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Galanis A, Karampitianis S, Vlamis J, Karampinas P, Vavourakis M, Vlachos C, Papagrigorakis E, Zachariou D, Sakellariou E, Varsamos I, Patilas C, Tsiplakou S, Papaioannou V, Kamariotis S. Corynebacterium striatum Periprosthetic Hip Joint Infection: An Uncommon Pathogen of Concern? Healthcare (Basel) 2024; 12:273. [PMID: 38275553 PMCID: PMC10815444 DOI: 10.3390/healthcare12020273] [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: 11/28/2023] [Revised: 01/08/2024] [Accepted: 01/19/2024] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Total hip arthroplasty is indubitably a dominant elective surgery in orthopaedics, contributing to prodigious improvement in the quality of life of patients with osteoarthritis. One of the most potentially devastating complications of this operation is periprosthetic joint infection. Immunocompromised patients might be afflicted by infrequent low-virulence organisms not typically detected with conventional procedures. Consequently, employing advanced identification methods, such as the circumstantial sonication of orthopaedic implants, could be crucial to managing such cases. CASE PRESENTATION We present a peculiar case of a 72-year-old female patient suffering from a chronic periprosthetic hip infection due to Corynebacterium striatum. The pathogen was only identified after rigorous sonication of the extracted implants. The overall management of this case was immensely exacting, primarily because of the patient's impaired immune system, and was finally treated with two-stage revision in our Institution. LITERATURE REVIEW Although copious literature exists concerning managing periprosthetic hip infections, no concrete guidelines are available for such infections in multimorbid or immunocompromised patients with rare low-virulence microorganisms. Hence, a diagnostic work-up, antibiotic treatment and appropriate revision timeline must be determined. Sonication of extracted implants could be a powerful tool in the diagnostic arsenal, as it can aid in identifying rare microbes, such as Corynebacterium spp. Pertinent antibiotic treatment based on antibiogram analysis and apposite final revision-surgery timing are the pillars for effective therapy of such infections. CLINICAL RELEVANCE Corynebacterium striatum has been increasingly recognized as an emerging cause of periprosthetic hip infection in the last decade. A conspicuous rise in such reports has been observed in multimorbid or immunocompromised patients after the COVID-19 pandemic. This case is the first report of Corynebacterium striatum periprosthetic hip infection diagnosed solely after the sonication of extracted implants. This paper aims to increase awareness surrounding Corynebacterium spp. prosthetic joint infections, while highlighting the fields for further apposite research.
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Affiliation(s)
- Athanasios Galanis
- 3rd Department of Orthopaedic Surgery, National & Kapodistrian University of Athens, KAT General Hospital, Kifisia, 14561 Athens, Greece; (A.G.); (S.K.); (J.V.); (P.K.); (C.V.); (E.P.); (D.Z.); (E.S.); (I.V.); (C.P.)
| | - Spyridon Karampitianis
- 3rd Department of Orthopaedic Surgery, National & Kapodistrian University of Athens, KAT General Hospital, Kifisia, 14561 Athens, Greece; (A.G.); (S.K.); (J.V.); (P.K.); (C.V.); (E.P.); (D.Z.); (E.S.); (I.V.); (C.P.)
| | - John Vlamis
- 3rd Department of Orthopaedic Surgery, National & Kapodistrian University of Athens, KAT General Hospital, Kifisia, 14561 Athens, Greece; (A.G.); (S.K.); (J.V.); (P.K.); (C.V.); (E.P.); (D.Z.); (E.S.); (I.V.); (C.P.)
| | - Panagiotis Karampinas
- 3rd Department of Orthopaedic Surgery, National & Kapodistrian University of Athens, KAT General Hospital, Kifisia, 14561 Athens, Greece; (A.G.); (S.K.); (J.V.); (P.K.); (C.V.); (E.P.); (D.Z.); (E.S.); (I.V.); (C.P.)
| | - Michail Vavourakis
- 3rd Department of Orthopaedic Surgery, National & Kapodistrian University of Athens, KAT General Hospital, Kifisia, 14561 Athens, Greece; (A.G.); (S.K.); (J.V.); (P.K.); (C.V.); (E.P.); (D.Z.); (E.S.); (I.V.); (C.P.)
| | - Christos Vlachos
- 3rd Department of Orthopaedic Surgery, National & Kapodistrian University of Athens, KAT General Hospital, Kifisia, 14561 Athens, Greece; (A.G.); (S.K.); (J.V.); (P.K.); (C.V.); (E.P.); (D.Z.); (E.S.); (I.V.); (C.P.)
| | - Eftychios Papagrigorakis
- 3rd Department of Orthopaedic Surgery, National & Kapodistrian University of Athens, KAT General Hospital, Kifisia, 14561 Athens, Greece; (A.G.); (S.K.); (J.V.); (P.K.); (C.V.); (E.P.); (D.Z.); (E.S.); (I.V.); (C.P.)
| | - Dimitrios Zachariou
- 3rd Department of Orthopaedic Surgery, National & Kapodistrian University of Athens, KAT General Hospital, Kifisia, 14561 Athens, Greece; (A.G.); (S.K.); (J.V.); (P.K.); (C.V.); (E.P.); (D.Z.); (E.S.); (I.V.); (C.P.)
