for the life-threatening respiratory illness, diphtheria which can lead to severe Nervous system disorders, mainly infecting the lungs, heart, and kidneys if left untreated. In the current study, Corynebacterium diphtheriae MtrA response regulator protein was targeted, which regulates a two-component system of bacterial pathogenesis, and initiates DNA replication and cell division. In the current study a computational approach have been described for drug development against C. diphtheriae infections by inhibiting MtrA protein by small molecules acting as potential inhibitors against it. Molecular docking analysis of the equilibrated MtrA protein revealed compound-0.2970, compound-0.3029, and compound-0.3016 from Asinex Library as the promising inhibitors based on their lowest binding energies (-9.8 kJ/mol, -9.2 kJ/mol, and -8.9 kJ/mol), highest gold scores (40.53, 47.41, and 48.41), drug-likeness and pharmacokinetic properties. The MD simulation studies of the identified top-ranked inhibitors at 100 ns elucidated the system stability and fluctuations in the binding pocket of MtrA protein. Molecular Dynamics Simulations of the top three docked complexes further revealed that the standard binding pocket was retained ensuring the system stability. The rearrangements of H-bonds, van der Waals, pi-pi, and solid hydrophobic interactions were also observed. The binding free energy calculations (MM/PBSA and MM/GBSA) suggested a fundamental binding capability of the ligand to the target receptor MtrA. Therefore, the current study has provided excellent candidates acting as potent inhibitors for developing therapeutic drugs against C. diphtheriae infections. However, in vivo and in vitro animal experiments and accurate clinical trials are needed to validate the potential inhibitory effect of these compounds.
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Affiliation(s)
- Zunera Khalid
- School of Life Sciences, University of Science and Technology of China, Hefei, Anhui, China.
| | - Amen Shamim
- Department of Computer Science, University of Agriculture Faisalabad, Pakistan; Manchester Institute of Biotechnology, University of Manchester, Manchester, United Kingdom
| | | | - Ahmed Alafnan
- Department of Pharmacology and Toxicology, College of Pharmacy, University of Hail, Hail, Saudi Arabia
| | - Mohd Alaraj
- Faculty of Pharmacy, Jerash Private University, Jerash, Jordan
| | | | - Tehreem Ashraf
- National Center for Bioinformatics, Quaid-i-Azam University, Islamabad, Pakistan
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2
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Garrigos T, Grimal A, Badell E, Traversier N, Picot S, Lignereux A, Ramiandrisoa M, Ben Cimon C, Jaffar-Bandjee MC, Gbaguidi-Haore H, Toubiana J, Brisse S, Miltgen G, Belmonte O. Emerging Corynebacterium diphtheriae Species Complex Infections, Réunion Island, France, 2015-2020. Emerg Infect Dis 2023; 29:1630-1633. [PMID: 37486209 PMCID: PMC10370861 DOI: 10.3201/eid2908.230106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2023] Open
Abstract
Clinical, epidemiologic, and microbiologic analyses revealed emergence of 26 cases of Corynebacterium diphtheriae species complex infections on Réunion Island, France, during 2015-2020. Isolates were genetically diverse, indicating circulation and local transmission of several diphtheria sublineages. Clinicians should remain aware of the risk for diphtheria and improve diagnostic methods and patient management.
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Wołkowicz T, Zacharczuk K, Zasada AA. Genomic Analysis of Corynebacterium diphtheriae Strains Isolated in the Years 2007-2022 with a Report on the Identification of the First Non-Toxigenic tox Gene-Bearing Strain in Poland. Int J Mol Sci 2023; 24:ijms24054612. [PMID: 36902043 PMCID: PMC10003741 DOI: 10.3390/ijms24054612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/17/2023] [Accepted: 02/21/2023] [Indexed: 03/03/2023] Open
Abstract
Infections caused by non-toxigenic Corynebacterium diphtheriae have been reported every year in Poland since 2004, with the ST8 biovar gravis strains being most commonly isolated. This study analyzed thirty strains isolated between 2017 and 2022 and six previously isolated strains. All the strains were characterized using classic methods in terms of species, biovar level, and diphtheria toxin production, as well as by means of whole genome sequencing. The phylogenetic relationship based on SNP analysis was determined. The number of C. diphtheriae infections has been rising in Poland every year with a maximum of 22 cases in the year 2019. Since 2022, only the non-toxigenic gravis ST8 (most common) and mitis ST439 (less common) strains have been isolated. An analysis of the genomes of the ST8 strains showed that they had many potential virulence factors, such as adhesins and iron-uptake systems. The situation rapidly changed in 2022 and strains from different STs were isolated (ST32, 40, and 819). The ST40 biovar mitis strain was found to be non-toxigenic tox gene-bearing (NTTB), with the tox gene inactivated due to a single nucleotide deletion. Such strains were previously isolated in Belarus. The sudden appearance of new C. diphtheriae strains with different STs and the isolation of the first NTTB strain in Poland indicate that C. diphtheriae should be classified as a pathogen of special public health concern.
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Affiliation(s)
- Tomasz Wołkowicz
- Department of Bacteriology and Biocontamination Control, National Institute of Public Health NIH—National Research Institute, 24 Chocimska Str., 00-791 Warsaw, Poland
- Correspondence:
| | - Katarzyna Zacharczuk
- Department of Bacteriology and Biocontamination Control, National Institute of Public Health NIH—National Research Institute, 24 Chocimska Str., 00-791 Warsaw, Poland
| | - Aleksandra Anna Zasada
- Department of Sera and Vaccines Evaluation, National Institute of Public Health NIH—National Research Institute, 24 Chocimska Str., 00-791 Warsaw, Poland
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Prygiel M, Polak M, Mosiej E, Wdowiak K, Formińska K, Zasada AA. New Corynebacterium Species with the Potential to Produce Diphtheria Toxin. Pathogens 2022; 11:1264. [PMID: 36365015 PMCID: PMC9693595 DOI: 10.3390/pathogens11111264] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 10/20/2022] [Accepted: 10/27/2022] [Indexed: 07/30/2023] Open
Abstract
Only three Corynebacterium species are known to produce a lethal exotoxin called diphtheria toxin. These are C. diphtheriae, C. ulcerans and C. pseudotuberculosis. The diphtheria toxin gene (tox) is carried in a family of closely related corynebacteriophages and therefore the toxin can be produced only through lysogenisation, in which the corynephage encoding tox is stably inserted into the chromosome. However, 'nontoxigenic tox gene-bearing' (NTTB) strains, which are genotypically tox-positive but do not express the protein, have been described. The emergence of NTTB strains was first observed during the 1990s diphtheria epidemic in Eastern Europe and nowadays such isolates have been detected in many countries in the world. Recently, novel species of Corynebacterium genus have been described which might have the potential of producing the diphtheria toxin due to the possession of the diphtheria toxin gene but it has not produced toxin in laboratory tests. The circulation of NTTB strains could be related to the increased risk for diphtheria disease arising from the risk of re-emerging toxin expression. The article presents the mechanism of diphtheria toxin expression and action, recently described novel species of NTTB corynebacteria as well as the taxonomic changes within the C. diphtheriae group.
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5
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Kawase J, Sakai T, Iwaki M, Umeda K, Fukuma A, Fujisawa N, Kawakami Y, Hayashi H, Wada M. Rapid detection and discrimination of potentially toxigenic Corynebacterium ulcerans and Corynebacterium pseudotuberculosis by multiplex real-time PCR and amplicon melting curve analysis. J Microbiol Methods 2022; 195:106454. [DOI: 10.1016/j.mimet.2022.106454] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 03/16/2022] [Accepted: 03/23/2022] [Indexed: 12/27/2022]
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Devanga Ragupathi NK, Muthuirulandi Sethuvel DP, Murugan D, Ranjan R, Gautam V, Gupta P, Johnson J, Sharma NC, Mutreja A, Haldar P, Kumar A, Bhatnagar P, Sangal L, Veeraraghavan B. Divergent evolution of Corynebacterium diphtheriae in India: An update from National Diphtheria Surveillance network. PLoS One 2021; 16:e0261435. [PMID: 34910778 PMCID: PMC8673651 DOI: 10.1371/journal.pone.0261435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 12/01/2021] [Indexed: 11/22/2022] Open
Abstract
Diphtheria is caused by a toxigenic bacterium Corynebacterium diphtheria which is being an emerging pathogen in India. Since diphtheria morbidity and mortality continues to be high in the country, the present study aimed to study the molecular epidemiology of C. diphtheriae strains from India. A total of 441 diphtheria suspected specimens collected as part of the surveillance programme between 2015 and 2020 were studied. All the isolates were confirmed as C. diphtheriae with standard biochemical tests, ELEK's test, and real-time PCR. Antimicrobial susceptibility testing for the subset of isolates showed intermediate susceptibility to penicillin and complete susceptible to erythromycin and cefotaxime. Isolates were characterized using multi locus sequence typing method. MLST analysis for the 216 C. diphtheriae isolates revealed major diversity among the sequence types. A total of 34 STs were assigned with majority of the isolates belonged to ST466 (30%). The second most common ST identified was ST405 that was present in 14% of the isolates. The international clone ST50 was also seen. The identified STs were grouped into 8 different clonal complexes (CC). The majority belongs to CC5 followed by CC466, CC574 and CC209, however a single non-toxigenic strain belongs to CC42. This epidemiological analysis revealed the emergence of novel STs and the clones with better dissemination properties. This study has also provided information on the circulating strains of C. diphtheriae among the different regions of India. The molecular data generated through surveillance system can be utilized for further actions in concern.
