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Prygiel M, Mosiej E, Polak M, Krysztopa-Grzybowska K, Wdowiak K, Formińska K, Zasada AA. Challenges of Diphtheria Toxin Detection. Toxins (Basel) 2024; 16:245. [PMID: 38922140 PMCID: PMC11209151 DOI: 10.3390/toxins16060245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 05/22/2024] [Accepted: 05/24/2024] [Indexed: 06/27/2024] Open
Abstract
Diphtheria toxin (DT) is the main virulence factor of Corynebacterium diphtheriae, C. ulcerans and C. pseudotuberculosis. Moreover, new Corynebacterium species with the potential to produce diphtheria toxin have also been described. Therefore, the detection of the toxin is the most important test in the microbiological diagnosis of diphtheria and other corynebacteria infections. Since the first demonstration in 1888 that DT is a major virulence factor of C. diphtheriae, responsible for the systemic manifestation of the disease, various methods for DT detection have been developed, but the diagnostic usefulness of most of them has not been confirmed on a sufficiently large group of samples. Despite substantial progress in the science and diagnostics of infectious diseases, the Elek test is still the basic recommended diagnostic test for DT detection. The challenge here is the poor availability of an antitoxin and declining experience even in reference laboratories due to the low prevalence of diphtheria in developed countries. However, recent and very promising assays have been developed with the potential for use as rapid point-of-care testing (POCT), such as ICS and LFIA for toxin detection, LAMP for tox gene detection, and biosensors for both.
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Affiliation(s)
| | | | | | | | | | | | - Aleksandra A. Zasada
- Department of Sera and Vaccines Evaluation, National Institute of Public Health NIH—National Research Institute, Chocimska 24, 00-791 Warsaw, Poland; (M.P.); (E.M.); (M.P.); (K.K.-G.); (K.W.); (K.F.)
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2
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Al-Kadmy IMS, Aziz SN, Hussein NH, El-Shafeiy SN, Hamzah IH, Suhail A, Alhomaidi E, Algammal AM, El-Saber Batiha G, ElBadre HM, Hetta HF. Sequencing analysis and efficient biodiesel production by lipase from Pseudomonas aeruginosa. Mol Biol Rep 2024; 51:323. [PMID: 38393680 DOI: 10.1007/s11033-023-09156-z] [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: 03/12/2023] [Accepted: 12/12/2023] [Indexed: 02/25/2024]
Abstract
BACKGROUND Recently, lipase processing for biodiesel production has shown a global increase as it is considered a potential alternative clean-fuel source. The current study's objective is to investigate of lipolytic activity of lipase produced from different strains of Pseudomonas aeruginosa (P. aeruginosa) in biodiesel production using edible plant oils. The goal is to develop an efficient and cost-effective method for producing inexpensive and environmentally friendly biodiesel. METHODS AND RESULTS Four P. aeruginosa isolates were obtained from different environmental sources (soil), phenotypically identified, and it was confirmed by the PCR detection of the 16SrRNA gene. The isolated P. aeruginosa strains were screened for lipase production, and the recovered lipase was purified. Besides, the lipase (lip) gene was detected by PCR, and the purified PCR products were sequenced and analyzed. The production of biofuel was conducted using gas chromatography among tested oils. It was found that castor oil was the best one that enhances lipase production in-vitro.
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Affiliation(s)
- Israa M S Al-Kadmy
- Branch of Biotechnology, Department of Biology, College of Science, Mustansiriyah University, Baghdad, 10422, Iraq.
| | - Sarah Naji Aziz
- Branch of'Microbiology, Department of Biology, College of Science, Mustansiriyah University, Baghdad, 10422, Iraq
| | - Nadheema Hammood Hussein
- Branch of'Microbiology, Department of Biology, College of Science, Mustansiriyah University, Baghdad, 10422, Iraq
| | - Samah N El-Shafeiy
- Plant Protection Research Institute, Agricultural Research Center, Dokki, Giza, 44516, Egypt
| | - Israa Hussein Hamzah
- Branch of Zoology, Department of Biology, College of Science, Mustansiriyah University, Baghdad, Iraq
| | - Ahmed Suhail
- Department of physics, College of science, Mosul University, Mosul, Iraq
| | - Eman Alhomaidi
- Department of biology, College of Science, Princess Nourah bint Abdulrahman University, P.O. Box 84428, 11671, Riyadh, Saudi Arabia
| | - Abdelazeem M Algammal
- Department of Bacteriology, Immunology and Mycology, Faculty of Veterinary Medicine, Suez Canal University, 41522, Ismailia, Egypt
| | - Gaber El-Saber Batiha
- Department of Pharmacology and Therapeutics, Faculty of Veterinary Medicines, Damanhour University, 22511, Damanhour, Egypt
| | - Hala M ElBadre
- Department of Medical Biochemistry, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Helal F Hetta
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Assiut University, Assiut, Egypt
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3
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Thomas A, Slifka AM, Hendrickson SM, Amanna IJ, Slifka MK. Active Circulation of Corynebacterium ulcerans among Nonhuman Primates. Microbiol Spectr 2022; 10:e0089422. [PMID: 35863003 PMCID: PMC9431270 DOI: 10.1128/spectrum.00894-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 06/27/2022] [Indexed: 11/20/2022] Open
Abstract
Diphtheria is rare in the United States. and many industrialized nations due to development of an effective vaccine, coupled with high vaccination coverage. Although there is continued risk of importation and transmission of Corynebacterium diphtheriae, C. ulcerans has now become the dominant source of diphtheria cases among several European countries. Bearing this in mind, a better understanding of C. ulcerans biology is clearly needed. Here, we identified active transmission of toxigenic C. ulcerans among indoor- and outdoor-housed rhesus macaques based on diphtheria toxin-specific serology assays as well as direct isolation of C. ulcerans from a recently infected animal. In addition to animal-to-animal transmission, we found serological evidence indicative of potential human transmission. Together, these results provide new details on natural Corynebacterium transmission among nonhuman primates and emphasizes the importance of maintaining high vaccination coverage to reduce the risk of potential zoonotic infection. IMPORTANCE C. ulcerans represents an emerging zoonotic agent of diphtheria, but little is known about its transmission or maintenance among animal reservoirs. In these studies, we identified diphtheria outbreaks among both outdoor- and indoor-housed rhesus macaques and isolated a toxigenic strain of C. ulcerans from a recently infected animal. Retrospective analysis indicated that toxigenic Corynebacteria have been circulating among these primates for decades with the potential for rare zoonotic transmission to humans.
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Affiliation(s)
- Archana Thomas
- Oregon Health & Science University, Beaverton, Oregon, USA
| | | | | | | | - Mark K. Slifka
- Oregon Health & Science University, Beaverton, Oregon, USA
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4
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Rosana Y, Prilandari LI, Ajisman R, Hartono TS, Yasmon A. Detection of toxin-producing Corynebacterium diphtheriae from throat swabs of diphtheria patients using duplex real-time PCR. IRANIAN JOURNAL OF MICROBIOLOGY 2020; 12:508-515. [PMID: 33613904 PMCID: PMC7884264 DOI: 10.18502/ijm.v12i6.5024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background and Objectives Diphtheria is a potentially fatal disease caused by toxigenic bacterial infection, particularly from Corynebacterium diphtheriae (C. diphtheriae). Isolation of C. diphtheriae is technically lacking in sensitivity, and Elek's test to detect toxin production has several difficulties associated with its application. Duplex real-time PCR to throat swab of suspected diphtheria patients can detect both bacteria and toxin-encoding genes simultaneously, faster, with higher sensitivity and specificity. Materials and Methods A total of 89 consecutive throat swabs from suspected diphtheria patients were collected from Sulianti Saroso Infectious Disease Hospital, Jakarta, during 2018 to 2019. Two pairs of primers and probes, targeting the rpoB gene of C. diphtheriae and the A-subunit of the diphtheria toxin gene, were used in this study. Parameters including annealing temperature, concentration of primers and probes, inhibitors, cross-reaction and detection limit were all optimized. Elek's toxigenicity test and clinical data were analyzed for comparison. Results The optimum annealing temperature was 55°C. The concentrations of Cd primer, Tox primer, Cd probe and Tox probe were 0.4, 0.6, 0.5 and 0.625 µM, respectively. DNA elution and template volumes were 50 µL and 5 µL. The detection limit was 2 CFU/mL. No cross-reaction with other microorganisms was observed. Of the 89 samples, duplex real-time PCR gave better results than the standard test, with 19 (21.3%) and 10 (11.2%) patients diagnosed with diphtheria, respectively. Conclusion Duplex real-time PCR increases the rate of laboratory diagnosis of diphtheria, compared to the standard method to detect potentially toxigenic C. diphtheriae.