| | - Evangelos Sakellariou
- 3rd Department of Orthopaedic Surgery, National & Kapodistrian University of Athens, KAT General Hospital, Kifisia, 14561 Athens, Greece; (A.G.); (S.K.); (J.V.); (P.K.); (C.V.); (E.P.); (D.Z.); (E.S.); (I.V.); (C.P.)
| | - Iordanis Varsamos
- 3rd Department of Orthopaedic Surgery, National & Kapodistrian University of Athens, KAT General Hospital, Kifisia, 14561 Athens, Greece; (A.G.); (S.K.); (J.V.); (P.K.); (C.V.); (E.P.); (D.Z.); (E.S.); (I.V.); (C.P.)
| | - Christos Patilas
- 3rd Department of Orthopaedic Surgery, National & Kapodistrian University of Athens, KAT General Hospital, Kifisia, 14561 Athens, Greece; (A.G.); (S.K.); (J.V.); (P.K.); (C.V.); (E.P.); (D.Z.); (E.S.); (I.V.); (C.P.)
| | - Sofia Tsiplakou
- Department of Microbiology, KAT General Hospital, Kifisia, 14561 Athens, Greece; (S.T.); (V.P.); (S.K.)
| | - Vasiliki Papaioannou
- Department of Microbiology, KAT General Hospital, Kifisia, 14561 Athens, Greece; (S.T.); (V.P.); (S.K.)
| | - Spyridon Kamariotis
- Department of Microbiology, KAT General Hospital, Kifisia, 14561 Athens, Greece; (S.T.); (V.P.); (S.K.)
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Omosigho PO, John OO, Adigun OA, Hassan HK, Olabode ON, Micheal AS, Haruna UA, Singh A, Manirambona E. The Re-emergence of Diphtheria Amidst Multiple Outbreaks in Nigeria. Infect Disord Drug Targets 2024; 24:20-28. [PMID: 38018182 DOI: 10.2174/0118715265251299231117045940] [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: 03/08/2023] [Revised: 10/03/2023] [Accepted: 10/19/2023] [Indexed: 11/30/2023]
Abstract
Diphtheria, a vaccine-preventable disease, has resurfaced in Nigeria, where many outbreaks have been reported in recent years. The outbreaks have occurred across the country, including in areas with high vaccination coverage. Corynebacterium diphtheriae, the causal agent, is a highly contagious bacteria that can cause severe respiratory and systemic symptoms and can be fatal if not treated. The reemergence of diphtheria in Nigeria is most likely due to a combination of factors, including gaps in routine immunization regimens. The outbreak is further aggravated by multiple epidemics, which have diverted resources and attention away from the emergency of other infectious diseases. Furthermore, there is a lack of awareness of diphtheria in Nigeria. With a focus on the difficulties in controlling the disease, methods of diagnosis, available treatments, and preventive measures, this study provides a thorough analysis of diphtheria, covering its historical context, clinical presentation, associated complications, and current outbreaks. It emphasizes how important vaccination, early detection, and better access to healthcare are in reducing diphtheria outbreaks. The study highlights the serious effects of diphtheria on public health, particularly in regions with scarce resources and vaccine resistance, and offers a number of suggestions to overcome these challenges and prevent further outbreaks.
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Affiliation(s)
- Pius Omoruyi Omosigho
- Department of Medical Laboratory Science, Edo State University Uzairue, Benin, Nigeria
| | - Okesanya Olalekan John
- Department of Medical Laboratory Science, Neuropsychiatric Hospital, Aro, Abeokuta, Nigeria
| | | | | | - Olaleke Noah Olabode
- Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Osun State, Nigeria
| | - Abioye Sunday Micheal
- Department of Public Health, Faculty of Basic Medical Sciences, Adeleke University, Ede, Osun State, Nigeria
| | | | - Amandeep Singh
- Department of Pharmaceutics, ISF College of Pharmacy, Moga, 142001, Punjab, India
| | - Emery Manirambona
- College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
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Burkovski A. Proteomics of Toxigenic Corynebacteria. Proteomes 2023; 12:2. [PMID: 38250813 PMCID: PMC10801583 DOI: 10.3390/proteomes12010002] [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: 10/31/2023] [Revised: 12/20/2023] [Accepted: 12/28/2023] [Indexed: 01/23/2024] Open
Abstract
Within the genus Corynebacterium, six species are potential carriers of the tox gene, which encodes the highly potent diphtheria exotoxin: Corynebacterium diphtheriae, Corynebacterium belfantii, Corynebacterium rouxii, Corynebacterium ulcerans, Corynebacterium pseudotuberculosis and Corynebacterium silvaticum. Based on their potential to infect different host species and cause either human infections, zoonotic diseases or infections of economically important animals, these bacteria are of high scientific and economic interest and different research groups have carried out proteome analyses. These showed that especially the combination of MS-based proteomics with bioinformatic tools helped significantly to elucidate the functional aspects of corynebacterial genomes and to handle the genome and proteome complexity. The combination of proteomic and bioinformatic approaches was also used to discover new vaccine and drug targets. In addition, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry has been established as a fast and precise tool for the identification of these bacteria.