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Affiliation(s)
- Naveen Kumar Devanga Ragupathi
- Department of Clinical Microbiology, Christian Medical College, Vellore, India
- Department of Chemical and Biological Engineering, The University of Sheffield, Sheffield, United Kingdom
| | | | - Dhivya Murugan
- Department of Clinical Microbiology, Christian Medical College, Vellore, India
| | - Ranjini Ranjan
- Department of Clinical Microbiology, Christian Medical College, Vellore, India
| | - Vikas Gautam
- Department of Medical Microbiology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Prashanth Gupta
- King George’s Medical University, Lucknow, Uttar Pradesh, India
| | | | | | - Ankur Mutreja
- Department of Medicine, Addenbrookes Hospital, University of Cambridge, Cambridge, United Kingdom
- Translational Health Science and Technology Institute (THSTI), Delhi-NCR, India
| | - Pradeep Haldar
- Ministry of Health and Family Welfare, Government of India, New Delhi, India
| | - Arun Kumar
- World Health Organization, New Delhi, India
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7
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Guglielmini J, Hennart M, Badell E, Toubiana J, Criscuolo A, Brisse S. Genomic Epidemiology and Strain Taxonomy of Corynebacterium diphtheriae. J Clin Microbiol 2021; 59:e0158121. [PMID: 34524891 PMCID: PMC8601238 DOI: 10.1128/jcm.01581-21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Accepted: 09/03/2021] [Indexed: 12/13/2022] Open
Abstract
Corynebacterium diphtheriae is highly transmissible and can cause large diphtheria outbreaks where vaccination coverage is insufficient. Sporadic cases or small clusters are observed in high-vaccination settings. The phylogeography and short timescale evolution of C. diphtheriae are not well understood, in part due to a lack of harmonized analytical approaches of genomic surveillance and strain tracking. We combined 1,305 genes with highly reproducible allele calls into a core genome multilocus sequence typing (cgMLST) scheme. We analyzed cgMLST gene diversity among 602 isolates from sporadic clinical cases, small clusters, or large outbreaks. We defined sublineages based on the phylogenetic structure within C. diphtheriae and strains based on the highest number of cgMLST mismatches within documented outbreaks. We performed time-scaled phylogenetic analyses of major sublineages. The cgMLST scheme showed high allele call rate in C. diphtheriae and the closely related species C. belfantii and C. rouxii. We demonstrate its utility to delineate epidemiological case clusters and outbreaks using a 25 mismatches threshold and reveal a number of cryptic transmission chains, most of which are geographically restricted to one or a few adjacent countries. Subcultures of the vaccine strain PW8 differed by up to 20 cgMLST mismatches. Phylogenetic analyses revealed a short-timescale evolutionary gain or loss of the diphtheria toxin and biovar-associated genes. We devised a genomic taxonomy of strains and deeper sublineages (defined using a 500-cgMLST-mismatch threshold), currently comprising 151 sublineages, only a few of which are geographically widespread based on current sampling. The cgMLST genotyping tool and nomenclature was made publicly accessible (https://bigsdb.pasteur.fr/diphtheria). Standardized genome-scale strain genotyping will help tracing transmission and geographic spread of C. diphtheriae. The unified genomic taxonomy of C. diphtheriae strains provides a common language for studies of ecology, evolution, and virulence heterogeneity among C. diphtheriae sublineages.
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Affiliation(s)
- Julien Guglielmini
- Institut Pasteur, Université de Paris, Bioinformatics and Biostatistics Hub, Department of Computational Biology, Paris, France
| | - Melanie Hennart
- Institut Pasteur, Université de Paris, Biodiversity and Epidemiology of Bacterial Pathogens, Paris, France
- Sorbonne Université, Collège Doctoral, Paris, France
| | - Edgar Badell
- Institut Pasteur, Université de Paris, Biodiversity and Epidemiology of Bacterial Pathogens, Paris, France
- National Reference Center for the Corynebacteria of the Diphtheriae Complex, Paris, France
| | - Julie Toubiana
- Institut Pasteur, Université de Paris, Biodiversity and Epidemiology of Bacterial Pathogens, Paris, France
- National Reference Center for the Corynebacteria of the Diphtheriae Complex, Paris, France
- Université de Paris, Service de Pédiatrie Générale et Maladies Infectieuses, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Alexis Criscuolo
- Institut Pasteur, Université de Paris, Bioinformatics and Biostatistics Hub, Department of Computational Biology, Paris, France
| | - Sylvain Brisse
- Institut Pasteur, Université de Paris, Biodiversity and Epidemiology of Bacterial Pathogens, Paris, France
- National Reference Center for the Corynebacteria of the Diphtheriae Complex, Paris, France
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8
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Marosevic DV, Berger A, Kahlmeter G, Payer SK, Hörmansdorfer S, Sing A. Antimicrobial susceptibility of Corynebacterium diphtheriae and Corynebacterium ulcerans in Germany 2011-17. J Antimicrob Chemother 2021; 75:2885-2893. [PMID: 32747952 DOI: 10.1093/jac/dkaa280] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 05/26/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Diphtheria is mainly caused by diphtheria-toxin-producing strains of Corynebacterium diphtheriae and Corynebacterium ulcerans. The recommended first-line antibiotic is penicillin or erythromycin, but reliable susceptibility data are scarce. OBJECTIVES To define WT MIC distributions of 12 antimicrobial agents and provide data for the determination of tentative epidemiological cut-off values (TECOFFs) for potentially toxigenic corynebacteria and to evaluate the potential usefulness of a gradient test (Etest) for susceptibility testing of penicillin, erythromycin and clindamycin. METHODS For the 421 human or veterinary isolates from the period 2011-17, MICs of 12 antimicrobial agents were determined. Etest performance was evaluated for penicillin, erythromycin and clindamycin. RESULTS MIC distributions were characterized and TECOFFs could be set for 11 out of 24 antibiotic/species combinations. The current EUCAST clinical breakpoints, predominantly determined for Corynebacterium species other than C. diphtheriae and C. ulcerans, divide the WT MIC distributions of penicillin and clindamycin, thereby making reproducible susceptibility testing of C. diphtheriae and C. ulcerans difficult. For erythromycin, 4% of C. diphtheriae and 2% of C. ulcerans had MICs higher than those for WT isolates. Phenotypically detectable resistance to other antibiotics was rare. Etest underestimated MICs of penicillin and lower concentrations needed to be included for erythromycin, while for clindamycin the Etest was not a good surrogate method. CONCLUSIONS MIC distributions based on reference broth microdilution for potentially toxigenic Corynebacterium spp. were developed. For five and six agents, TECOFFs were suggested for C. diphtheriae and C. ulcerans, respectively, but for Corynebacterium pseudotuberculosis the number of isolates was too low.
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Affiliation(s)
- Durdica V Marosevic
- Public Health Microbiology, Bavarian Health and Food Safety Authority, Oberschleißheim, Germany.,European Programme for Public Health Microbiology Training (EUPHEM), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Anja Berger
- Public Health Microbiology, Bavarian Health and Food Safety Authority, Oberschleißheim, Germany.,Consultant Laboratory for Diphtheria, Bavarian Health and Food Safety Authority, Oberschleißheim, Germany
| | - Gunnar Kahlmeter
- Clinical Microbiology and the EUCAST Development Laboratory, Central Hospital, Växjö, Sweden
| | - Sarah Katharina Payer
- Public Health Microbiology, Bavarian Health and Food Safety Authority, Oberschleißheim, Germany
| | - Stefan Hörmansdorfer
- Public Health Microbiology, Bavarian Health and Food Safety Authority, Oberschleißheim, Germany
| | - Andreas Sing
- Public Health Microbiology, Bavarian Health and Food Safety Authority, Oberschleißheim, Germany.,Consultant Laboratory for Diphtheria, Bavarian Health and Food Safety Authority, Oberschleißheim, Germany
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9
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Zou J, Chorlton SD, Romney MG, Payne M, Lawson T, Wong A, Champagne S, Ritchie G, Lowe CF. Phenotypic and Genotypic Correlates of Penicillin Susceptibility in Nontoxigenic Corynebacterium diphtheriae, British Columbia, Canada, 2015-2018. Emerg Infect Dis 2021; 26:97-103. [PMID: 31855139 PMCID: PMC6924910 DOI: 10.3201/eid2601.191241] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
In 2015, the Clinical and Laboratory Standards Institute (CLSI) updated its breakpoints for penicillin susceptibility in Corynebacterium species from <1 mg/L to <0.12 mg/L. We assessed the effect of this change on C. diphtheriae susceptibility reported at an inner city, tertiary care center in Vancouver, British Columbia, Canada, during 2015–2018 and performed whole-genome sequencing to investigate phenotypic and genotypic resistance to penicillin. We identified 44/45 isolates that were intermediately susceptible to penicillin by the 2015 breakpoint, despite meeting previous CLSI criteria for susceptibility. Sequencing did not reveal β-lactam resistance genes. Multilocus sequence typing revealed a notable predominance of sequence type 76. Overall, we saw no evidence of penicillin nonsusceptibility at the phenotypic or genotypic level in C. diphtheriae isolates from our institution. The 2015 CLSI breakpoint change could cause misclassification of penicillin susceptibility in C. diphtheriae isolates, potentially leading to suboptimal antimicrobial treatment selection.