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Affiliation(s)
- Yeva Rosana
- Department of Microbiology, School of Medicine, Universitas Indonesia, Ciptomangunkusumo Hospital, Jakarta, Indonesia
| | - Luh Inta Prilandari
- Department of Microbiology, Clinical Microbiologist Program, School of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Ruhsyahadati Ajisman
- Department of Microbiology, Clinical Microbiologist Program, School of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Teguh Sarry Hartono
- Department of Microbiology, Sulianti Saroso Infectious Diseases Hospital, Jakarta, Indonesia
| | - Andi Yasmon
- Department of Microbiology, School of Medicine, Universitas Indonesia, Ciptomangunkusumo Hospital, Jakarta, Indonesia
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5
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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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Borisova OY, Pimenova AS, Chaplin AV, Kafarskaya LI, Afanasiev SS, Aleshkin VA, Aleshkin AV, Afanasiev MS, Karaulov AV. AN ACCELERATED METHOD OF DIPHTHERIA GENE DIAGNOSTICS BASED ON ISOTHERMAL AMPLIFICATION TO DETECT DNA OF THE CAUSATIVE AGENT. ЖУРНАЛ МИКРОБИОЛОГИИ, ЭПИДЕМИОЛОГИИ И ИММУНОБИОЛОГИИ 2017. [DOI: 10.36233/0372-9311-2017-5-24-32] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- O. Yu. Borisova
- Gabrichevsky Moscow Research Institute of Epidemiology and Microbiology, Pirogov Russian National Research Medical University
| | - A. S. Pimenova
- Gabrichevsky Moscow Research Institute of Epidemiology and Microbiology
| | - A. V. Chaplin
- Gabrichevsky Moscow Research Institute of Epidemiology and Microbiology, Pirogov Russian National Research Medical University
| | - L. I. Kafarskaya
- Gabrichevsky Moscow Research Institute of Epidemiology and Microbiology
| | - S. S. Afanasiev
- Gabrichevsky Moscow Research Institute of Epidemiology and Microbiology
| | - V. A. Aleshkin
- Gabrichevsky Moscow Research Institute of Epidemiology and Microbiology
| | - A. V. Aleshkin
- Gabrichevsky Moscow Research Institute of Epidemiology and Microbiology
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Otsuji K, Fukuda K, Endo T, Shimizu S, Harayama N, Ogawa M, Yamamoto A, Umeda K, Umata T, Seki H, Iwaki M, Kamochi M, Saito M. The first fatal case of Corynebacterium ulcerans infection in Japan. JMM Case Rep 2017; 4:e005106. [PMID: 29026633 PMCID: PMC5610708 DOI: 10.1099/jmmcr.0.005106] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 07/18/2017] [Indexed: 11/18/2022] Open
Abstract
Introduction.Corynebacterium ulcerans (C. ulcerans) is a zoonotic pathogen that occasionally causes diphtheria-like symptoms in humans. Cases of C. ulcerans infection have been increasing in recent years, and C. ulcerans has been recognized as an emerging pathogen. Case presentation. Here we report a case of asphyxia death due to pseudomembrane caused by diphtheria toxin (DT)-producing C. ulcerans. This is, to our knowledge, the first fatal case of C. ulcerans infection in Japan. A strain of C. ulcerans was obtained from the patient's pet cat and was confirmed to be identical to the patient's isolate by sequencing of the 16S rRNA gene and the DT gene, by pulsed-field gel electrophoresis (PFGE) and by ribotyping. In the same way, it was revealed that the isolate in this case belonged to the same molecular type as the C. ulcerans 0102 isolated from the first case in Japan in a distant prefecture 15 years earlier, in 2001. Conclusion. DT-producing C. ulcerans can be contracted from a companion animal and causes human death if the appropriate treatment is delayed. The finding indicates that this molecular type of virulent C. ulcerans is currently widespread in Japan.
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Affiliation(s)
- Ken Otsuji
- Department of Microbiology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.,Department of Critical Care Medicine, Hospital of the University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Kazumasa Fukuda
- Department of Microbiology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Takeru Endo
- Department of Critical Care Medicine, Hospital of the University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Satoko Shimizu
- Department of Critical Care Medicine, Hospital of the University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Nobuya Harayama
- Department of Critical Care Medicine, Hospital of the University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Midori Ogawa
- Department of Microbiology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Akihiko Yamamoto
- Department of Bacteriology II, National Institute of Infectious Diseases, Tokyo, Japan
| | - Kaoru Umeda
- Department of Microbiology, Osaka City Institute of Public Health and Environmental Sciences, Osaka, Japan
| | - Toshiyuki Umata
- Radioisotope Research Center, Facility for Education and Research Support, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Hiroyuki Seki
- Department of Laboratory and Transfusion Medicine, Hospital of the University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Masaaki Iwaki
- Department of Bacteriology II, National Institute of Infectious Diseases, Tokyo, Japan
| | - Masayuki Kamochi
- Department of Critical Care Medicine, Hospital of the University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Mitsumasa Saito
- Department of Microbiology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
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8
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Silva GP, Santos RS, Pereira-Manfro WF, Ferreira B, Barreto DM, Frota ACC, Hofer CB, Milagres LG. A cross-reacting material CRM 197 conjugate vaccine induces diphtheria toxin neutralizing antibody response in children and adolescents infected or not with HIV. Vaccine 2017; 35:3803-3807. [PMID: 28599793 DOI: 10.1016/j.vaccine.2017.05.080] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 05/24/2017] [Accepted: 05/26/2017] [Indexed: 10/19/2022]
Abstract
Anti-diphtheria antibody levels decrease with aging, and frequent booster vaccinations are required to maintain herd immunity. We analyzed the diphtheria toxin neutralizing antibody (DT-Nab) response induced by a conjugate vaccine (meningococcal C polysaccharide-CRM197) in HIV-vertically infected (HI) children and adolescents and healthy controls (HC) with matched age. We report the association of DT-Nab with the bactericidal antibodies to serogroup C meningococcus (MenC). Before vaccination, 21 HI patients (50%) had no protection against diphtheria (≤0.01IU/ml of antibody) and only 8 (19%) showed complete protection (≥0.1IU/ml). About half of the HC (56%) had complete protection before immunization and 6 subjects (12%) had no protection against diphtheria. After one and two vaccine injections, 96% of HC and 64% of HI vaccinees, respectively, showed full protection against diphtheria. These data indicate that CRM197 was able to induce primary and/or booster response in both groups of individuals.
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Affiliation(s)
- Giselle P Silva
- State University of Rio de Janeiro, Department of Microbiology, Immunology and Parasitology, Rio de Janeiro, Brazil
| | - Rafaela S Santos
- State University of Rio de Janeiro, Department of Microbiology, Immunology and Parasitology, Rio de Janeiro, Brazil
| | - Wânia F Pereira-Manfro
- State University of Rio de Janeiro, Department of Microbiology, Immunology and Parasitology, Rio de Janeiro, Brazil
| | - Bianca Ferreira
- Instituto de Puericultura e Pediatria Martagão Gesteira, Rio de Janeiro, Brazil
| | - Daniella M Barreto
- Instituto de Puericultura e Pediatria Martagão Gesteira, Rio de Janeiro, Brazil
| | | | - Cristina B Hofer
- Instituto de Puericultura e Pediatria Martagão Gesteira, Rio de Janeiro, Brazil; Preventive Medicine Department, School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Lucimar G Milagres
- State University of Rio de Janeiro, Department of Microbiology, Immunology and Parasitology, Rio de Janeiro, Brazil.