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Affiliation(s)
- Andreas Burkovski
- Microbiology Division, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91058 Erlangen, Germany
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Sting R, Pölzelbauer C, Eisenberg T, Bonke R, Blazey B, Peters M, Riße K, Sing A, Berger A, Dangel A, Rau J. Corynebacterium ulcerans Infections in Eurasian Beavers ( Castor fiber). Pathogens 2023; 12:979. [PMID: 37623939 PMCID: PMC10459376 DOI: 10.3390/pathogens12080979] [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: 06/07/2023] [Revised: 07/20/2023] [Accepted: 07/21/2023] [Indexed: 08/26/2023] Open
Abstract
The Eurasian beaver (Castor fiber) has been reintroduced successfully in Germany since the 1990s. Since wildlife is an important source of zoonotic infectious diseases, monitoring of invasive and reintroduced species is crucial with respect to the One Health approach. Three Eurasian beavers were found dead in the German federal states of Bavaria, North Rhine-Westphalia and Baden-Wuerttemberg in 2015, 2021 and 2022, respectively. During post-mortem examinations, Corynebacterium (C.) ulcerans could be isolated from the abscesses of two beavers and from the lungs of one of the animals. Identification of the bacterial isolates at the species level was carried out by spectroscopic analysis using MALDI-TOF MS, FT-IR and biochemical profiles and were verified by molecular analysis based on 16-23S internal transcribed spacer (ITS) region sequencing. Molecular characterization of the C. ulcerans isolates using whole-genome sequencing (WGS) revealed a genome size of about 2.5 Mbp and a GC content of 53.4%. Multilocus sequence typing (MLST) analysis classified all three isolates as the sequence type ST-332. A minimum spanning tree (MST) based on cgMLST allelic profiles, including 1211 core genes of the sequenced C. ulcerans isolates, showed that the beaver-derived isolates clearly group on the branch of C. ulcerans with the closest relationship to each other, in close similarity to an isolate from a dog. Antibiotic susceptibility testing revealed resistance to clindamycin and, in one strain, to erythromycin according to EUCAST, while all isolates were susceptible to the other antimicrobials tested.
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Affiliation(s)
- Reinhard Sting
- Chemical and Veterinary Analysis Agency (CVUA) Stuttgart, 70736 Fellbach, Germany; (C.P.); (B.B.); (J.R.)
- Consiliary Laboratory for Corynebacterium pseudotuberculosis (DVG), 70736 Fellbach, Germany
| | - Catharina Pölzelbauer
- Chemical and Veterinary Analysis Agency (CVUA) Stuttgart, 70736 Fellbach, Germany; (C.P.); (B.B.); (J.R.)
| | - Tobias Eisenberg
- Hessian State Laboratory (LHL), 35392 Giessen, Germany; (T.E.); (R.B.); (K.R.)
| | - Rebecca Bonke
- Hessian State Laboratory (LHL), 35392 Giessen, Germany; (T.E.); (R.B.); (K.R.)
| | - Birgit Blazey
- Chemical and Veterinary Analysis Agency (CVUA) Stuttgart, 70736 Fellbach, Germany; (C.P.); (B.B.); (J.R.)
| | - Martin Peters
- Chemical and Veterinary Investigation Office Westfalen, 59821 Arnsberg, Germany;
| | - Karin Riße
- Hessian State Laboratory (LHL), 35392 Giessen, Germany; (T.E.); (R.B.); (K.R.)
| | - Andreas Sing
- Germany National Consiliary Laboratory for Diphtheria, 85764 Oberschleißheim, Germany; (A.S.); (A.B.)
| | - Anja Berger
- Germany National Consiliary Laboratory for Diphtheria, 85764 Oberschleißheim, Germany; (A.S.); (A.B.)
| | - Alexandra Dangel
- Bavarian Health and Food Safety Authority, 85764 Oberschleißheim, Germany;
| | - Jörg Rau
- Chemical and Veterinary Analysis Agency (CVUA) Stuttgart, 70736 Fellbach, Germany; (C.P.); (B.B.); (J.R.)