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10
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Assessing the Genetic Diversity of Austrian Corynebacterium diphtheriae Clinical Isolates, 2011 to 2019. J Clin Microbiol 2021; 59:JCM.02529-20. [PMID: 33268541 PMCID: PMC8106727 DOI: 10.1128/jcm.02529-20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 11/25/2020] [Indexed: 02/01/2023] Open
Abstract
Diphtheria is a vaccine-preventable disease with a high potential for reemergence. One of its causative agents is Corynebacterium diphtheriae, with some strains producing diphtheria toxin. From 2011 to 2019, 57 clinical C. diphtheriae strains were isolated in Austria, either from the respiratory tract or from skin infections. The aim of this study was to investigate the genetic diversity of these C. diphtheriae isolates using whole-genome sequencing. Isolates were characterized by genome-wide comparisons using single nucleotide polymorphism analysis or core genome multilocus sequence typing and by searching sequence data for antimicrobial resistance genes and genes involved in diphtheria toxin production. The genetic diversity among the isolates was high, with no clear distribution over time or place. Corynebacterium belfantii isolates were separated from other strains and were strongly associated with respiratory infections (odds ratio [OR] = 57). Two clusters, limited in time and space, were identified. Almost 40% of strains carried resistance genes against tetracycline or sulfonamides, mostly from skin infections. Microbiological tests showed that 55% of isolates were resistant to penicillin but did not carry genes conferring β-lactam resistance. A diphtheria toxin gene with no nonsynonymous mutation was found in three isolates only. This study showed that sequencing can provide valuable information complementing routine microbiological and epidemiological investigations. It allowed us to identify unknown clusters, evaluate antimicrobial resistance more broadly, and support toxigenicity results obtained by PCR. For these reasons, C. diphtheriae surveillance could strongly benefit from the routine implementation of whole-genome sequencing.
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11
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Hennart M, Panunzi LG, Rodrigues C, Gaday Q, Baines SL, Barros-Pinkelnig M, Carmi-Leroy A, Dazas M, Wehenkel AM, Didelot X, Toubiana J, Badell E, Brisse S. Population genomics and antimicrobial resistance in Corynebacterium diphtheriae. Genome Med 2020; 12:107. [PMID: 33246485 PMCID: PMC7694903 DOI: 10.1186/s13073-020-00805-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 11/11/2020] [Indexed: 12/21/2022] Open
Abstract
Background Corynebacterium diphtheriae, the agent of diphtheria, is a genetically diverse bacterial species. Although antimicrobial resistance has emerged against several drugs including first-line penicillin, the genomic determinants and population dynamics of resistance are largely unknown for this neglected human pathogen. Methods Here, we analyzed the associations of antimicrobial susceptibility phenotypes, diphtheria toxin production, and genomic features in C. diphtheriae. We used 247 strains collected over several decades in multiple world regions, including the 163 clinical isolates collected prospectively from 2008 to 2017 in France mainland and overseas territories. Results Phylogenetic analysis revealed multiple deep-branching sublineages, grouped into a Mitis lineage strongly associated with diphtheria toxin production and a largely toxin gene-negative Gravis lineage with few toxin-producing isolates including the 1990s ex-Soviet Union outbreak strain. The distribution of susceptibility phenotypes allowed proposing ecological cutoffs for most of the 19 agents tested, thereby defining acquired antimicrobial resistance. Penicillin resistance was found in 17.2% of prospective isolates. Seventeen (10.4%) prospective isolates were multidrug-resistant (≥ 3 antimicrobial categories), including four isolates resistant to penicillin and macrolides. Homologous recombination was frequent (r/m = 5), and horizontal gene transfer contributed to the emergence of antimicrobial resistance in multiple sublineages. Genome-wide association mapping uncovered genetic factors of resistance, including an accessory penicillin-binding protein (PBP2m) located in diverse genomic contexts. Gene pbp2m is widespread in other Corynebacterium species, and its expression in C. glutamicum demonstrated its effect against several beta-lactams. A novel 73-kb C. diphtheriae multiresistance plasmid was discovered. Conclusions This work uncovers the dynamics of antimicrobial resistance in C. diphtheriae in the context of phylogenetic structure, biovar, and diphtheria toxin production and provides a blueprint to analyze re-emerging diphtheria. Supplementary information Supplementary information accompanies this paper at 10.1186/s13073-020-00805-7.
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Affiliation(s)
- Melanie Hennart
- Institut Pasteur, Biodiversity and Epidemiology of Bacterial Pathogens, Paris, France.,Collège doctoral, Sorbonne Université, F-75005, Paris, France
| | - Leonardo G Panunzi
- Institut Pasteur, Biodiversity and Epidemiology of Bacterial Pathogens, Paris, France.,Institut Français de Bioinformatique, CNRS UMS 3601, Evry, France
| | - Carla Rodrigues
- Institut Pasteur, Biodiversity and Epidemiology of Bacterial Pathogens, Paris, France
| | - Quentin Gaday
- Unité de Microbiologie Structurale, Institut Pasteur, CNRS UMR 3528, Université de Paris, F-75015, Paris, France
| | - Sarah L Baines
- Doherty Applied Microbial Genomics, Department of Microbiology & Immunology, The University of Melbourne at The Peter Doherty Institute for Infection & Immunity, Melbourne, Victoria, Australia
| | | | - Annick Carmi-Leroy
- Institut Pasteur, Biodiversity and Epidemiology of Bacterial Pathogens, Paris, France.,Institut Pasteur, National Reference Center for Corynebacteria of the Diphtheriae Complex, Paris, France
| | - Melody Dazas
- Institut Pasteur, Biodiversity and Epidemiology of Bacterial Pathogens, Paris, France.,Institut Pasteur, National Reference Center for Corynebacteria of the Diphtheriae Complex, Paris, France
| | - Anne Marie Wehenkel
- Unité de Microbiologie Structurale, Institut Pasteur, CNRS UMR 3528, Université de Paris, F-75015, Paris, France
| | - Xavier Didelot
- School of Life Sciences and Department of Statistics, University of Warwick, Coventry, UK
| | - Julie Toubiana
- Institut Pasteur, Biodiversity and Epidemiology of Bacterial Pathogens, Paris, France.,Institut Pasteur, National Reference Center for Corynebacteria of the Diphtheriae Complex, Paris, France.,Department of General Pediatrics and Pediatric Infectious Diseases, Hôpital Necker-Enfants Malades, APHP, Université de Paris, Paris, France
| | - Edgar Badell
- Institut Pasteur, Biodiversity and Epidemiology of Bacterial Pathogens, Paris, France.,Institut Pasteur, National Reference Center for Corynebacteria of the Diphtheriae Complex, Paris, France
| | - Sylvain Brisse
- Institut Pasteur, Biodiversity and Epidemiology of Bacterial Pathogens, Paris, France. .,Institut Pasteur, National Reference Center for Corynebacteria of the Diphtheriae Complex, Paris, France.
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12
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Husada D, Soegianto SDP, Kurniawati IS, Hendrata AP, Irawan E, Kartina L, Puspitasari D, Basuki PS, Ismoedijanto. First-line antibiotic susceptibility pattern of toxigenic Corynebacterium diphtheriae in Indonesia. BMC Infect Dis 2019; 19:1049. [PMID: 31829153 PMCID: PMC6907133 DOI: 10.1186/s12879-019-4675-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 11/29/2019] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Diphtheria has been reported as an outbreak in some regions in Indonesia, most especially in East Java Province. Resistance to penicillin, erythromycin, and other antibiotics, single or multiple, has been reported in several studies. This study aims to evaluate the first-line antibiotic susceptibility pattern of toxigenic Corynebacterium diphtheriae isolates. METHODS This descriptive observational study was performed from August to November 2018. C. diphtheriae isolates were collected from diphtheria patients and carriers in East Java from 2012 to 2017 and kept at the Balai Besar Laboratorium Kesehatan Daerah Surabaya or the Public Health Laboratory of Surabaya. Sample selection was done by random cluster sampling. The sensitivity test by E-test®of the five antibiotics (penicillin, oxacillin, erythromycin, azithromycin, and clarithromycin) was done to determine the minimum inhibitory concentration (MIC). The Clinical and Laboratory Standards Institute M45A (2015) Corynebacterium spp. for penicillin and erythromycin was used as standard. RESULTS From 114 targeted isolates, 108 were viable and toxigenic. The E-test was performed on the viable isolates. The majority of the hosts were male (58.3%), with median (range) age of 6.5 (1-14) years. Half of the samples were from the 1 to 5-year-old age group. The isolates were acquired much more from patients (78.7%) than carriers (21.3%) and from pharyngeal swab (74.1%). Most of these isolates were from Madura Island (47.2%) and the northern and eastern parts of the province (horseshoe area). Mitis isolates were the major variant (76.9%). The susceptibility pattern of C. diphtheriae to erythromycin was better than that to penicillin. The E-test result for penicillin was 68.52% susceptible, 31.48% intermediate, and 0% resistant (MIC range, < 0.016 to 2 μg/L) and for erythromycin (MIC range, < 0.016 to > 256 μg/L) was 85.2% susceptible, 12% intermediate, and 2.8% resistant The MIC range for oxacillin was 1 to 96 μg/L, while for both azithromycin and clarithromycin were < 0.016 to > 256 μg/L. CONCLUSION The susceptibility rate of C. diphtheriae to erythromycin is higher than that to penicillin. The regular update of antibiotic selection to the national guidelines is recommended. The MIC reference standard to azithromycin and clarithromycin is also needed.