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Billard-Pomares T, Rouyer C, Walewski V, Badell-Ocando E, Dumas M, Zumelzu C, Jaureguy F, Brisse S, Caux F, Bouchaud O, Carbonnelle E. Diagnosis in France of a Non-Toxigenic tox Gene-Bearing Strain of Corynebacterium diphtheriae in a Young Male Back From Senegal. Open Forum Infect Dis 2017; 4:ofw271. [PMID: 28480263 PMCID: PMC5413993 DOI: 10.1093/ofid/ofw271] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 12/28/2016] [Indexed: 12/17/2022] Open
Abstract
Cutaneous diphtheria is uncommon in Europe. In this study, we report a case of imported cutaneous infection due to a non-toxigenic but tox gene-bearing (NTTB) strain of Corynebacterium diphtheriae. The NTTB strains are recognized as emerging pathogens across Europe, and physicians and bacteriologists should be aware of the circulation of these strains.
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Affiliation(s)
- Typhaine Billard-Pomares
- Microbiology Department, Hôpital Avicenne, Assistance Publique-Hôpitaux de Paris (AP-HP), Bobigny, France.,Infection, Antimicrobiens, Modélisation, Evolution, Unité Mixte de Recherche 1137, Université Paris 13 - Sorbonne Paris Cité, France
| | - Cécile Rouyer
- Infectious Diseases Unit, Hôpital Avicenne, AP-HP, Bobigny, France
| | - Violaine Walewski
- Microbiology Department, Hôpital Avicenne, Assistance Publique-Hôpitaux de Paris (AP-HP), Bobigny, France.,Infection, Antimicrobiens, Modélisation, Evolution, Unité Mixte de Recherche 1137, Université Paris 13 - Sorbonne Paris Cité, France
| | - Edgar Badell-Ocando
- Institut Pasteur, National Reference Center for Corynebacteria of the diphtheriae Complex, Paris, France
| | - Marc Dumas
- Dermatology Department, Hôpital Avicenne, AP-HP, Bobigny, France
| | - Coralie Zumelzu
- Dermatology Department, Hôpital Avicenne, AP-HP, Bobigny, France
| | - Françoise Jaureguy
- Microbiology Department, Hôpital Avicenne, Assistance Publique-Hôpitaux de Paris (AP-HP), Bobigny, France.,Infection, Antimicrobiens, Modélisation, Evolution, Unité Mixte de Recherche 1137, Université Paris 13 - Sorbonne Paris Cité, France
| | - Sylvain Brisse
- Institut Pasteur, National Reference Center for Corynebacteria of the diphtheriae Complex, Paris, France
| | - Frédéric Caux
- Dermatology Department, Hôpital Avicenne, AP-HP, Bobigny, France
| | - Olivier Bouchaud
- Infectious Diseases Unit, Hôpital Avicenne, AP-HP, Bobigny, France
| | - Etienne Carbonnelle
- Microbiology Department, Hôpital Avicenne, Assistance Publique-Hôpitaux de Paris (AP-HP), Bobigny, France.,Infection, Antimicrobiens, Modélisation, Evolution, Unité Mixte de Recherche 1137, Université Paris 13 - Sorbonne Paris Cité, France
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10
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Hacker E, Antunes CA, Mattos-Guaraldi AL, Burkovski A, Tauch A. Corynebacterium ulcerans, an emerging human pathogen. Future Microbiol 2016; 11:1191-208. [PMID: 27545005 DOI: 10.2217/fmb-2016-0085] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
While formerly known infections of Corynebacterium ulcerans are rare and mainly associated with contact to infected cattle, C. ulcerans has become an emerging pathogen today. In Western Europe, cases of respiratory diphtheria caused by C. ulcerans have been reported more often than infections by Corynebacterium diphtheria, while systemic infections are also increasingly reported. Little is known about factors that contribute to host colonization and virulence of this zoonotic pathogen. Research in this field has received new impetus by the publication of several C. ulcerans genome sequences in the past years. This review gives a comprehensive overview of the basic knowledge of C. ulcerans, as well as the recent advances made in the analysis of putative virulence factors.
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Affiliation(s)
- Elena Hacker
- Professur für Mikrobiologie, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Camila A Antunes
- Professur für Mikrobiologie, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.,Laboratory of Diphtheria and Clinically Important Corynebacteria (LDCIC), Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Ana L Mattos-Guaraldi
- Laboratory of Diphtheria and Clinically Important Corynebacteria (LDCIC), Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Andreas Burkovski
- Professur für Mikrobiologie, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Andreas Tauch
- Centrum für Biotechnologie, Universität Bielefeld, Bielefeld, Germany
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11
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Ceyhan M, Ozsurekci Y, Aydin MM, Akcali KC, Talim B, Celik M, Karadag Oncel E, Gurbuz V, Aycan AE, Onbasilar I, Buzgan T. Determination of the presence of diphtheria toxin in the myocardial tissue of rabbits and a female subject by using an immunofluorescent antibody method. J Clin Med Res 2015; 7:472-8. [PMID: 25883712 PMCID: PMC4394922 DOI: 10.14740/jocmr2142w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2015] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Clinical diagnosis of diphtheria is often difficult, in particular in countries where the disease is rarely observed, such as Turkey. In 2011, after 12 years of no recorded diphtheria cases in Turkey, a 34-year-old woman was diagnosed with diphtheria; she later died of myocarditis. In this study, we aimed to demonstrate the diagnostic potential of an immunofluorescent antibody method to determine the presence of diphtheria toxin (DT) in the myocardial cells of DT-injected rabbits and the female subject. METHODS We randomly divided rabbits into two groups: a control group and a DT-injected group. Diphtheria intoxication was simulated in the rabbits by intravenous injection of DT. The myocardium of the rabbits and the female subject were harvested for histopathologic and immunofluorescence examination. A mouse monoclonal anti-DT antibody was used for the immunofluorescent antibody method. RESULTS The presence of DT in the myocardial cells of both the rabbits and the female subject was visualized using the immunofluorescent method. CONCLUSIONS Laboratory diagnosis of diphtheria is challenging because of non-toxigenic C. diphtheriae strains and/or the dysfunction of DT. However, visualizing the presence of DT in the myocardial tissue may act as an indicator of biologically active DT. We validated that an immunofluorescent method, which utilizes a monoclonal anti-DT (A-subunit specific) antibody, is a useful diagnostic tool to determine the presence of DT in the myocardium of rabbits and human.
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Affiliation(s)
- Mehmet Ceyhan
- Department of Pediatrics, Division of Infectious Diseases, Hacettepe University Faculty of Medicine, Ankara, Turkey
- These authors contributed equally to this work and shared first authorship
| | - Yasemin Ozsurekci
- Department of Pediatrics, Division of Infectious Diseases, Hacettepe University Faculty of Medicine, Ankara, Turkey
- These authors contributed equally to this work and shared first authorship
| | - Merve M. Aydin
- Department of Molecular Biology and Genetics, Bilkent University, Ankara, Turkey
| | - Kamil Can Akcali
- Department of Molecular Biology and Genetics, Bilkent University, Ankara, Turkey
| | - Beril Talim
- Department of Pediatrics, Pathology Unit, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Melda Celik
- Department of Pediatrics, Division of Infectious Diseases, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Eda Karadag Oncel
- Department of Pediatrics, Division of Infectious Diseases, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Venhar Gurbuz
- Department of Pediatrics, Division of Infectious Diseases, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ahmet Emre Aycan
- Department of Pediatrics, Division of Infectious Diseases, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ilyas Onbasilar
- Laboratory Animal Breeding and Research Unit, Hacettepe University Faculty of Medicine, Ankara, Turkey
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12
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Diphtheria outbreak in Maranhão, Brazil: microbiological, clinical and epidemiological aspects. Epidemiol Infect 2015; 143:791-8. [PMID: 25703400 DOI: 10.1017/s0950268814001241] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
We describe microbiological, clinical and epidemiological aspects of a diphtheria outbreak that occurred in Maranhão, Brazil. The majority of the 27 confirmed cases occurred in partially (n = 16) or completely (n = 10) immunized children (n = 26). Clinical signs and characteristic symptoms of diphtheria such as cervical lymphadenopathy and pseudomembrane formation were absent in 48% and 7% of the cases, respectively. Complications such as paralysis of lower limbs were observed. Three cases resulted in death, two of them in completely immunized children. Microbiological analysis identified the isolates as Corynebacterium diphtheriae biovar intermedius with a predominant PFGE type. Most of them were toxigenic and some showed a decrease in penicillin G susceptibility. In conclusion, diphtheria remains endemic in Brazil. Health professionals need to be aware of the possibility of atypical cases of C. diphtheriae infection, including pharyngitis without pseudomembrane formation.