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Elsinga J, van Meijeren D, Reubsaet F. Surveillance of diphtheria in the Netherlands between 2000-2021: cutaneous diphtheria supersedes the respiratory form. BMC Infect Dis 2023; 23:420. [PMID: 37344769 DOI: 10.1186/s12879-023-08388-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 06/08/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND Diphtheria is a severe respiratory or cutaneous infectious disease, caused by exotoxin producing Corynebacterium diphtheriae, C. ulcerans and C. pseudotuberculosis. Diphtheria is once again prevalent due to breakdown of immunisation programmes, social disruption and unrest. AIM This study describes the notified diphtheria cases in the Netherlands between 2000-2021 and isolates that were sent to the National Institute for Public Health and the Environment (RIVM). METHODS File investigation was performed including all notified cases and isolates of C. diphtheriae, C. ulcerans and C. pseudotuberculosis that were tested for toxin production using a toxin-PCR and Elek test. An exploratory review was performed to understand transmission in populations with a high vaccination uptake. RESULTS Eighteen diphtheria notifications were made with confirmed toxigenic C. diphtheriae (n = 9) or ulcerans (n = 9) between 2000 and 2021. Seventeen (94.4%) presented with a cutaneous infection. All cases with a suspected source abroad (n = 8) concerned infection with C. diphtheriae. In contrast, 9/10 cases infected in the Netherlands were caused by C. ulcerans, a zoonosis. Secondary transmission was not reported. Isolates of C. ulcerans sent to the RIVM produced more often the diphtheria exotoxin (11/31; 35%) than C. diphtheriae (7/89; 7.9%). CONCLUSION Both human-to-human transmission of C. diphtheriae and animal-to-human transmission of C. ulcerans rarely occurs in the Netherlands. Cases mainly present with a cutaneous infection. Travel-related cases remain a risk for transmission to populations with low vaccination coverage, highlighting the importance of immunization and diphtheria control measures.
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Affiliation(s)
- Jelte Elsinga
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Antonie Van Leeuwenhoeklaan 9, 3721 MA, Bilthoven, The Netherlands.
- Department of Medical Microbiology and Infection Prevention, Amsterdam UMC, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
| | - Dimphey van Meijeren
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Antonie Van Leeuwenhoeklaan 9, 3721 MA, Bilthoven, The Netherlands
| | - Frans Reubsaet
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Antonie Van Leeuwenhoeklaan 9, 3721 MA, Bilthoven, The Netherlands
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Santos RGD, Seyffert N, Dorneles EMS, Aguiar ERGR, Ramos CP, Haas DJ, Assis GBN, Portela RD, Goes-Neto A, Pacheco LGC, Figueiredo HCP, Sousa TDJ, Tiwari S, Jaiswal AK, Lage AP, Castro TLP, Azevedo V. Exploring the MALDI Biotyper for the Identification of Corynebacterium pseudotuberculosis biovar Ovis and Equi. JOURNAL OF THE AMERICAN SOCIETY FOR MASS SPECTROMETRY 2022; 33:2055-2062. [PMID: 36239433 DOI: 10.1021/jasms.2c00174] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Biochemical, serological, and molecular methods have been developed for the laboratory diagnosis of diseases caused by C. pseudotuberculosis (CP), but the identification of the pathogen and biovars differentiation may be time-consuming, expensive, and confusing compared with other bacteria. This study aimed to evaluate MALDI Biotyper and Overall Genome Relatedness Index (OGRI) analysis to optimize the identification and differentiation of biovars of C. pseudotuberculosis. Out of 230 strains isolated from several hosts and countries, 202 (87.8%) were precisely classified using MALDI Biotyper and the BioNumerics platform. The classification accuracies for the Ovis and Equi biovars were 80 (88.75%) and 82 (92.68%), respectively. When analyzing a sampling of these strains by Average Nucleotide Identity based on BLAST and TETRA analyses using genomic sequence data, it was possible to differentiate 100% of the strains in Equi and Ovis. Our data show that MALDI Biotyper and OGRI analysis help identify C. pseudotuberculosis at the species and biovar levels.
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Affiliation(s)
| | - Nubia Seyffert
- Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil
- Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador 40231-300, Brazil
| | - Elaine M S Dorneles
- Departamento de Medicina Veterinária, Universidade Federal de Lavras, Lavras 37200-000, Brazil
| | - Eric R G R Aguiar
- Centro de Biotecnologia e Genética, Universidade Estadual de Santa Cruz, Ilhéus 45662-900, Brazil
| | - Carolina P Ramos
- Departamento de Medicina Veterinária Preventiva, Escola de Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil
| | - Dionei J Haas
- Departamento de Medicina Veterinária Preventiva, Escola de Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil
| | - Gabriella B N Assis
- Departamento de Medicina Veterinária Preventiva, Escola de Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil
| | - Ricardo Dias Portela
- Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador 40231-300, Brazil
| | - Aristóteles Goes-Neto
- Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil
| | - Luis G C Pacheco
- Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador 40231-300, Brazil
| | - Henrique C P Figueiredo
- Departamento de Medicina Veterinária Preventiva, Escola de Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil
| | - Thiago de Jesus Sousa
- Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil
| | - Sandeep Tiwari
- Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil
| | - Arun Kumar Jaiswal
- Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil
| | - Andrey P Lage
- Departamento de Medicina Veterinária Preventiva, Escola de Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil
| | - Thiago L P Castro
- Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil
- Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador 40231-300, Brazil
| | - Vasco Azevedo
- Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil
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Badenschier F, Berger A, Dangel A, Sprenger A, Hobmaier B, Sievers C, Prins H, Dörre A, Wagner-Wiening C, Külper-Schiek W, Wichmann O, Sing A. Outbreak of imported diphtheria with Corynebacterium diphtheriae among migrants arriving in Germany, 2022. Euro Surveill 2022; 27:2200849. [PMID: 36398576 PMCID: PMC9673234 DOI: 10.2807/1560-7917.es.2022.27.46.2200849] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 11/17/2022] [Indexed: 07/25/2023] Open
Abstract
From July 2022, cases of imported diphtheria with toxigenic Corynebacterium diphtheriae remarkably increased among migrants arriving in Germany. Up to 30 September 2022, 44 cases have been reported to the national public health institute, all laboratory-confirmed, male, and mainly coming from Syria (n = 21) and Afghanistan (n = 17). Phylogeny and available journey information indicate that most cases (n = 19) were infected along the Balkan route. Active case finding, increased laboratory preparedness and epicentre localisation in countries along this route are important.