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Affiliation(s)
- Dominicus Husada
- Department of Child Health, Faculty of Medicine Universitas Airlangga/Dr. Soetomo Academic General Hospital, Surabaya, Indonesia
| | - Sugi Deny Pranoto Soegianto
- Department of Child Health, Faculty of Medicine Universitas Airlangga/Dr. Soetomo Academic General Hospital, Surabaya, Indonesia
| | | | | | - Eveline Irawan
- Balai Besar Laboratorium Kesehatan Daerah (BBLK), Surabaya, Indonesia
| | - Leny Kartina
- Department of Child Health, Faculty of Medicine Universitas Airlangga/Dr. Soetomo Academic General Hospital, Surabaya, Indonesia
| | - Dwiyanti Puspitasari
- Department of Child Health, Faculty of Medicine Universitas Airlangga/Dr. Soetomo Academic General Hospital, Surabaya, Indonesia
| | - Parwati Setiono Basuki
- Department of Child Health, Faculty of Medicine Universitas Airlangga/Dr. Soetomo Academic General Hospital, Surabaya, Indonesia
| | - Ismoedijanto
- Department of Child Health, Faculty of Medicine Universitas Airlangga/Dr. Soetomo Academic General Hospital, Surabaya, Indonesia
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13
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Seth-Smith HMB, Egli A. Whole Genome Sequencing for Surveillance of Diphtheria in Low Incidence Settings. Front Public Health 2019; 7:235. [PMID: 31497588 PMCID: PMC6713046 DOI: 10.3389/fpubh.2019.00235] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 08/06/2019] [Indexed: 12/29/2022] Open
Abstract
Corynebacterium diphtheriae (C. diphtheriae) is a relatively rare pathogen in most Western countries. While toxin producing strains can cause pharyngeal diphtheria with potentially fatal outcomes, the more common presentation is wound infections. The diphtheria toxin is encoded on a prophage and can also be carried by Corynebacterium ulcerans and Corynebacterium pseudotuberculosis. Currently, across Europe, infections are mainly diagnosed in travelers and refugees from regions where diphtheria is more endemic, patients from urban areas with poor hygiene, and intravenous drug users. About half of the cases are non-toxin producing isolates. Rapid identification of the bacterial pathogen and toxin production is a critical element of patient and outbreak management. Beside the immediate clinical management of the patient, public health agencies should be informed of toxigenic C. diphtheriae diagnoses as soon as possible. The collection of case-related epidemiological data from the patient is often challenging due to language barriers and social circumstances. However, information on patient contacts, vaccine status and travel/refugee route, where appropriate, is critical, and should be documented. In addition, isolates should be characterized using high resolution typing, in order to identify transmissions and outbreaks. In recent years, whole genome sequencing (WGS) has become the gold standard of high-resolution typing methods, allowing detailed investigations of pathogen transmissions. De-centralized sequencing strategies with redundancy in sequencing capacities, followed by data exchange may be a valuable future option, especially since WGS becomes more available and portable. In this context, the sharing of sequence data, using public available platforms, is essential. A close interaction between microbiology laboratories, treating physicians, refugee centers, social workers, and public health officials is a key element in successful management of suspected outbreaks. Analyzing bacterial isolates at reference centers may further help to provide more specialized microbiological techniques and to standardize information, but this is also more time consuming during an outbreak. Centralized communication strategies between public health agencies and laboratories helps considerably in establishing and coordinating effective surveillance and infection control. We review the current literature on high-resolution typing of C. diphtheriae and share our own experience with the coordination of a Swiss-German outbreak.
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Affiliation(s)
- Helena M. B. Seth-Smith
- Division of Clinical Bacteriology and Mycology, University Hospital Basel, Basel, Switzerland
- Applied Microbiology Research, Department of Biomedicine, University of Basel, Basel, Switzerland
- SIB Swiss Institute of Bioinformatics, Basel, Switzerland
| | - Adrian Egli
- Division of Clinical Bacteriology and Mycology, University Hospital Basel, Basel, Switzerland
- Applied Microbiology Research, Department of Biomedicine, University of Basel, Basel, Switzerland
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14
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Ramdhan N, Blom J, Sutcliffe I, Pereira-Ribeiro P, Santos C, Mattos-Guaraldi A, Burkovski A, Sangal V. Genomic analysis of a novel nontoxigenic Corynebacterium diphtheriae strain isolated from a cancer patient. New Microbes New Infect 2019; 30:100544. [PMID: 31061711 PMCID: PMC6488682 DOI: 10.1016/j.nmni.2019.100544] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 03/22/2019] [Accepted: 04/02/2019] [Indexed: 12/03/2022] Open
Abstract
The genome of a novel nontoxigenic Corynebacterium diphtheriae, strain 5015, isolated from a patient with adenoid cystic carcinoma was sequenced and compared with 117 publically available genomes. This strain is phylogenetically distinct and lacks virulence genes encoding the toxin, BigA and Sdr-like adhesins. Strain 5015 possesses spaD-type and spaH-type pilus gene clusters with a loss of some gene functions, and 31 unique genes that need molecular characterization to understand their potential role in virulence characteristics.
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Affiliation(s)
- N.D. Ramdhan
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, England, UK
| | - J. Blom
- Bioinformatics and Systems Biology, Justus-Liebig-Universität, Gießen, Germany
| | - I.C. Sutcliffe
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, England, UK
| | - P.M.A. Pereira-Ribeiro
- Laboratory of Diphtheria and Corynebacteria of Clinical Relevance-LDCIC, Faculty of Medical Sciences, Rio de Janeiro State University–UERJ, Rio de Janeiro, Brazil
| | - C.S. Santos
- Laboratory of Diphtheria and Corynebacteria of Clinical Relevance-LDCIC, Faculty of Medical Sciences, Rio de Janeiro State University–UERJ, Rio de Janeiro, Brazil
| | - A.L. Mattos-Guaraldi
- Laboratory of Diphtheria and Corynebacteria of Clinical Relevance-LDCIC, Faculty of Medical Sciences, Rio de Janeiro State University–UERJ, Rio de Janeiro, Brazil
| | - A. Burkovski
- Department of Microbiology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - V. Sangal
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, England, UK
- Corresponding author: V. Sangal, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, NE1 8ST, England, UK.
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Dangel A, Berger A, Konrad R, Bischoff H, Sing A. Geographically Diverse Clusters of Nontoxigenic Corynebacterium diphtheriae Infection, Germany, 2016-2017. Emerg Infect Dis 2019; 24:1239-1245. [PMID: 29912709 PMCID: PMC6038752 DOI: 10.3201/eid2407.172026] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
From 2016 through the middle of 2017, the German Consiliary Laboratory on Diphtheria noted an increase in nontoxigenic Corynebacterium diphtheriae isolates submitted from cities in northern Germany. Many patients for whom epidemiologic data were available were homeless, alcohol or drug abusers, or both. After performing routine diagnostics and multilocus sequence typing (MLST), we analyzed isolates of sequence type (ST) 8 and previously submitted isolates by whole-genome sequencing. Results were analyzed for phylogenetic relationship by core genome MLST (cg-MLST) and whole-genome single-nucleotide polymorphism profiles. Next-generation sequencing–based cg-MLST revealed several outbreak clusters caused by ST8; the geographic focus was in the metropolitan areas of Hamburg and Berlin. To achieve enhanced analytical depth, we used additional cg-MLST target genes and genome-wide single-nucleotide polymorphisms. We identified patient characteristics and detected transmission events, providing evidence that nontoxigenic C. diphtheriae infection is a potential public health threat in industrialized countries.