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13
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Hirai-Yuki A, Komiya T, Suzaki Y, Ami Y, Katsukawa C, Takahashi M, Yamamoto A, Yamada YK. Isolation and characterization of toxigenic Corynebacterium ulcerans from 2 closed colonies of cynomolgus macaques (Macaca fascicularis) in Japan. Comp Med 2013; 63:272-278. [PMID: 23759530 PMCID: PMC3690433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2012] [Revised: 10/03/2012] [Accepted: 12/09/2012] [Indexed: 06/02/2023]
Abstract
The aim of the present study was to determine the prevalence of infection by toxigenic Corynebacterium ulcerans in cynomolgus macaques (Macaca fascicularis) housed in an animal facility in Japan. Samples from the pharynges of animals from 2 closed colonies (colony A, n = 47; colony B, n = 21) were cultured. C. ulcerans grew from 43% and 47% of the samples from colonies A and B, respectively. The toxigenicity of these isolates was assessed by using PCR analysis for the diphtheria toxin gene and the Elek test and Vero cytotoxicity assay to detect diphtheria toxin. The proportion of macaques harboring toxigenic C. ulcerans was 6% in colony A and 29% in colony B. Analysis of diphtheria antitoxin neutralization titers in the sera revealed that 23% and 33% of macaques from colonies A and B, respectively, had a history of infection with toxigenic C. ulcerans. Pulsed-field gel electrophoresis of the toxigenic isolates showed that all of those recovered from macaques in colony B showed an identical genotype, suggesting that transmission of the organism occurred within the colony. However, isolates from colony A macaques showed 3 different genotypes, one of which was identical to the isolate from colony B. Additional studies evaluating the prevalence and transmission of toxigenic C. ulcerans within colonies of nonhuman primates are necessary to help control the spread of the infection. The current study is the first description of the isolation and characterization of toxigenic C. ulcerans from nonhuman primates in Japan.
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Affiliation(s)
- Asuka Hirai-Yuki
- Division of Experimental Animal Research, National Institute of Infectious Diseases, Tokyo, Japan.
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14
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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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15
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Castro TLP, Seyffert N, Ramos RTJ, Barbosa S, Carvalho RDO, Pinto AC, Carneiro AR, Silva WM, Pacheco LGC, Downson C, Schneider MPC, Miyoshi A, Azevedo V, Silva A. Ion Torrent-based transcriptional assessment of a Corynebacterium pseudotuberculosis equi strain reveals denaturing high-performance liquid chromatography a promising rRNA depletion method. Microb Biotechnol 2013; 6:168-77. [PMID: 23316806 PMCID: PMC3917459 DOI: 10.1111/1751-7915.12020] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2012] [Revised: 11/13/2012] [Accepted: 11/14/2012] [Indexed: 11/29/2022] Open
Abstract
Corynebacterium pseudotuberculosis equi is a Gram-positive pathogenic bacterium which affects a variety of hosts. Besides the great economic losses it causes to horse-breeders, this organism is also known to be an important infectious agent to cattle and buffaloes. As an outcome of the efforts in characterizing the molecular basis of its virulence, several complete genome sequences were made available in recent years, enabling the large-scale assessment of genes throughout distinct isolates. Meanwhile, the RNA-seq stood out as the technology of choice for comprehensive transcriptome studies, which may bring valuable information regarding active genomic regions, despite of the still impeditive associated costs. In an attempt to increase the use of generated reads per instrument run, by effectively eliminating unwanted rRNAs from total RNA samples without relying on any commercially available kits, we applied denaturing high-performance liquid chromatography (DHPLC) as an alternative method to assess the transcriptional profile of C. pseudotuberculosis. We have found that the DHPLC depletion method, allied to Ion Torrent sequencing, allows mapping of transcripts in a comprehensive way and identifying novel transcripts when a de novo approach is used. These data encourage us to use DHPLC in future transcriptional evaluations in C. pseudotuberculosis.
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Affiliation(s)
- Thiago L P Castro
- Institute of Biological Sciences, Universidade Federal de Minas GeraisBelo Horizonte, Brazil
| | - Nubia Seyffert
- Institute of Biological Sciences, Universidade Federal de Minas GeraisBelo Horizonte, Brazil
| | - Rommel T J Ramos
- Genome and Proteome Network of the State of Pará, Universidade Federal do ParáBrazil
| | - Silvanira Barbosa
- Genome and Proteome Network of the State of Pará, Universidade Federal do ParáBrazil
| | - Rodrigo D O Carvalho
- Institute of Biological Sciences, Universidade Federal de Minas GeraisBelo Horizonte, Brazil
| | - Anne Cybelle Pinto
- Institute of Biological Sciences, Universidade Federal de Minas GeraisBelo Horizonte, Brazil
| | | | - Wanderson Marques Silva
- Institute of Biological Sciences, Universidade Federal de Minas GeraisBelo Horizonte, Brazil
| | - Luis G C Pacheco
- Institute of Health Sciences, Universidade Federal da BahiaSalvador, Brazil
| | | | - Maria P C Schneider
- Genome and Proteome Network of the State of Pará, Universidade Federal do ParáBrazil
| | - Anderson Miyoshi
- Institute of Biological Sciences, Universidade Federal de Minas GeraisBelo Horizonte, Brazil
| | - Vasco Azevedo
- Institute of Biological Sciences, Universidade Federal de Minas GeraisBelo Horizonte, Brazil
| | - Artur Silva
- Genome and Proteome Network of the State of Pará, Universidade Federal do ParáBrazil
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16
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Silva GP, Cruz SC, Cruz AC, Milagres LG. Short-term and long-term antibody response by mice after immunization against Neisseria meningitidis B or diphtheria toxoid. Braz J Med Biol Res 2013; 46:148-53. [PMID: 23369971 PMCID: PMC3854364 DOI: 10.1590/1414-431x20122556] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2012] [Accepted: 09/24/2012] [Indexed: 11/22/2022] Open
Abstract
Serogroup B Neisseria meningitidis (MenB) is a major cause of invasive disease in early childhood worldwide. The only MenB vaccine available in Brazil was produced in Cuba and has shown unsatisfactory efficacy when used to immunize millions of children in Brazil. In the present study, we compared the specific functional antibody responses evoked by the Cuban MenB vaccine with a standard vaccine against diphtheria (DTP: diphtheria, tetanus, pertussis) after primary immunization and boosting of mice. The peak of bactericidal and opsonic antibody titers to MenB and of neutralizing antibodies to diphtheria toxoid (DT) was reached after triple immunization with the MenB vaccine or DTP vaccine, respectively. However, 4 months after immunization, protective DT antibody levels were present in all DTP-vaccinated mice but in only 20% of the mice immunized against MenB. After 6 months of primary immunization, about 70% of animals still had protective neutralizing DT antibodies, but none had significant bactericidal antibodies to MenB. The booster doses of DTP or MenB vaccines produced a significant antibody recall response, suggesting that both vaccines were able to generate and maintain memory B cells during the period studied (6 months post-triple immunization). Therefore, due to the short duration of serological memory induced by the MenB vaccine (VA-MENGOC-BC® vaccine), its use should be restricted to outbreaks of meningococcal disease.
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Affiliation(s)
- G P Silva
- Universidade do Estado do Rio de Janeiro, Departamento de Microbiologia, Imunologia e Parasitologia, Faculdade de Ciências Médicas, Rio de Janeiro, RJ, Brasil
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17
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18
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The genus corynebacterium and other medically relevant coryneform-like bacteria. J Clin Microbiol 2012; 50:3152-8. [PMID: 22837327 DOI: 10.1128/jcm.00796-12] [Citation(s) in RCA: 221] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Catalase-positive Gram-positive bacilli, commonly called "diphtheroids" or "coryneform" bacteria were historically nearly always dismissed as contaminants when recovered from patients, but increasingly have been implicated as the cause of significant infections. These taxa have been underreported, and the taxa were taxonomically confusing. The mechanisms of pathogenesis, especially for newly described taxa, were rarely studied. Antibiotic susceptibility data were relatively scant. In this minireview, clinical relevance, phenotypic and genetic identification methods, matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) evaluations, and antimicrobial susceptibility testing involving species in the genus Corynebacterium and other medically relevant Gram-positive rods, collectively called coryneforms, are described.