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Affiliation(s)
- Franziska Badenschier
- Department of Infectious Disease Epidemiology, Postgraduate Training for Applied Epidemiology, Robert Koch Institute (RKI), Berlin, Germany
- ECDC Fellowship Programme, EPIET Associated Programme, European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Anja Berger
- National Consiliary Laboratory for Diphtheria, Bavarian Health and Food Safety Authority, Oberschleißheim, Germany
- Unit of Bacteriology, Public Health Microbiology, Bavarian Health and Food Safety Authority (LGL), Oberschleißheim, Germany
| | - Alexandra Dangel
- NGS Core Unit, Public Health Microbiology, Bavarian Health and Food Safety Authority (LGL), Oberschleißheim, Germany
| | - Annika Sprenger
- NGS Core Unit, Public Health Microbiology, Bavarian Health and Food Safety Authority (LGL), Oberschleißheim, Germany
| | - Bernhard Hobmaier
- Unit of Bacteriology, Public Health Microbiology, Bavarian Health and Food Safety Authority (LGL), Oberschleißheim, Germany
| | - Claudia Sievers
- Department of Infectious Disease Epidemiology, Postgraduate Training for Applied Epidemiology, Robert Koch Institute (RKI), Berlin, Germany
- ECDC Fellowship Programme, EPIET Associated Programme, European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Henrieke Prins
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
- ECDC Fellowship Programme, Field Epidemiology path (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Achim Dörre
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | | | - Wiebe Külper-Schiek
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Ole Wichmann
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Andreas Sing
- National Consiliary Laboratory for Diphtheria, Bavarian Health and Food Safety Authority, Oberschleißheim, Germany
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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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Park S, Shin H, Kim S, Lee T, Lee H, Nam K, Yoon W, Kim H, Seo Y, Won Y, Kwon H. Distribution of Corynebacterium Species and Comparative Results of Diagnostic Methods for Identifying Corynebacterium in Experimental Mice in Korea. Vet Sci 2022; 9:vetsci9070328. [PMID: 35878345 PMCID: PMC9318398 DOI: 10.3390/vetsci9070328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 06/21/2022] [Accepted: 06/25/2022] [Indexed: 12/03/2022] Open
Abstract
Simple Summary Experimental mice are the most commonly used laboratory animals for biomedical research and comparative studies. However, microbial infection may alter the mouse phenotype and confound interpretation results. The genus Corynebacterium, Gram-positive diphtheroid rod-shaped bacteria, induces severe diseases, such as hyperkeratosis and pseudotuberculosis, in immunodeficient mice. In this report, we described the population of Corynebacterium spp. isolated from laboratory mice in Korea using different approaches, comparing the accuracy and problems associated with each method. When identified based on molecular methods such as 16S rRNA and rpoB gene sequence analysis, the main Corynebacterium species were C. mastitidis (44.8%), C. bovis (25.5%), C. lowii (21.2%), and C. amycolatum (8.5%). In addition, matrix-assisted laser desorption/ionization–time of flight mass spectrometry (MALDI-TOF MS) yielded results that were 77.9% identical to the molecular results, whereas biochemical methods showed only 15.5% identical to molecular identification. Collectively, our findings indicate that the different results may be obtained depending on the method used to identify Corynebacterium isolated from experimental mice, highlighting the importance of selecting an appropriate Corynebacterium identification method in obtaining accurate identification results. This result will help to increase the reliability of Corynebacterium diagnosis result from experimental mice. Abstract The genus Corynebacterium, composed of Gram-positive diphtheroid rod-shaped bacteria, induces severe diseases, such as Corynebacterium-associated hyperkeratosis and pseudotuberculosis, in immunodeficient mice. We isolated and identified a total of 165 strains of Corynebacterium species from experimental mice in Korean laboratories, diagnosed using several methods. When identified based on molecular methods, namely, 16S rRNA and rpoB gene sequence analysis, the main Corynebacterium species isolated in Korean laboratory mice were C. mastitidis (44.8%, n = 74), C. bovis (25.5%, n = 42), C. lowii (21.2%, n = 35), and C. amycolatum (8.5%, n = 14). Diagnoses were also performed using matrix-assisted laser desorption/ionization–time of flight mass spectrometry (MALDI-TOF MS) and biochemical methods. MALDI-TOF MS yielded results that were 77.9% identical to the molecular identification results, whereas biochemical methods showed only 15.5% identical to molecular identification, partly owing to difficulties in distinguishing among C. mastitidis strains. Collectively, our findings indicate that molecular biological methods are better suited for detecting and identifying Corynebacterium species candidates isolated from mice than biochemical methods. Because of limitations associated with the use of MALDI-TOF MS, more precise results will be obtained by complementing this approach with other methods when used for rapid identification testing.