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16
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Subtractive proteomics revealed plausible drug candidates in the proteome of multi-drug resistant Corynebacterium diphtheriae. Meta Gene 2018. [DOI: 10.1016/j.mgene.2018.04.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
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17
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Iron and Zinc Regulate Expression of a Putative ABC Metal Transporter in Corynebacterium diphtheriae. J Bacteriol 2018; 200:JB.00051-18. [PMID: 29507090 DOI: 10.1128/jb.00051-18] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 02/28/2018] [Indexed: 11/20/2022] Open
Abstract
Corynebacterium diphtheriae, a Gram-positive, aerobic bacterium, is the causative agent of diphtheria and cutaneous infections. While mechanisms required for heme iron acquisition are well known in C. diphtheriae, systems involved in the acquisition of other metals such as zinc and manganese remain poorly characterized. In this study, we identified a genetic region that encodes an ABC-type transporter (iutBCD) and that is flanked by two genes (iutA and iutE) encoding putative substrate binding proteins of the cluster 9 family, a related group of transporters associated primarily with the import of Mn and Zn. We showed that IutA and IutE are both membrane proteins with comparable Mn and Zn binding abilities. We demonstrated that the iutABCD genes are cotranscribed and repressed in response to iron by the iron-responsive repressor DtxR. Transcription of iutE was positively regulated in response to iron availability in a DtxR-dependent manner and was repressed in response to Zn by the Zn-dependent repressor Zur. Electrophoretic mobility shift assays showed that DtxR does not bind to the iutE upstream region, which indicates that DtxR regulation of iutE is indirect and that other regulatory factors controlled by DtxR are likely responsible for the iron-responsive regulation. Analysis of the iutE promoter region identified a 50-bp sequence at the 3' end of the iutD gene that is required for the DtxR-dependent and iron-responsive activation of the iutE gene. These findings indicate that transcription of iutE is controlled by a complex mechanism that involves multiple regulatory factors whose activity is impacted by both Zn and Fe.IMPORTANCE Vaccination against diphtheria prevents toxin-related symptoms but does not inhibit bacterial colonization of the human host by the bacterium. Thus, Corynebacterium diphtheriae remains an important human pathogen that poses a significant health risk to unvaccinated individuals. The ability to acquire iron, zinc, and manganese is critical to the pathogenesis of many disease-causing organisms. Here, we describe a gene cluster in C. diphtheriae that encodes a metal importer that is homologous to broadly distributed metal transport systems, some with important roles in virulence in other bacterial pathogens. Two metal binding components of the gene cluster encode surface exposed proteins, and studies of such proteins may guide the development of second-generation vaccines for C. diphtheriae.
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18
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Zasada AA, Mosiej E. Contemporary microbiology and identification of Corynebacteria spp. causing infections in human. Lett Appl Microbiol 2018; 66:472-483. [PMID: 29573441 DOI: 10.1111/lam.12883] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 03/09/2018] [Accepted: 03/09/2018] [Indexed: 11/29/2022]
Abstract
The Corynebacterium is a genus of bacteria of growing clinical importance. Progress in medicine results in growing population of immunocompromised patients and growing number of infections caused by opportunistic pathogens. A new infections caused by new Corynebacterium species and species previously regarded as commensal micro-organisms have been described. Parallel with changes in Corynebacteria infections, the microbiological laboratory diagnostic possibilities are changing. But identification of this group of bacteria to the species level remains difficult. In the paper, we present various manual, semi-automated and automated assays used in clinical laboratories for Corynebacterium identification, such as API Coryne, RapID CB Plus, BBL Crystal Gram Positive ID System, MICRONAUT-RPO, VITEK 2, BD Phoenix System, Sherlock Microbial ID System, MicroSeq Microbial Identification System, Biolog Microbial Identification Systems, MALDI-TOF MS systems, polymerase chain reaction (PCR)-based and sequencing-based assays. The presented assays are based on various properties, like biochemical tests, specific DNA sequences, composition of cellular fatty acids, protein profiles and have specific limitations. SIGNIFICANCE AND IMPACT OF THE STUDY The number of opportunistic infections caused by Corynebacteria is increasing due to increase in number of immunocompromised patients. New Corynebacterium species and new human infections, caused by this group of bacteria, has been described recently. However, identification of Corynebacteria is still a challenge despite application of sophisticated laboratory methods. In the study we present possibilities and limitations of various commercial systems for identification of Corynebacteria.
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Affiliation(s)
- A A Zasada
- Department of Sera and Vaccines Evaluation, National Institute of Public Health - National Institute of Hygiene, Warsaw, Poland
| | - E Mosiej
- Department of Sera and Vaccines Evaluation, National Institute of Public Health - National Institute of Hygiene, Warsaw, Poland
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19
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du Plessis M, Wolter N, Allam M, de Gouveia L, Moosa F, Ntshoe G, Blumberg L, Cohen C, Smith M, Mutevedzi P, Thomas J, Horne V, Moodley P, Archary M, Mahabeer Y, Mahomed S, Kuhn W, Mlisana K, McCarthy K, von Gottberg A. Molecular Characterization of Corynebacterium diphtheriae Outbreak Isolates, South Africa, March-June 2015. Emerg Infect Dis 2018; 23:1308-1315. [PMID: 28726616 PMCID: PMC5547784 DOI: 10.3201/eid2308.162039] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
In 2015, a cluster of respiratory diphtheria cases was reported from KwaZulu-Natal Province in South Africa. By using whole-genome analysis, we characterized 21 Corynebacterium diphtheriae isolates collected from 20 patients and contacts during the outbreak (1 patient was infected with 2 variants of C. diphtheriae). In addition, we included 1 cutaneous isolate, 2 endocarditis isolates, and 2 archived clinical isolates (ca. 1980) for comparison. Two novel lineages were identified, namely, toxigenic sequence type (ST) ST-378 (n = 17) and nontoxigenic ST-395 (n = 3). One archived isolate and the cutaneous isolate were ST-395, suggesting ongoing circulation of this lineage for >30 years. The absence of preexisting molecular sequence data limits drawing conclusions pertaining to the origin of these strains; however, these findings provide baseline genotypic data for future cases and outbreaks. Neither ST has been reported in any other country; this ST appears to be endemic only in South Africa.
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20
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Czajka U, Wiatrzyk A, Mosiej E, Formińska K, Zasada AA. Changes in MLST profiles and biotypes of Corynebacterium diphtheriae isolates from the diphtheria outbreak period to the period of invasive infections caused by nontoxigenic strains in Poland (1950-2016). BMC Infect Dis 2018. [PMID: 29523087 PMCID: PMC5845185 DOI: 10.1186/s12879-018-3020-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Background Corynebacterium diphtheriae is a re-emerging pathogen in Europe causing invasive infections in vaccinated persons and classical diphtheria in unvaccinated persons. In the presented study we analysed genetic changes in C. diphtheriae isolates collected in Poland from the period before the introduction of the mass anti-diphtheria vaccination to the present time when over 98% of the population is vaccinated. Methods A total of 62 C. diphtheriae isolates collected in the 1950s–1960s, 1990s and 2000–2016 in Poland were investigated. Examined properties of the isolates included toxigenic status, presence of tox gene, biotype, MLST type (ST) and type of infection. Results A total of 12 sequence types (STs) were identified among the analysed C. diphtheriae isolates. The highest variability of STs was observed among isolates from diphtheria and asymptomatic carriers collected in the XX century. Over 95% of isolates collected from invasive and wound infections in 2004–2016 belonged to ST8. Isolates from the XX century represented all four biotypes: mitis, gravis, intermedius and belfanti, but the belfanti biotype appeared only after the epidemic in the 1990s. All except three isolates from the XXI century represented the biotype gravis. Conclusions During a diphtheria epidemic period, non-epidemic clones of C. diphtheriae might also disseminate and persist in a particular area after the epidemic. An increase of the anti-diphtheria antibody level in the population causes not only the elimination of toxigenic strains from the population but may also influence the reduction of diversity of C. diphtheriae isolates. MLST types do not reflect the virulence of isolates. Each ST can be represented by various virulent variants representing various pathogenic capacities, for example toxigenic non-invasive, nontoxigenic invasive and nontoxigenic non-invasive.
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Affiliation(s)
- Urszula Czajka
- Department of Vaccines and Sera Evaluation, National Institute of Public Health - National Institute of Hygiene, Chocimska 24, 00-791, Warsaw, Poland
| | - Aldona Wiatrzyk
- Department of Vaccines and Sera Evaluation, National Institute of Public Health - National Institute of Hygiene, Chocimska 24, 00-791, Warsaw, Poland
| | - Ewa Mosiej
- Department of Vaccines and Sera Evaluation, National Institute of Public Health - National Institute of Hygiene, Chocimska 24, 00-791, Warsaw, Poland
| | - Kamila Formińska
- Department of Vaccines and Sera Evaluation, National Institute of Public Health - National Institute of Hygiene, Chocimska 24, 00-791, Warsaw, Poland
| | - Aleksandra A Zasada
- Department of Vaccines and Sera Evaluation, National Institute of Public Health - National Institute of Hygiene, Chocimska 24, 00-791, Warsaw, Poland.