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19
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Dias AADSDO, Santos LS, Sabbadini PS, Santos CS, Silva Junior FC, Napoleão F, Nagao PE, Villas-Bôas MHS, Hirata Junior R, Guaraldi ALM. Corynebacterium ulcerans diphtheria: an emerging zoonosis in Brazil and worldwide. Rev Saude Publica 2012; 45:1176-91. [PMID: 22124745 DOI: 10.1590/s0034-89102011000600021] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2010] [Accepted: 05/27/2011] [Indexed: 11/21/2022] Open
Abstract
The article is a literature review on the emergence of human infections caused by Corynebacterium ulcerans in many countries including Brazil. Articles in Medline/PubMed and SciELO databases published between 1926 and 2011 were reviewed, as well as articles and reports of the Brazilian Ministry of Health. It is presented a fast, cost-effective and easy to perform screening test for the presumptive diagnosis of C. ulcerans and C. diphtheriae infections in most Brazilian public and private laboratories. C. ulcerans spread in many countries and recent isolation of this pathogen in Rio de Janeiro, southeastern Brazil, is a warning to clinicians, veterinarians, and microbiologists on the occurrence of zoonotic diphtheria and C. ulcerans dissemination in urban and rural areas of Brazil and/or Latin America.
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20
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Zakikhany K, Efstratiou A. Diphtheria in Europe: current problems and new challenges. Future Microbiol 2012; 7:595-607. [DOI: 10.2217/fmb.12.24] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Diphtheria, caused by toxigenic strains of Corynebacterium diphtheriae, is an ancient disease with high incidence and mortality that has always been characterized by epidemic waves of occurrence. Whilst towards the beginning of the 1980s, many European countries were progressing towards the elimination of diphtheria, an epidemic re-emergence of diphtheria in the Russian Federation and the Newly Independent States of the former Soviet Union demonstrated a continuous threat of the disease into the 1990s. At present, the epidemic is under control and only sporadic cases are observed in Europe. However, the circulation of toxigenic strains is still observed in all parts of the world, posing a constant threat to the population with low levels of seroprotection. More recently, Corynebacterium ulcerans has been increasingly isolated as emerging zoonotic agent of diphtheria from companion animals such as cats or dogs, indicating the enduring threat of this thought-to-be controlled disease.
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Affiliation(s)
- Katherina Zakikhany
- The European Programme for Public Health Microbiology Training (EUPHEM), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Androulla Efstratiou
- Health Protection Agency (HPA), Microbiology Services Divison: Colindale, Respiratory & Systemic Infection Laboratory (RSIL), WHO Global Collaborating Centre for Diphtheria, London, UK
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21
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Corti MAM, Bloemberg GV, Borelli S, Kutzner H, Eich G, Hoelzle L, Lautenschlager S. Rare human skin infection with Corynebacterium ulcerans: transmission by a domestic cat. Infection 2012; 40:575-8. [PMID: 22403045 DOI: 10.1007/s15010-012-0254-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2011] [Accepted: 03/01/2012] [Indexed: 12/01/2022]
Abstract
Corynebacterium ulcerans is mainly known for its ability to cause animal infections. Some strains of C. ulcerans produce diphtheria toxin, which can cause life-threatening cardiopathies and neuropathies in humans. Human cutaneous C. ulcerans infection is a very rare disease that mimics classical cutaneous diphtheria. We present a very rare case of a C. ulcerans skin infection caused by a non-diphtheria toxin-producing strain of C. ulcerans that resolved after 3 weeks of therapy with amoxicillin-clavulanate. A pet cat was the probable source of infection. The presence of C. ulcerans in the mouth of the cat was confirmed by 16S rRNA gene analysis and the API Coryne system. In cases of human infection with potentially toxigenic corynebacteria, it is important to determine the species and examine the isolate for diphtheria toxin production. If toxigenicity is present, diphtheria antitoxin should be administered immediately. Carriers and potential infectious sources of C. ulcerans include not only domestic livestock but also pet animals. For the primary prevention of disease caused by diphtheria toxin-producing corynebacteria, vaccination with diphtheria toxoid is recommended.
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Affiliation(s)
- M A M Corti
- Outpatient Clinic of Dermatology, Triemli Hospital, Zurich, Switzerland
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22
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Canada's first case of a multidrug-resistant Corynebacterium diphtheriae strain, isolated from a skin abscess. J Clin Microbiol 2011; 49:4003-5. [PMID: 21880960 DOI: 10.1128/jcm.05296-11] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A toxigenic Corynebacterium diphtheriae biovar mitis sequence type 136 (ST136) strain was recovered from a toe infection of an unvaccinated patient recently returned from India. The isolate was resistant to clindamycin, erythromycin (ermX positive), tetracycline, and trimethoprim-sulfamethoxazole, intermediate to ceftriaxone and cefotaxime, and had high MICs for telithromycin and chloramphenicol but was sensitive to other drugs.
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23
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Cutaneous diphtheria in the urban poor population of Vancouver, British Columbia, Canada: a 10-year review. J Clin Microbiol 2011; 49:2664-6. [PMID: 21525220 DOI: 10.1128/jcm.00362-11] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Between 1998 and 2007, records from 33 patients with cutaneous diphtheria from Vancouver's inner city were reviewed. Cases were associated with injection drug use and poverty. Coinfections with Staphylococcus aureus, Streptococcus pyogenes, and Arcanobacterium haemolyticum occurred. Corynebacterium diphtheriae is endemic in Vancouver's urban core, with strains of multilocus sequence type (MLST) 76 predominating.
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24
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Contzen M, Sting R, Blazey B, Rau J. Corynebacterium ulcerans from diseased wild boars. Zoonoses Public Health 2011; 58:479-88. [PMID: 21824349 DOI: 10.1111/j.1863-2378.2011.01396.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Two Corynebacterium strains were isolated from lymph nodes of wild boars showing severe alterations caused by caseous lymphadenitis. The wild boars came from different districts in southern Germany; one was found dead, the other had been shot. The two Corynebacterium strains obtained were both positive for phospholipase D. Further analysis of biochemical profiles did not allow unambiguous differentiation between Corynebacterium ulcerans and Corynebacterium pseudotuberculosis. Fourier-transformed infrared spectroscopy as well as partial sequencing of the genes for 16S rRNA and RNA polymerase beta subunit (rpoB) clearly identified both strains as Corynebacterium ulcerans. The tox gene for diphtheria toxin (DT) could be detected in both porcine isolates by PCR. Partial DNA sequencing of this tox gene showed significant differences from sequences described for other Corynebacterium ulcerans strains and a higher degree of similarity to that of Corynebacterium diphtheria. Production of diphtheria toxin could not be detected. These results indicate that wild game could be a reservoir for zoonotic Corynebacterium ulcerans.
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Affiliation(s)
- M Contzen
- Chemisches und Veterinaeruntersuchungsamt (CVUA) Stuttgart, Fellbach, Germany
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25
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Sabbadini PS, Genovez MRN, Silva CFD, Adelino TLN, Santos CSD, Pereira GA, Nagao PE, Dias AADSDO, Mattos-Guaraldi AL, Hirata Júnior R. Fibrinogen binds to nontoxigenic and toxigenic Corynebacterium diphtheriae strains. Mem Inst Oswaldo Cruz 2010; 105:706-11. [DOI: 10.1590/s0074-02762010000500018] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2010] [Accepted: 05/18/2010] [Indexed: 11/22/2022] Open
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26
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Sykes J, Mapes S, Lindsay L, Samitz E, Byrne B. Corynebacterium ulcerans Bronchopneumonia in a Dog. J Vet Intern Med 2010; 24:973-6. [DOI: 10.1111/j.1939-1676.2010.0491.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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27
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Hirata R, Pereira GA, Filardy AA, Gomes DLR, Damasco PV, Rosa ACP, Nagao PE, Pimenta FP, Mattos-Guaraldi AL. Potential pathogenic role of aggregative-adhering Corynebacterium diphtheriae of different clonal groups in endocarditis. Braz J Med Biol Res 2009; 41:986-91. [PMID: 19099151 DOI: 10.1590/s0100-879x2008001100007] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2008] [Accepted: 10/30/2008] [Indexed: 11/22/2022] Open
Abstract
Invasive diseases caused by Corynebacterium diphtheriae have been described increasingly. Several reports indicate the destructive feature of endocarditis attributable to nontoxigenic strains. However, few reports have dealt with the pathogenicity of invasive strains. The present investigation demonstrates a phenotypic trait that may be used to identify potentially invasive strains. The study also draws attention to clinical and microbiological aspects observed in 5 cases of endocarditis due to C. diphtheriae that occurred outside Europe. Four cases occurred in female school-age children (7-14 years) treated at different hospitals in Rio de Janeiro, Brazil. All patients developed other complications including septicemia, renal failure and/or arthritis. Surgical treatment was performed on 2 patients for valve replacement. Lethality was observed in 40% of the cases. Microorganisms isolated from 5 blood samples and identified as C. diphtheriae subsp mitis (N = 4) and C. diphtheriae subsp gravis (N = 1) displayed an aggregative adherence pattern to HEp-2 cells and identical one-dimensional SDS-PAGE protein profiles. Aggregative-adhering invasive strains of C. diphtheriae showed 5 distinct RAPD profiles. Despite the clonal diversity, all 5 C. diphtheriae invasive isolates seemed to display special bacterial adhesive properties that may favor blood-barrier disruption and systemic dissemination of bacteria. In conclusion, blood isolates from patients with endocarditis exhibited a unique adhering pattern, suggesting a pathogenic role of aggregative-adhering C. diphtheriae of different clones in endocarditis. Accordingly, the aggregative-adherence pattern may be used as an indication of some invasive potential of C. diphtheriae strains.