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Affiliation(s)
- Sehee Park
- Laboratory Animal Resource Center, Korea Research Institute of Biology and Biotechnology, 30, Yeongudanji-ro, Cheongwon-gu, Cheongju-si 28116, Korea; (S.P.); (H.S.); (S.K.); (T.L.); (H.L.); (K.N.); (W.Y.); (H.K.); (Y.S.)
| | - Hijo Shin
- Laboratory Animal Resource Center, Korea Research Institute of Biology and Biotechnology, 30, Yeongudanji-ro, Cheongwon-gu, Cheongju-si 28116, Korea; (S.P.); (H.S.); (S.K.); (T.L.); (H.L.); (K.N.); (W.Y.); (H.K.); (Y.S.)
| | - Sangwoon Kim
- Laboratory Animal Resource Center, Korea Research Institute of Biology and Biotechnology, 30, Yeongudanji-ro, Cheongwon-gu, Cheongju-si 28116, Korea; (S.P.); (H.S.); (S.K.); (T.L.); (H.L.); (K.N.); (W.Y.); (H.K.); (Y.S.)
| | - Teakchang Lee
- Laboratory Animal Resource Center, Korea Research Institute of Biology and Biotechnology, 30, Yeongudanji-ro, Cheongwon-gu, Cheongju-si 28116, Korea; (S.P.); (H.S.); (S.K.); (T.L.); (H.L.); (K.N.); (W.Y.); (H.K.); (Y.S.)
| | - Haejin Lee
- Laboratory Animal Resource Center, Korea Research Institute of Biology and Biotechnology, 30, Yeongudanji-ro, Cheongwon-gu, Cheongju-si 28116, Korea; (S.P.); (H.S.); (S.K.); (T.L.); (H.L.); (K.N.); (W.Y.); (H.K.); (Y.S.)
| | - Kihoan Nam
- Laboratory Animal Resource Center, Korea Research Institute of Biology and Biotechnology, 30, Yeongudanji-ro, Cheongwon-gu, Cheongju-si 28116, Korea; (S.P.); (H.S.); (S.K.); (T.L.); (H.L.); (K.N.); (W.Y.); (H.K.); (Y.S.)
| | - Wonkee Yoon
- Laboratory Animal Resource Center, Korea Research Institute of Biology and Biotechnology, 30, Yeongudanji-ro, Cheongwon-gu, Cheongju-si 28116, Korea; (S.P.); (H.S.); (S.K.); (T.L.); (H.L.); (K.N.); (W.Y.); (H.K.); (Y.S.)
| | - Hyoungchin Kim
- Laboratory Animal Resource Center, Korea Research Institute of Biology and Biotechnology, 30, Yeongudanji-ro, Cheongwon-gu, Cheongju-si 28116, Korea; (S.P.); (H.S.); (S.K.); (T.L.); (H.L.); (K.N.); (W.Y.); (H.K.); (Y.S.)
| | - Youngwon Seo
- Laboratory Animal Resource Center, Korea Research Institute of Biology and Biotechnology, 30, Yeongudanji-ro, Cheongwon-gu, Cheongju-si 28116, Korea; (S.P.); (H.S.); (S.K.); (T.L.); (H.L.); (K.N.); (W.Y.); (H.K.); (Y.S.)
| | - Youngsuk Won
- Laboratory Animal Resource Center, Korea Research Institute of Biology and Biotechnology, 30, Yeongudanji-ro, Cheongwon-gu, Cheongju-si 28116, Korea; (S.P.); (H.S.); (S.K.); (T.L.); (H.L.); (K.N.); (W.Y.); (H.K.); (Y.S.)
- Correspondence: (Y.W.); (H.K.)
| | - Hyojung Kwon
- Department of Veterinary Pathology, College of Veterinary Medicine, Chungnam National University, 99, Daehak-ro, Yuseong-gu, Daejeon 34134, Korea
- Correspondence: (Y.W.); (H.K.)
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10
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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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11
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Fong P, Butel-Simoes G, Francis MJ, Korman TM, Graham M. Corynebacterium macginleyi in the era of MALDI-TOF MS: epidemiology, susceptibility patterns and prevalence of co-infection. Pathology 2021; 54:336-343. [PMID: 34635321 DOI: 10.1016/j.pathol.2021.07.007] [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: 12/29/2020] [Revised: 07/01/2021] [Accepted: 07/08/2021] [Indexed: 11/28/2022]
Abstract
Corynebacterium macginleyi has long been associated with ocular infections and has more recently been rarely implicated in systemic infections. There is a paucity of literature regarding the rate of C. macginleyi co-infection with other bacterial and viral pathogens and regarding the incidence of C. macginleyi infection in the paediatric population. In this study, we report 30 isolates of C. macginleyi of ocular origin from 26 patients, identified using matrix-assisted laser desorption ionisation-time of flight mass spectrometry (MALDI-TOF MS). The rates of co-isolation with bacterial and viral pathogens were 62% (n=16/26) and 39% (n=5/13), respectively, in this study. Of these, 13 patients had molecular testing performed as requested by treating clinicians for either the Chlamydia trachomatis/Neisseria gonorrhoeae PCR or herpes/enterovirus/adenovirus multiplex PCR. All isolates tested susceptible to linezolid, vancomycin and ciprofloxacin, with variable resistance to tetracycline, clindamycin and penicillin using EUCAST breakpoints.