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21
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Grosse-Kock S, Kolodkina V, Schwalbe EC, Blom J, Burkovski A, Hoskisson PA, Brisse S, Smith D, Sutcliffe IC, Titov L, Sangal V. Genomic analysis of endemic clones of toxigenic and non-toxigenic Corynebacterium diphtheriae in Belarus during and after the major epidemic in 1990s. BMC Genomics 2017; 18:873. [PMID: 29132312 PMCID: PMC5683216 DOI: 10.1186/s12864-017-4276-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 11/03/2017] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Diphtheria remains a major public health concern with multiple recent outbreaks around the world. Moreover, invasive non-toxigenic strains have emerged globally causing severe infections. A diphtheria epidemic in the former Soviet Union in the 1990s resulted in ~5000 deaths. In this study, we analysed the genome sequences of a collection of 93 C. diphtheriae strains collected during and after this outbreak (1996 - 2014) in a former Soviet State, Belarus to understand the evolutionary dynamics and virulence capacities of these strains. RESULTS C. diphtheriae strains from Belarus belong to ten sequence types (STs). Two major clones, non-toxigenic ST5 and toxigenic ST8, encompassed 76% of the isolates that are associated with sore throat and diphtheria in patients, respectively. Core genomic diversity is limited within outbreak-associated ST8 with relatively higher mutation rates (8.9 × 10-7 substitutions per strain per year) than ST5 (5.6 × 10-7 substitutions per strain per year) where most of the diversity was introduced by recombination. A variation in the virulence gene repertoire including the presence of tox gene is likely responsible for pathogenic differences between different strains. However, strains with similar virulence potential can cause disease in some individuals and remain asymptomatic in others. Eight synonymous single nucleotide polymorphisms were observed between the tox genes of the vaccine strain PW8 and other toxigenic strains of ST8, ST25, ST28, ST41 and non-toxigenic tox gene-bearing (NTTB) ST40 strains. A single nucleotide deletion at position 52 in the tox gene resulted in the frameshift in ST40 isolates, converting them into NTTB strains. CONCLUSIONS Non-toxigenic C. diphtheriae ST5 and toxigenic ST8 strains have been endemic in Belarus both during and after the epidemic in 1990s. A high vaccine coverage has effectively controlled diphtheria in Belarus; however, non-toxigenic strains continue to circulate in the population. Recombination is an important evolutionary force in shaping the genomic diversity in C. diphtheriae. However, the relative role of recombination and mutations in diversification varies between different clones.
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Affiliation(s)
- Steffen Grosse-Kock
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Valentina Kolodkina
- Republican Research and Practical Centre for Epidemiology and Microbiology, Minsk, Republic of Belarus
| | - Edward C. Schwalbe
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | | | - Andreas Burkovski
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Paul A. Hoskisson
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UK
| | - Sylvain Brisse
- Institut Pasteur, Biodiversity and Epidemiology of Bacterial Pathogens, Paris, France
| | - Darren Smith
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Iain C. Sutcliffe
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Leonid Titov
- Republican Research and Practical Centre for Epidemiology and Microbiology, Minsk, Republic of Belarus
| | - Vartul Sangal
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
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Peixoto RS, Hacker E, Antunes CA, Weerasekera D, Dias AA, Martins CA, Hirata R, Santos KRND, Burkovski A, Mattos-Guaraldi AL. Pathogenic properties of a Corynebacterium diphtheriae strain isolated from a case of osteomyelitis. J Med Microbiol 2017; 65:1311-1321. [PMID: 27902402 DOI: 10.1099/jmm.0.000362] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Corynebacterium diphtheriae is typically recognized as a colonizer of the upper respiratory tract (respiratory diphtheria) and the skin (cutaneous diphtheria). However, different strains of Corynebacteriumdiphtheriae can also cause invasive infections. In this study, the characterization of a non-toxigenic Corynebacteriumdiphtheriae strain (designated BR-INCA5015) isolated from osteomyelitis in the frontal bone of a patient with adenoid cystic carcinoma was performed. Pathogenic properties of the strain BR-INCA5015 were tested in a Caenorhabditis elegans survival assay showing strong colonization and killing by this strain. Survival rates of 3.8±2.7 %, 33.6±7.3 % and 0 % were observed for strains ATCC 27010T, ATCC 27012 and BR-INCA5015, respectively, at day 7. BR-INCA5015 was able to colonize epithelial cells, showing elevated capacity to adhere to and survive within HeLa cells compared to other Corynebacteriumdiphtheriae isolates. Intracellular survival in macrophages (THP-1 and RAW 264.7) was significantly higher compared to control strains ATCC 27010T (non-toxigenic) and ATCC 27012 (toxigenic). Furthermore, the ability of BR-INCA5015 to induce osteomyelitis was confirmed by in vivo assay using Swiss Webster mice.
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Affiliation(s)
- Renata Stavracakis Peixoto
- Professur für Mikrobiologie, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.,Department of Medical Microbiology, Institute of Microbiology, Rio de Janeiro Federal University (IMPPG/UFRJ), Rio de Janeiro, RJ, Brazil.,Laboratory of Diphtheria and Corynebacteria of Clinical Relevance-LDCIC, Faculty of Medical Sciences, Rio de Janeiro State University - UERJ, Rio de Janeiro, RJ, Brazil
| | - Elena Hacker
- Professur für Mikrobiologie, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Camila Azevedo Antunes
- Professur für Mikrobiologie, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.,Laboratory of Diphtheria and Corynebacteria of Clinical Relevance-LDCIC, Faculty of Medical Sciences, Rio de Janeiro State University - UERJ, Rio de Janeiro, RJ, Brazil
| | - Dulanthi Weerasekera
- Professur für Mikrobiologie, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - A A Dias
- National Institute for Quality Control in Health (INCQS), Fundação Oswaldo Cruz-FIOCRUZ, Rio de Janeiro, RJ, Brazil
| | - Carlos Alberto Martins
- Brazilian National Cancer Institute - Ministry of Health, INCA, Rio de Janeiro, RJ, Brazil
| | - Raphael Hirata
- Laboratory of Diphtheria and Corynebacteria of Clinical Relevance-LDCIC, Faculty of Medical Sciences, Rio de Janeiro State University - UERJ, Rio de Janeiro, RJ, Brazil
| | - Kátia Regina Netto Dos Santos
- Department of Medical Microbiology, Institute of Microbiology, Rio de Janeiro Federal University (IMPPG/UFRJ), Rio de Janeiro, RJ, Brazil
| | - Andreas Burkovski
- Professur für Mikrobiologie, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Ana Luíza Mattos-Guaraldi
- Laboratory of Diphtheria and Corynebacteria of Clinical Relevance-LDCIC, Faculty of Medical Sciences, Rio de Janeiro State University - UERJ, Rio de Janeiro, RJ, Brazil.,Department of Medical Microbiology, Institute of Microbiology, Rio de Janeiro Federal University (IMPPG/UFRJ), Rio de Janeiro, RJ, Brazil
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Benamrouche N, Hasnaoui S, Badell E, Guettou B, Lazri M, Guiso N, Rahal K. Microbiological and molecular characterization of Corynebacterium diphtheriae isolated in Algeria between 1992 and 2015. Clin Microbiol Infect 2016; 22:1005.e1-1005.e7. [PMID: 27585941 DOI: 10.1016/j.cmi.2016.08.013] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Revised: 08/17/2016] [Accepted: 08/19/2016] [Indexed: 11/24/2022]
Abstract
The objectives of this study were to undertake the microbiological and molecular characterization of Corynebacterium diphtheriae isolates collected in Algeria during epidemic and post-epidemic periods between 1992 and 2015. Microbiological characterization includes the determination of biotype and toxigenicity status using phenotypic and genotypic methods. Antimicrobial susceptibility was determined by the E-test method. Molecular characterization was performed by multi-locus sequence typing. In total, there were 157 cases of C. diphtheriae isolates, 127 in patients with respiratory diphtheria and 30 with ozena. Isolates with a mitis biotype were predominant (122 out of 157; 77.7%) followed by belfanti (28 out of 157; 17.8%) and gravis biotype (seven out of 157; 4.5%). Toxigenic isolates were predominant in the period 1992-2006 (74 out of 134) whereas in the period 2007-2015, only non-toxigenic isolates circulated (23 out of 23). All 157 isolates were susceptible to erythromycin, gentamicin, vancomycin and cotrimoxazole. Reduced susceptibility to penicillin G, cefotaxime, tetracycline and chloramphenicol was detected in 90 (57.3%), 88 (56.1%), 112 (71.3%) and 90 (57.3%) isolates, respectively. Multi-locus sequence typing analysis indicates that sequence type 116 (ST-116) was the most frequent, with 65 out of 100 isolates analysed, in particular during the epidemic period 1992-1999 (57 out of 65 isolates). In the post-epidemic period, 2000-2015, 13 different sequence types were isolated. All belfanti isolates (ten out of 100 isolates) belonged to closely related sequence types grouped in a phylogenetically distinct eBurst group and were collected exclusively in ozena cases. In conclusion, the epidemic period was associated with ST-116 while the post-epidemic period was characterized by more diversity. Belfanti isolates are grouped in a phylogenetically distinct clonal complex.