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Affiliation(s)
- R Hirata
- Departamento de Microbiologia, Imunologia e Parasitologia, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro
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28
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Pimenta FP, Hirata R, Rosa ACP, Milagres LG, Mattos-Guaraldi AL. A multiplex PCR assay for simultaneous detection of Corynebacterium diphtheriae and differentiation between non-toxigenic and toxigenic isolates. J Med Microbiol 2008; 57:1438-1439. [DOI: 10.1099/jmm.0.2008/000414-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Fabricia P. Pimenta
- Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Raphael Hirata
- Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Ana C. P. Rosa
- Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Lucimar G. Milagres
- Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Ana L. Mattos-Guaraldi
- Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
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29
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Pereira GA, Pimenta FP, Santos FRWD, Damasco PV, Hirata Júnior R, Mattos-Guaraldi AL. Antimicrobial resistance among Brazilian Corynebacterium diphtheriae strains. Mem Inst Oswaldo Cruz 2008; 103:507-10. [DOI: 10.1590/s0074-02762008000500019] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2008] [Accepted: 07/16/2008] [Indexed: 11/21/2022] Open
Affiliation(s)
- Gabriela Andrade Pereira
- Universidade do Estado do Rio de Janeiro, Brasil; Universidade Federal do Rio de Janeiro, Brasil
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30
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Mattos-Guaraldi AL, Sampaio JLM, Santos CS, Pimenta FP, Pereira GA, Pacheco LGC, Miyoshi A, Azevedo V, Moreira LO, Gutierrez FL, Costa JLF, Costa-Filho R, Damasco PV, Camello TCF, Hirata Jr R. First detection of Corynebacterium ulcerans producing a diphtheria-like toxin in a case of human with pulmonary infection in the Rio de Janeiro metropolitan area, Brazil. Mem Inst Oswaldo Cruz 2008; 103:396-400. [DOI: 10.1590/s0074-02762008000400014] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2007] [Accepted: 06/05/2008] [Indexed: 11/21/2022] Open
Affiliation(s)
| | - JLM Sampaio
- Fleury Centro de Medicina Diagnóstica, Brasil
| | - CS Santos
- Universidade do Estado do Rio de Janeiro, Brasil; Universidade Federal do Rio de Janeiro, Brasil
| | - FP Pimenta
- Universidade do Estado do Rio de Janeiro, Brasil
| | - GA Pereira
- Universidade do Estado do Rio de Janeiro, Brasil
| | - LGC Pacheco
- Universidade Federal de Minas Gerais, Brasil
| | - A Miyoshi
- Universidade Federal de Minas Gerais, Brasil
| | - V Azevedo
- Universidade Federal de Minas Gerais, Brasil
| | - LO Moreira
- Universidade do Estado do Rio de Janeiro, Brasil
| | | | | | | | - PV Damasco
- Universidade do Estado do Rio de Janeiro, Brasil; Universidade Federal do Estado do Rio de Janeiro, Brasil
| | - TCF Camello
- Universidade do Estado do Rio de Janeiro, Brasil
| | - R Hirata Jr
- Universidade do Estado do Rio de Janeiro, Brasil
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31
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Pimenta F, Souza M, Pereira G, Hirata R, Camello T, Mattos-Guaraldi A. DNase test as a novel approach for the routine screening of Corynebacterium diphtheriae. Lett Appl Microbiol 2008; 46:307-11. [DOI: 10.1111/j.1472-765x.2007.02310.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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32
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A PCR for dtxR gene: application to diagnosis of non-toxigenic and toxigenic Corynebacterium diphtheriae. Mol Cell Probes 2008; 22:189-92. [PMID: 18378421 DOI: 10.1016/j.mcp.2008.01.001] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2007] [Revised: 01/26/2008] [Accepted: 01/30/2008] [Indexed: 11/22/2022]
Abstract
The significant rise in the percentage of adults susceptible to diphtheria and the emergence of non-toxigenic Corynebacterium diphtheriae strains as the causative agent of endocarditis and other systemic infections emphasize the need for alternative laboratory diagnostic procedures. In this study, for the first time, the value of a species-specific PCR assay that targets the dtxR gene is documented as a procedure for differentiating C. diphtheriae from Corynebacterium-like colonies. The results of the PCR-dtxR were all positive for 91 C. diphtheriae (54 non-toxigenic and 37 toxigenic) strains. PCR-dtxR completely correlated with the standard biochemical and commercial identification for all C. diphtheriae strains tested. Conversely, the PCR-dtxR results were negative in 100% of the 111 non-diphtherial Gram-positive rod strains obtained during identification procedures in a hospital laboratory. Thus, the PCR-dtxR assay emerged as viable, cost-effective screening method for C. diphtheriae laboratory identification.
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33
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Vitek CR, Wharton M. Diphtheria toxoid. Vaccines (Basel) 2008. [DOI: 10.1016/b978-1-4160-3611-1.50014-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023] Open
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34
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Analysis of toxigenic Corynebacterium ulcerans strains revealing potential for false-negative real-time PCR results. J Clin Microbiol 2007; 46:331-3. [PMID: 17989189 DOI: 10.1128/jcm.01251-07] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Diphtheria surveillance depends on the rapid and reliable recognition of the toxin gene in Corynebacterium diphtheriae. Real-time PCR is a rapid tool to confirm the presence of the diphtheria toxin gene (tox) in an isolate or specimen. We report that some toxigenic Corynebacterium ulcerans strains show atypical results in a real-time PCR for tox.
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35
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Bachran C, Sutherland M, Bachran D, Fuchs H. Quantification of diphtheria toxin mediated ADP-ribosylation in a solid-phase assay. Clin Chem 2007; 53:1676-83. [PMID: 17712004 DOI: 10.1373/clinchem.2007.085365] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Because of reduced vaccination programs, the number of diphtheria infections has increased in the last decade. Diphtheria toxin (DT) is expressed by Corynebacterium diphtheriae and is responsible for the lethality of diphtheria. DT inhibits cellular protein synthesis by ADP-ribosylation of the eukaryotic elongation factor 2 (eEF2). No in vitro system for the quantification of DT enzymatic activity exists. We developed a solid-phase assay for the specific detection of ADP-ribosylation by DT. METHODS Solid phase-bound his-tag eEF2 is ADP-ribosylated by toxins using biotinylated NAD(+) as substrate, and the transferred biotinylated ADP-ribose is detected by streptavidin-peroxidase. DT enzymatic activity correlated with absorbance. We measured the amount of ADP-ribosylated eEF2 after precipitation with streptavidin-Sepharose. Quantification was done after Western blotting and detection with anti-his-tag antibody using an LAS-1000 System. RESULTS The assay detected enzymatically active DT at 30 ng/L, equivalent to 5 mU/L ADP-ribosylating activity. Pseudomonas exotoxin A (PE) activity was also detected at 100 ng/L. We verified the assay with chimeric toxins composed of the catalytic domain of DT or PE and a tumor-specific ligand. These chimeric toxins revealed increased signals at 1000 ng/L. Heat-inactivated DT and cholera toxin that ADP-ribosylates G-proteins did not show any signal increase. CONCLUSIONS The assay may be the basis for the development of a routine diagnostic assay for the detection of DT activity and highly specific inhibitors of DT.