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Affiliation(s)
- Peivern Fong
- Department of Microbiology, Monash Health, Clayton, Vic, Australia.
| | | | | | - Tony M Korman
- Department of Microbiology, Monash Health, Clayton, Vic, Australia; Monash Infectious Diseases, Monash Health, Clayton, Vic, Australia; Centre for Inflammatory Diseases, Monash University, Clayton, Vic, Australia
| | - Maryza Graham
- Department of Microbiology, Monash Health, Clayton, Vic, Australia; Monash Infectious Diseases, Monash Health, Clayton, Vic, Australia; Centre for Inflammatory Diseases, Monash University, Clayton, Vic, Australia; Microbiological Diagnostic Unit Public Health Laboratory, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia
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12
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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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13
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Kim E, Yang SM, Kim HY. Analysis of Cultivable Microbial Community during Kimchi Fermentation Using MALDI-TOF MS. Foods 2021; 10:foods10051068. [PMID: 34066045 PMCID: PMC8151656 DOI: 10.3390/foods10051068] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 04/28/2021] [Accepted: 05/08/2021] [Indexed: 12/31/2022] Open
Abstract
Kimchi, a traditional Korean fermented vegetable, has received considerable attention for its health-promoting effects. This study analyzes the cultivable microbial community in kimchi fermented at different temperatures using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) to comprehensively understand the factors affecting the quality of kimchi. Of the 5204 strains isolated from kimchi, aligned with the in-house database, 4467 (85.8%) were correctly identified at the species level. The fermentation temperature affected the microbial community by varying the pH and acidity, which was mainly caused by temperature-dependent competition between the different lactic acid bacteria (LAB) species in kimchi. LAB, such as Levilactobacillus (Lb.) brevis and Lactiplantibacillus (Lpb.) plantarum associated with rancidity and tissue softening, proliferated faster at higher temperatures than at low temperature. In addition, LAB, such as Latilactobacillus (Lat.) sakei and Leuconostoc (Leu.) mesenteroides, which produce beneficial substances and flavor, were mainly distributed in kimchi fermented at 4 °C. This study shows as a novelty that MALDI-TOF MS is a robust and economically affordable method for investigating viable microbial communities in kimchi.
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Affiliation(s)
| | | | - Hae-Yeong Kim
- Correspondence: ; Tel.: +82-31-201-2600; Fax: +82-31-204-8116
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14
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De-Simone SG, Gomes LR, Napoleão-Pêgo P, Lechuga GC, de Pina JS, da Silva FR. Epitope Mapping of the Diphtheria Toxin and Development of an ELISA-Specific Diagnostic Assay. Vaccines (Basel) 2021; 9:313. [PMID: 33810325 PMCID: PMC8066203 DOI: 10.3390/vaccines9040313] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 03/11/2021] [Accepted: 03/16/2021] [Indexed: 01/06/2023] Open
Abstract
Background: The diphtheria toxoid antigen is a major component in pediatric and booster combination vaccines and is known to raise a protective humoral immune response upon vaccination. Although antibodies are considered critical for diphtheria protection, little is known about the antigenic determinants that maintain humoral immunity. Methods: One-hundred and twelve 15 mer peptides covering the entire sequence of diphtheria toxin (DTx) protein were prepared by SPOT synthesis. The immunoreactivity of membrane-bound peptides with sera from mice immunized with a triple DTP vaccine allowed mapping of continuous B-cell epitopes, topological studies, multiantigen peptide (MAP) synthesis, and Enzyme-Linked Immunosorbent Assay (ELISA) development. Results: Twenty epitopes were identified, with two being in the signal peptide, five in the catalytic domain (CD), seven in the HBFT domain, and five in the receptor-binding domain (RBD). Two 17 mer (CB/Tx-2/12 and CB/DTx-4-13) derived biepitope peptides linked by a Gly-Gly spacer were chemically synthesized. The peptides were used as antigens to coat ELISA plates and assayed with human (huVS) and mice vaccinated sera (miVS) for in vitro diagnosis of diphtheria. The assay proved to be highly sensitive (99.96%) and specific (100%) for huVS and miVS and, when compared with a commercial ELISA test, demonstrated a high performance. Conclusions: Our work displayed the complete picture of the linear B cell IgG response epitope of the DTx responsible for the protective effect and demonstrated sufficient specificity and eligibility for phase IIB studies of some epitopes to develop new and fast diagnostic assays.