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Affiliation(s)
- N Benamrouche
- Medical Bacteriology Laboratory, Institut Pasteur, Algiers, Algeria.
| | - S Hasnaoui
- Medical Bacteriology Laboratory, Institut Pasteur, Algiers, Algeria
| | - E Badell
- Molecular Prevention and Therapy of Human Diseases Unit, Institut Pasteur, Paris, France
| | - B Guettou
- Medical Bacteriology Laboratory, Institut Pasteur, Algiers, Algeria
| | - M Lazri
- Medical Bacteriology Laboratory, Institut Pasteur, Algiers, Algeria
| | - N Guiso
- Molecular Prevention and Therapy of Human Diseases Unit, Institut Pasteur, Paris, France
| | - K Rahal
- Medical Bacteriology Laboratory, Institut Pasteur, Algiers, Algeria
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Sangal V, Hoskisson PA. Evolution, epidemiology and diversity of Corynebacterium diphtheriae: New perspectives on an old foe. INFECTION GENETICS AND EVOLUTION 2016; 43:364-70. [PMID: 27291708 DOI: 10.1016/j.meegid.2016.06.024] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 06/07/2016] [Accepted: 06/08/2016] [Indexed: 11/19/2022]
Abstract
Diphtheria is a debilitating disease caused by toxigenic Corynebacterium diphtheriae strains and has been effectively controlled by the toxoid vaccine, yet several recent outbreaks have been reported across the globe. Moreover, non-toxigenic C. diphtheriae strains are emerging as a major global health concern by causing severe pharyngitis and tonsillitis, endocarditis, septic arthritis and osteomyelitis. Molecular epidemiological investigations suggest the existence of outbreak-associated clones with multiple genotypes circulating around the world. Evolution and pathogenesis appears to be driven by recombination as major virulence factors, including the tox gene and pilus gene clusters, are found within genomic islands that appear to be mobile between strains. The number of pilus gene clusters and variation introduced by gain or loss of gene function correlate with the variable adhesive and invasive properties of C. diphtheriae strains. Genomic variation does not support the separation of C. diphtheriae strains into biovars which correlates well with findings of studies based on multilocus sequence typing. Genomic analyses of a relatively small number of strains also revealed a recombination driven diversification of strains within a sequence type and indicate a wider diversity among C. diphtheriae strains than previously appreciated. This suggests that there is a need for increased effort from the scientific community to study C. diphtheriae to help understand the genomic diversity and pathogenicity within the population of this important human pathogen.
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Affiliation(s)
- Vartul Sangal
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne NE1 8ST, UK
| | - Paul A Hoskisson
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, 161 Cathedral Street, Glasgow, G4 0RE, UK.
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Sangal V, Blom J, Sutcliffe IC, von Hunolstein C, Burkovski A, Hoskisson PA. Adherence and invasive properties of Corynebacterium diphtheriae strains correlates with the predicted membrane-associated and secreted proteome. BMC Genomics 2015; 16:765. [PMID: 26452736 PMCID: PMC4600297 DOI: 10.1186/s12864-015-1980-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Accepted: 10/02/2015] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Non-toxigenic Corynebacterium diphtheriae strains are emerging as a major cause of severe pharyngitis and tonsillitis as well as invasive diseases such as endocarditis, septic arthritis, splenic abscesses and osteomyelitis. C. diphtheriae strains have been reported to vary in their ability to adhere and invade different cell lines. To identify the genetic basis of variation in the degrees of pathogenicity, we sequenced the genomes of four strains of C. diphtheriae (ISS 3319, ISS 4060, ISS 4746 and ISS 4749) that are well characterised in terms of their ability to adhere and invade mammalian cells. RESULTS Comparative analyses of 20 C. diphtheriae genome sequences, including 16 publicly available genomes, revealed a pan-genome comprising 3,989 protein coding sequences that include 1,625 core genes and 2,364 accessory genes. Most of the genomic variation between these strains relates to uncharacterised genes encoding hypothetical proteins or transposases. Further analyses of protein sequences using an array of bioinformatic tools predicted most of the accessory proteome to be located in the cytoplasm. The membrane-associated and secreted proteins are generally involved in adhesion and virulence characteristics. The genes encoding membrane-associated proteins, especially the number and organisation of the pilus gene clusters (spa) including the number of genes encoding surface proteins with LPXTG motifs differed between different strains. Other variations were among the genes encoding extracellular proteins, especially substrate binding proteins of different functional classes of ABC transport systems and 'non-classical' secreted proteins. CONCLUSIONS The structure and organisation of the spa gene clusters correlates with differences in the ability of C. diphtheriae strains to adhere and invade the host cells. Furthermore, differences in the number of genes encoding membrane-associated proteins, e.g., additional proteins with LPXTG motifs could also result in variation in the adhesive properties between different strains. The variation in the secreted proteome may be associated with the degree of pathogenesis. While the role of the 'non-classical' secretome in virulence remains unclear, differences in the substrate binding proteins of various ABC transport systems and cytoplasmic proteins potentially suggest strain variation in nutritional requirements or a differential ability to utilize various carbon sources.
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Affiliation(s)
- Vartul Sangal
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, NE1 8ST, UK.
| | - Jochen Blom
- Heinrich-Buff-Ring 58, Justus-Liebig-Universität, 35392, Gießen, Germany.
| | - Iain C Sutcliffe
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, NE1 8ST, UK.
| | | | - Andreas Burkovski
- Professur für Mikrobiologie, Friedrich-Alexander-Universität Erlangen-Nürnberg, Staudtstr. 5, 91058, Erlangen, Germany.
| | - Paul A Hoskisson
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, 161 Cathedral Street, Glasgow, G4 0RE, UK.
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Non-toxigenic tox gene-bearing Corynebacterium ulcerans in a traumatic ulcer from a human case and his asymptomatic dog. Microbes Infect 2015; 17:717-9. [PMID: 26284490 DOI: 10.1016/j.micinf.2015.07.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Revised: 07/24/2015] [Accepted: 07/24/2015] [Indexed: 02/06/2023]
Abstract
A non-toxigenic tox gene-bearing (NTTB) Corynebacterium ulcerans was grown from the wound of a 61-year-old gardener and in a nasal specimen from the patient's asymptomatic dog. The two isolates were similar in terms of antibiogram, multilocus sequence typing (ST341), virulence genes, and only three SNPs were found to differentiate the two NTTB C. ulcerans isolates supporting a zoonotic transmission to or between the patient and his dog. Of interest, we found that the two C. ulcerans isolates, although not expressing the diphtheria toxin tox, possessed 13 out of 14 recently described virulence candidate genes.
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Abstract
Twenty-five cases of nontoxigenic Corynebacterium diphtheriae infection were recorded in Poland during 2004–2012, of which 18 were invasive. Alcoholism, homelessness, hepatic cirrhosis, and dental caries were predisposing factors for infection. However, for 17% of cases, no concomitant diseases or predisposing factors were found.
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Zasada AA, Formińska K, Wołkowicz T, Badell E, Guiso N. The utility of the PCR melting profile technique for typing Corynebacterium diphtheriae isolates. Lett Appl Microbiol 2014; 59:292-8. [PMID: 24749659 DOI: 10.1111/lam.12274] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Revised: 04/09/2014] [Accepted: 04/09/2014] [Indexed: 11/30/2022]
Abstract
UNLABELLED Selection of appropriate typing method depends on a number of factors, including the scale of the investigation, the rapidity required of the results and the financial and technical resources available. Several typing methods have been applied to Corynebacterium diphtheriae genotyping, but most are laborious and time-consuming or require expensive equipment. We report an evaluation of the utility of the PCR melting profile technique for simple and easy-to-perform genotyping of C. diphtheriae. We compared the method with ribotyping-the 'gold standard' for C. diphtheriae typing-and PFGE, MLST, AFLP, RAPD and spoligotyping. SIGNIFICANCE AND IMPACT OF THE STUDY Occurrence of Corynebacterium diphtheriae infections-in the form of diphtheria in endemic countries and in the form of invasive infections in countries with high antidiphtheria vaccination coverage-indicates the need for maintenance of ability to genotype this pathogen by laboratories. Application of an appropriate typing method is essential not only in outbreak investigations for understanding and predicting epidemics but also in monitoring of the evolution and spread of epidemic clones of C. diphtheriae. The PCR melting profile method presented in the study is a good alternative for C. diphtheriae typing.
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Affiliation(s)
- A A Zasada
- Department of Bacteriology, National Institute of Public Health - National Institute of Hygiene, Warsaw, Poland
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May MLA, McDougall RJ, Robson JM. Corynebacterium diphtheriae and the returned tropical traveler. J Travel Med 2014; 21:39-44. [PMID: 24383653 DOI: 10.1111/jtm.12074] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2013] [Revised: 08/12/2013] [Accepted: 08/15/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND In Western countries, nontoxigenic Corynebacterium diphtheriae is known to cause skin and soft tissue infections (SSIs), upper respiratory tract infections, and occasionally invasive disease. Its role as a skin pathogen in returned travelers from tropical destinations where the organism is endemic is often forgotten. A retrospective analysis of a large Australian private pathology laboratory's experience with C. diphtheriae was performed to identify how frequently overseas travel was associated with C. diptheriae infection/colonization. METHODS All C. diphtheriae isolates cultured from 2002 to 2012 were reviewed. Recorded clinical information regarding recent travel, country, and cause of infection was assessed. Antibiotic susceptibility was verified on all isolates. RESULTS In all there were 72 patients who had C. diphtheriae isolated on clinical specimens, and information about prior travel was available for 63. Seventy percent of these were healthy individuals with an SSI and history of recent travel to a tropical nation. Ninety-seven percent had associated copathogens. Two isolates were penicillin resistant. There was uniform susceptibility to cephalothin, clindamycin, erythromycin, and vancomycin, with 14% resistance to trimethoprim/sulfamethoxazole and 4% resistance to tetracycline. Only one isolate was a toxigenic strain. CONCLUSION The majority of C. diphtheriae isolated were from SSIs in otherwise healthy travelers returning from tropical destinations, rather than classical risk groups. Clinicians and laboratories need to be aware of this potential source of C. diphtheriae infection due to rare toxigenic strains.