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Affiliation(s)
- Christopher Bachran
- Zentralinstitut für Laboratoriumsmedizin und Pathobiochemie, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
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36
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Casas V, Miyake J, Balsley H, Roark J, Telles S, Leeds S, Zurita I, Breitbart M, Bartlett D, Azam F, Rohwer F. Widespread occurrence of phage-encoded exotoxin genes in terrestrial and aquatic environments in Southern California. FEMS Microbiol Lett 2006; 261:141-9. [PMID: 16842371 DOI: 10.1111/j.1574-6968.2006.00345.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Many human diseases are caused by pathogens that produce exotoxins. The genes that encode these exotoxins are frequently encoded by mobile DNA elements such as plasmids or phage. Mobile DNA elements can move exotoxin genes among microbial hosts, converting avirulent bacteria into pathogens. Phage and bacteria from water, soil, and sediment environments represent a potential reservoir of phage- and plasmid-encoded exotoxin genes. The genes encoding exotoxins that are the causes of cholera, diphtheria, enterohemorrhagic diarrhea, and Staphylococcus aureus food poisoning were found in soil, sediment, and water samples by standard PCR assays from locations where the human diseases are uncommon or nonexistent. On average, at least one of the target exotoxin genes was detected in approximately 15% of the more than 300 environmental samples tested. The results of standard PCR assays were confirmed by quantitative PCR (QPCR) and Southern dot blot analyses. Agreement between the results of the standard PCR and QPCR ranged from 63% to 84%; and the agreement between standard PCR and Southern dot blots ranged from 50% to 66%. Both the cholera and shiga exotoxin genes were also found in the free phage DNA fraction. The results indicate that phage-encoded exotoxin genes are widespread and mobile in terrestrial and aquatic environments.
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Affiliation(s)
- Veronica Casas
- Department of Biology, San Diego State University, San Diego, CA 92182-4614, USA.
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37
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Romney MG, Roscoe DL, Bernard K, Lai S, Efstratiou A, Clarke AM. Emergence of an invasive clone of nontoxigenic Corynebacterium diphtheriae in the urban poor population of Vancouver, Canada. J Clin Microbiol 2006; 44:1625-9. [PMID: 16672385 PMCID: PMC1479180 DOI: 10.1128/jcm.44.5.1625-1629.2006] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Invasive disease due to Corynebacterium diphtheriae is rare in North America. Here we describe the emergence of a predominant clone of a nontoxigenic strain of C. diphtheriae in the impoverished population of Vancouver's downtown core. This clone has caused significant morbidity and contributed to at least two deaths. Over a 5-year period, seven cases of bacteremia due to C. diphtheriae were detected in patients admitted to Vancouver hospitals. Injection drug use, diabetes mellitus, skin colonization/infection with C. diphtheriae, and homelessness all appeared to be related to the development of bacteremia with the organism. Ribotyping of isolates recovered from blood culture revealed a predominant ribotype pattern that has not previously been reported in North America.
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Affiliation(s)
- M G Romney
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada.
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38
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Pimenta FP, Damasco PV, Cerbino Neto J, Lopes GS, Hirata R, Milagres LG, Mattos-Guaraldi AL. Diphtheria-neutralizing antibody levels in healthy adults from Rio de Janeiro, Brazil. Mem Inst Oswaldo Cruz 2006; 101:459-62. [PMID: 16951820 DOI: 10.1590/s0074-02762006000400019] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2006] [Accepted: 05/05/2006] [Indexed: 11/21/2022] Open
Abstract
In Brazil, until 2004, the immunization policy against diphtheria involved childhood vaccination with no official routine booster dose administered after 15 years of age. This study assessed functional antibody levels against diphtheria among blood donors. A total of 140 blood samples were collected, and diphtheria antitoxin levels were evaluated by Vero cell neutralization test. The mean age of the population was 34 years old (range: 18-61 years); 37.8% females and 62.2% males. Overall, 30.7% (95%, CI: 23.4-38.7) individuals presented neutralizing antitoxin antibody titers < 0.01 IU/ml; 42.1% (95%, CI: 34.1-50.4) showed values between 0.01-0.09 IU/ml and, 27.1% (95%, CI: 20.2-34.9) had (3) 0.1 IU/ml. In the subgroup of individuals with history of diphtheria immunization during childhood (85%), a number of 28.5% showed unprotective levels of circulating neutralizing antibody (< 0.01 IU/ml). Despite the continuous progress of immunization programs directed to Brazilian population, currently healthy adults remain susceptible to diphtheria.
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Affiliation(s)
- Fabricia Pires Pimenta
- Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, 20551-030, Brasil
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39
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Corynebacterium species and coryneforms: An update on taxonomy and diseases attributed to these taxa. ACTA ACUST UNITED AC 2005. [DOI: 10.1016/j.clinmicnews.2005.01.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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40
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Sing A, Hogardt M, Bierschenk S, Heesemann J. Detection of differences in the nucleotide and amino acid sequences of diphtheria toxin from Corynebacterium diphtheriae and Corynebacterium ulcerans causing extrapharyngeal infections. J Clin Microbiol 2004; 41:4848-51. [PMID: 14532240 PMCID: PMC254330 DOI: 10.1128/jcm.41.10.4848-4851.2003] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
While Corynebacterium ulcerans can mimic classical diphtheria, extrapharyngeal infections are extremely rare. Sequencing of the diphtheria toxin (DT)-encoding tox gene of two C. ulcerans isolates from extrapharyngeal infections revealed differences from C. diphtheriae DT sequences, mainly in the translocation and receptor-binding domains. C. ulcerans supernatants were much less potent than supernatant from C. diphtheriae. A C. ulcerans DT-specific PCR is described below.
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Affiliation(s)
- Andreas Sing
- National Consiliary Laboratory on Diphtheria, 80336 Munich, Germany.
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41
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Mattos-Guaraldi AL, Moreira LO, Damasco PV, Hirata Júnior R. Diphtheria remains a threat to health in the developing world: an overview. Mem Inst Oswaldo Cruz 2003; 98:987-93. [PMID: 15049077 DOI: 10.1590/s0074-02762003000800001] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Changes in the epidemiology of diphtheria are occurring worldwide. A large proportion of adults in many industrialized and developing countries are now susceptible to diphtheria. Vaccine-induced immunity wanes over time unless periodic booster is given or exposure to toxigenic Corynebacterium diphtheriae occurs. Immunity gap in adults coupled with large numbers of susceptible children creates the potential for new extensive epidemics. Epidemic emergencies may not be long in coming in countries experiencing rapid industrialization or undergoing sociopolitical instability where many of the factors thought to be important in producing epidemic such as mass population movements and difficult hygienic and economic conditions are present. The continuous circulation of toxigenic C. diphtheriae emphasizes the need to be aware of epidemiological features, clinical signs, and symptoms of diphtheria in vaccine era so that cases can be promptly diagnosed and treated, and further public health measures can be taken to contain this serious disease. This overview focused on worldwide data obtained from diphtheria with particular emphasis to main factors leading to recent epidemics, new clinical forms of C. diphtheriae infections, expression of virulence factors, other than toxin production, control strategies, and laboratory diagnosis procedures.
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Affiliation(s)
- Ana Luíza Mattos-Guaraldi
- Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Av. 28 de Setembro 87, fundos, 3o andar, 20551-030 Rio de Janeiro, RJ, Brasil.
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42
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Toxinotypie de souches de Corynebacterium diphtheriae isolées en Algérie. Med Mal Infect 2003. [DOI: 10.1016/s0399-077x(02)00022-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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43
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Gilbert GL. Molecular diagnostics in infectious diseases and public health microbiology: cottage industry to postgenomics. Trends Mol Med 2002; 8:280-7. [PMID: 12067614 DOI: 10.1016/s1471-4914(02)02349-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Molecular methods have been used increasingly over the past ten years to improve the sensitivity and speed of diagnosis in infectious diseases. Although their routine use is still limited to the detection of pathogens that are difficult to culture in vitro,'real-time' methods, commercial kits, quantification and automation will increase potential applications. Molecular methods are now widely used for epidemiological fingerprinting of isolates of public health importance. Sequence-based identification and strain typing, together with the development of tools that can probe for thousands of markers, will allow detailed strain fingerprinting to assist in disease management and control.
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Affiliation(s)
- Gwendolyn L Gilbert
- Centre for Infectious Diseases and Microbiology, Institute of Clinical Pathology and Medical Research, University of Sydney, Westmead Hospital, Westmead, NSW 2145, Australia.
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44
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Damian M, Grimont F, Narvskaya O, Straut M, Surdeanu M, Cojocaru R, Mokrousov I, Diaconescu A, Andronescu C, Melnic A, Mutoi L, Grimont PAD. Study of Corynebacterium diphtheriae strains isolated in Romania, northwestern Russia and the Republic of Moldova. Res Microbiol 2002; 153:99-106. [PMID: 11902155 DOI: 10.1016/s0923-2508(01)01294-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
A selection of 167 Corynebacterium diphtheriae strains isolated in Romania, the Russian Federation and the Republic of Moldova were analysed by biotyping, phage typing, the toxin production test and by molecular techniques such as ribotyping, pulsed field gel electrophoresis and random amplified polymorphic DNA, in order to establish the epidemiological relatedness, genetic divergence and strain circulation within and between the bordering countries. Using a set of five digoxigenin-labeled oligonucleotides and BstEII digestion, 34 ribotypes were identified. The strains isolated in the epidemic areas (Russia and Moldova) were very closely related but different from those isolated in Romania. C1 and C5 were the main ribotypes identified in these areas. Neither ribotype was found in Romania, where the main circulating types were C3 and C7. Field inversion gel electrophoresis was more discriminative than ribotyping and revealed 54 macrorestriction profiles after SfiI restriction. Both methods showed a significant homogeneity of the strains from epidemic areas and a large diversity among the Romanian strains. Random amplification was useful as an identification method for the epidemic strains, but not for the Romanian ones which displayed a large number of amplification profiles. The phenotypic methods associated with molecular typing techniques enabled distinguishing between strains, detecting the epidemic clone, and sustaining the absence of transmission across borders.
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Affiliation(s)
- Maria Damian
- Molecular Epidemiology Laboratory, Cantacuzino Institute, Bucharest, Romania
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45
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Engler KH, Efstratiou A, Norn D, Kozlov RS, Selga I, Glushkevich TG, Tam M, Melnikov VG, Mazurova IK, Kim VE, Tseneva GY, Titov LP, George RC. Immunochromatographic strip test for rapid detection of diphtheria toxin: description and multicenter evaluation in areas of low and high prevalence of diphtheria. J Clin Microbiol 2002; 40:80-3. [PMID: 11773096 PMCID: PMC120113 DOI: 10.1128/jcm.40.1.80-83.2002] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
An immunochromatographic strip (ICS) test was developed for the detection of diphtheria toxin by using an equine polyclonal antibody as the capture antibody and colloidal gold-labeled monoclonal antibodies specific for fragment A of the diphtheria toxin molecule as the detection antibody. The ICS test has been fully optimized for the detection of toxin from bacterial cultures; the limit of detection was approximately 0.5 ng of diphtheria toxin per ml within 10 min. In a comparative study with 915 pure clinical isolates of Corynebacterium spp., the results of the ICS test were in complete agreement with those of the conventional Elek test. The ICS test was also evaluated for its ability to detect toxigenicity from clinical specimens (throat swabs) in two field studies conducted within areas of the former USSR where diphtheria is epidemic. Eight hundred fifty throat swabs were examined by conventional culture and by use of directly inoculated broth cultures for the ICS test. The results showed 99% concordance (848 of 850 specimens), and the sensitivity and specificity of the ICS test were 98% (95% confidence interval, 91 to 99%) and 99% (95% confidence interval, 99 to 100%), respectively.
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Affiliation(s)
- K H Engler
- Central Public Health Laboratory, Public Health Laboratory Service, London, United Kingdom.
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46
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Wagner J, Ignatius R, Voss S, Höpfner V, Ehlers S, Funke G, Weber U, Hahn H. Infection of the skin caused by Corynebacterium ulcerans and mimicking classical cutaneous diphtheria. Clin Infect Dis 2001; 33:1598-600. [PMID: 11568853 DOI: 10.1086/322969] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2001] [Revised: 05/10/2001] [Indexed: 11/03/2022] Open
Abstract
Extrapharyngeal infections caused by Corynebacterium ulcerans have rarely been reported previously, and diphtheria toxin production has usually not been addressed. This case demonstrates that strains of C. ulcerans that produce diphtheria toxin can cause infections of the skin that completely mimic typical cutaneous diphtheria, thereby potentially providing a source of bacteria capable of causing life-threatening diseases in the patient's environment. Therefore, it is recommended to screen wound swabs for coryneform bacteria, identify all isolates, carefully assess possible toxin production, and send questionable strains to a specialist or a reference laboratory.
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Affiliation(s)
- J Wagner
- Department of Medical Microbiology and Immunology of Infection, Benjamin Franklin Medical Center, Free University Berlin, Berlin, Germany.
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47
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Engler KH, Efstratiou A. Rapid enzyme immunoassay for determination of toxigenicity among clinical isolates of corynebacteria. J Clin Microbiol 2000; 38:1385-9. [PMID: 10747112 PMCID: PMC86450 DOI: 10.1128/jcm.38.4.1385-1389.2000] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/1999] [Accepted: 01/17/2000] [Indexed: 11/20/2022] Open
Abstract
A rapid enzyme immunoassay (EIA) was developed for the phenotypic detection of diphtheria toxin among clinical isolates of corynebacteria. The assay uses equine polyclonal antitoxin as the capture antibody and an alkaline phosphatase-labeled monoclonal antibody, specific for fragment A of the toxin molecule, as the detecting antibody. The assay is rapid, sensitive, and specific: a final result is available within 3 h of colony selection, and the limits of detection are 0.1 ng of pure diphtheria toxin/ml. Toxigenicity could be detected with isolates grown on a diverse range of culture media, including selective agars. Toxin detection using the EIA was compared to that with the Elek test and PCR detection of fragment A of the diphtheria toxin (tox) gene, using 245 isolates of corynebacteria. The results for the EIA were in complete concordance with those of the Elek test: 87 toxigenic and 158 nontoxigenic isolates. Ten of the phenotypically nontoxigenic strains were found to contain fragment A of the tox gene but did not express the toxin protein. These isolates were found to be nontoxigenic in the Vero cell tissue culture cytotoxicity assay and were therefore nontoxigenic for diagnostic purposes. The EIA is a simple rapid phenotypic test which provides a definitive result on toxigenicity within one working day.
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Affiliation(s)
- K H Engler
- Respiratory and Systemic Infection Laboratory, Central Public Health Laboratory, London NW9 5HT, United Kingdom.
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48
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Efstratiou A, Engler KH, Mazurova IK, Glushkevich T, Vuopio-Varkila J, Popovic T. Current approaches to the laboratory diagnosis of diphtheria. J Infect Dis 2000; 181 Suppl 1:S138-45. [PMID: 10657205 DOI: 10.1086/315552] [Citation(s) in RCA: 73] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Despite the success of mass immunization in many countries, diphtheria continues to play a major role as a potentially lethal resurgent infectious disease. Early, accurate diagnosis is imperative since delay in specific therapy may result in death. The microbiologic diagnosis of the disease, the identification of contacts and carriers, and the appropriate clinical management of these patients are therefore crucial. The epidemiology of diseases caused by Corynebacterium diphtheriae has changed dramatically over the decades, a situation that is highlighted by the resurgence of infections in the European region. These factors have strengthened the need for laboratories to screen for C. diphtheriae. Many modified and new methodologies are now used widely within laboratories for diphtheria diagnosis. Recent developments have focused upon methods for detection of the lethal and potent exotoxin produced by the causative organism, C. diphtheriae; this detection is the definitive test for the microbiologic diagnosis of diphtheria.
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Affiliation(s)
- A Efstratiou
- World Health Organization Collaborating Center for Diphtheria and Streptococcal Infections, Public Health Laboratory Service, Central Public Health Laboratory, NW95HT London, United Kingdom.
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