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Affiliation(s)
- Meryta L A May
- Department of Microbiology, Sullivan Nicolaides Pathology, Brisbane, QLD, Australia
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Sangal V, Burkovski A, Hunt AC, Edwards B, Blom J, Hoskisson PA. A lack of genetic basis for biovar differentiation in clinically important Corynebacterium diphtheriae from whole genome sequencing. INFECTION GENETICS AND EVOLUTION 2013; 21:54-7. [PMID: 24200588 DOI: 10.1016/j.meegid.2013.10.019] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2013] [Revised: 10/22/2013] [Accepted: 10/23/2013] [Indexed: 11/26/2022]
Abstract
The differentiation of clinically important Corynebacterium diphtheriae into specific biovars is complex and phylogenetically unclear. Comparative genomic analyses of 17 strains indicate that the division of C. diphtheriae into different biovars does not correlate with the variation in the gene content in the relevant metabolic categories that are potentially involved in the biovar discrimination. The biochemical separation is also not supported by phylogenetic analyses, suggesting molecular methods of typing C. diphtheriae strains should be adopted much more widely.
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Affiliation(s)
- Vartul Sangal
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, 161 Cathedral Street, Glasgow G4 0RE, UK
| | - Andreas Burkovski
- Lehrstuhl für Mikrobiologie, Friedrich-Alexander-Universität Erlangen-Nürnberg, Germany
| | - Alison C Hunt
- Department of Medical Microbiology, Aberdeen Royal Infirmary, Foresterhill, Aberdeen AB25 2ZN, UK
| | - Becky Edwards
- Microbiology Department, Royal Infirmary of Edinburgh, 51 Little France Cresent, Old Dalkeith Road, Edinburgh EH16 4SA, UK
| | - Jochen Blom
- Bioinformatics Resource Facility, Center for Biotechnology (CeBiTec), Bielefeld University, Germany
| | - Paul A Hoskisson
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, 161 Cathedral Street, Glasgow G4 0RE, UK.
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Sangal V, Fineran PC, Hoskisson PA. Novel configurations of type I and II CRISPR–Cas systems in Corynebacterium diphtheriae. Microbiology (Reading) 2013; 159:2118-2126. [DOI: 10.1099/mic.0.070235-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Affiliation(s)
- Vartul Sangal
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, 161 Cathedral Street, Glasgow G4 0RE, UK
| | - Peter C. Fineran
- Department of Microbiology and Immunology, University of Otago, PO Box 56, Dunedin 9054, New Zealand
| | - Paul A. Hoskisson
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, 161 Cathedral Street, Glasgow G4 0RE, UK
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Torres LDFC, Ribeiro D, Hirata R, Pacheco LGC, Souza MC, dos Santos LS, dos Santos CS, Salah M, da Costa MM, Ribeiro MG, Selim SA, Azevedo VADC, Mattos-Guaraldi AL. Multiplex polymerase chain reaction to identify and determine the toxigenicity of Corynebacterium spp with zoonotic potential and an overview of human and animal infections. Mem Inst Oswaldo Cruz 2013; 108:S0074-02762013000300272. [PMID: 23778659 PMCID: PMC4005569 DOI: 10.1590/s0074-02762013000300003] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2012] [Accepted: 09/14/2012] [Indexed: 11/21/2022] Open
Abstract
Corynebacterium diphtheriae, Corynebacterium ulcerans and Corynebacterium pseudotuberculosis constitute a group of potentially toxigenic microorganisms that are related to different infectious processes in animal and human hosts. Currently, there is a lack of information on the prevalence of disease caused by these pathogens, which is partially due to a reduction in the frequency of routine laboratory testing. In this study, a multiplex polymerase chain reaction (mPCR) assay that can simultaneously identify and determine the toxigenicity of these corynebacterial species with zoonotic potential was developed. This assay uses five primer pairs targeting the following genes: rpoB (Corynebacterium spp), 16S rRNA (C. ulcerans and C. pseudotuberculosis), pld (C. pseudotuberculosis), dtxR (C. diphtheriae) and tox [diphtheria toxin (DT) ]. In addition to describing this assay, we review the literature regarding the diseases caused by these pathogens. Of the 213 coryneform strains tested, the mPCR results for all toxigenic and non-toxigenic strains of C . diphtheriae, C. ulcerans and C. pseudotuberculosis were in 100% agreement with the results of standard biochemical tests and PCR-DT. As an alternative to conventional methods, due to its advantages of specificity and speed, the mPCR assay used in this study may successfully be applied for the diagnosis of human and/or animal diseases caused by potentially toxigenic corynebacterial species.
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Affiliation(s)
- Luciene de Fátima Costa Torres
- Laboratório de Difteria e Corinebactérias de Importância Clínica, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - Dayana Ribeiro
- Departamento de Biologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Raphael Hirata
- Laboratório de Difteria e Corinebactérias de Importância Clínica, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | | | - Monica Cristina Souza
- Laboratório de Difteria e Corinebactérias de Importância Clínica, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - Louisy Sanches dos Santos
- Laboratório de Difteria e Corinebactérias de Importância Clínica, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - Cíntia Silva dos Santos
- Laboratório de Difteria e Corinebactérias de Importância Clínica, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - Mohammad Salah
- Faculdade de Medicina Veterinária, Universidade do Cairo, Giza, Egito
| | | | - Marcio Garcia Ribeiro
- Departamento de Higiene Veterinária e Saúde Pública, Escola de Medicina Veterinária e Ciência Animal, Universidade Estadual Paulista, Botucatu, SP, Brasil
| | - Salah A Selim
- Faculdade de Medicina Veterinária, Universidade do Cairo, Giza, Egito
| | | | - Ana Luiza Mattos-Guaraldi
- Laboratório de Difteria e Corinebactérias de Importância Clínica, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
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Farfour E, Badell E, Dinu S, Guillot S, Guiso N. Microbiological changes and diversity in autochthonous non-toxigenic Corynebacterium diphtheriae isolated in France. Clin Microbiol Infect 2013; 19:980-7. [PMID: 23320433 DOI: 10.1111/1469-0691.12103] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2012] [Revised: 11/09/2012] [Accepted: 11/09/2012] [Indexed: 11/28/2022]
Abstract
Autochtonous toxigenic Corynebacterium diphtheriae have disappeared in mainland France, but non-toxigenic C. diphtheriae are still circulating. Using phenotypic and molecular tools, we retrospectively characterized 103 non-toxigenic C. diphtheriae collected in mainland France and highlight several changes. The proportion of C. diphtheriae belfanti increased between 1977 and 2011 and it is the most frequent biotype recovered in recent years. Resistance to ciprofloxacin has increased and most isolates with decreased sensitivity belong to the belfanti biotype. Using multilocus sequence typing, we demonstrate that French isolates are distributed in a large number of sequence types and identify three distinct lineages. C. diphtheriae mitis and gravis form lineage I while C. diphtheriae belfanti forms lineages II and III. Almost all isolates of lineage II are part of a unique clonal complex or are very close to it. Most French isolates have a dtxR sequence homologous to that of toxigenic isolates, suggesting that if lyzogenised by a corynephage, they can express diphtheria toxin.
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Affiliation(s)
- E Farfour
- Institut Pasteur, Unité Prévention et Thérapies Moléculaires des Maladies Humaines, Centre National de Référence des Corynébactéries du Complexe Diphtheriae, Paris, France; CNRS-URA 3012, Paris, France
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Ott L, Scholz B, Höller M, Hasselt K, Ensser A, Burkovski A. Induction of the NFκ-B signal transduction pathway in response to Corynebacterium diphtheriae infection. Microbiology (Reading) 2013; 159:126-135. [DOI: 10.1099/mic.0.061879-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Lisa Ott
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Lehrstuhl für Mikrobiologie, Staudtstr. 5, 91058 Erlangen, Germany
| | - Brigitte Scholz
- Klinische und Molekulare Virologie, Virologisches Institut des Universitätsklinikums Erlangen, Schlossgarten 4, 91054, Erlangen, Germany
| | - Martina Höller
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Lehrstuhl für Mikrobiologie, Staudtstr. 5, 91058 Erlangen, Germany
| | - Kristin Hasselt
- BioCer Entwicklungs-GmbH, Ludwig-Thoma-Str. 36c, 95447 Bayreuth, Germany
| | - Armin Ensser
- Klinische und Molekulare Virologie, Virologisches Institut des Universitätsklinikums Erlangen, Schlossgarten 4, 91054, Erlangen, Germany
| | - Andreas Burkovski
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Lehrstuhl für Mikrobiologie, Staudtstr. 5, 91058 Erlangen, Germany
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