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Affiliation(s)
- Salvatore Giovanni De-Simone
- Center for Technological Development in Health (CDTS), Oswaldo Cruz Foundation (FIOCRUZ), National Institute of Science and Technology for Innovation in Neglected Diseases Populations (INCT-IDNP), Rio de Janeiro 21040-900, Brazil; (L.R.G.); (P.N.-P.); (G.C.L.); (J.S.d.P.); (F.R.d.S.)
- Molecular and Cellular Biology Department, Biology Institute, Federal Fluminense University, Niterói 24020-141, Brazil
| | - Larissa Rodrigues Gomes
- Center for Technological Development in Health (CDTS), Oswaldo Cruz Foundation (FIOCRUZ), National Institute of Science and Technology for Innovation in Neglected Diseases Populations (INCT-IDNP), Rio de Janeiro 21040-900, Brazil; (L.R.G.); (P.N.-P.); (G.C.L.); (J.S.d.P.); (F.R.d.S.)
| | - Paloma Napoleão-Pêgo
- Center for Technological Development in Health (CDTS), Oswaldo Cruz Foundation (FIOCRUZ), National Institute of Science and Technology for Innovation in Neglected Diseases Populations (INCT-IDNP), Rio de Janeiro 21040-900, Brazil; (L.R.G.); (P.N.-P.); (G.C.L.); (J.S.d.P.); (F.R.d.S.)
| | - Guilherme Curty Lechuga
- Center for Technological Development in Health (CDTS), Oswaldo Cruz Foundation (FIOCRUZ), National Institute of Science and Technology for Innovation in Neglected Diseases Populations (INCT-IDNP), Rio de Janeiro 21040-900, Brazil; (L.R.G.); (P.N.-P.); (G.C.L.); (J.S.d.P.); (F.R.d.S.)
| | - Jorge Soares de Pina
- Center for Technological Development in Health (CDTS), Oswaldo Cruz Foundation (FIOCRUZ), National Institute of Science and Technology for Innovation in Neglected Diseases Populations (INCT-IDNP), Rio de Janeiro 21040-900, Brazil; (L.R.G.); (P.N.-P.); (G.C.L.); (J.S.d.P.); (F.R.d.S.)
| | - Flavio Rocha da Silva
- Center for Technological Development in Health (CDTS), Oswaldo Cruz Foundation (FIOCRUZ), National Institute of Science and Technology for Innovation in Neglected Diseases Populations (INCT-IDNP), Rio de Janeiro 21040-900, Brazil; (L.R.G.); (P.N.-P.); (G.C.L.); (J.S.d.P.); (F.R.d.S.)
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15
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Jahan NA, Godden SM, Royster E, Schoenfuss TC, Gebhart C, Timmerman J, Fink RC. Evaluation of the matrix-assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF MS) system in the detection of mastitis pathogens from bovine milk samples. J Microbiol Methods 2021; 182:106168. [PMID: 33600875 DOI: 10.1016/j.mimet.2021.106168] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 12/08/2020] [Accepted: 01/18/2021] [Indexed: 10/22/2022]
Abstract
MALDI-TOF is a chemistry analytical tool that has recently been deployed in the identification of microorganisms isolated from nosocomial environments. Its use in diagnostics has been extremely advantageous in terms of cost effectiveness, sample preparation easiness, turn-around time and result analysis accessibility. In the dairy industry, where mastitis causes great financial losses, a rapid diagnostic method such as MALDI-TOF could assist in the control and prevention program of mastitis, in addition to the sanitation and safety level of the dairy farms and processing facility. However, the diagnostic strengths and limitations of this test method require further understanding. In the present study, we prospectively compared MALDI-TOF MS to conventional 16S rDNA sequencing method for the identification of pathogens recovered from milk associated with clinical and subclinical bovine mastitis cases. Initially, 810 bacterial isolates were collected from raw milk samples over a period of three months. However, only the isolates (481) having both 16S rDNA sequencing and MALDI-TOF identification were included in the final phase of the study. Among the 481 milk isolates, a total of 26 genera (12 g-postive and 14 g-negative), including 71 different species, were taxonomically charecterized by 16S rDNA at the species level. Comparatively, MALDI-TOF identified 17 genera (9 g-positive and 8 g-negative) and 33 differernt species. Overall, 445 (93%) were putatively identified to the genus level by MALDI-TOF MS and 355 (74%) were identified to the species level, but no reliable identification was obtained for 16 (3.3%), and 20 (4.2%) discordant results were identified. Future studies may help to overcome the limitations of the MALDI database and additional sample preparation steps might help to reduce the number of discordances in identification. In conclusion, our results show that MALDI-TOF MS is a fast and reliable technique which has the potential to replace conventional identification methods for common mastitis pathogens, routinely isolated from raw milk. Thus it's adoption will strengthen the capacity, quality, and possibly the scope of diagnostic services to support the dairy industry.
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Affiliation(s)
- Nusrat A Jahan
- Department of Biology, St. Cloud State University, Saint Cloud, MN, USA
| | - Sandra M Godden
- College of Veterinary Medicine, University of Minnesota, St. Paul, MN, USA
| | - Erin Royster
- College of Veterinary Medicine, University of Minnesota, St. Paul, MN, USA
| | - Tonya C Schoenfuss
- Department of Food Science and Nutrition, University of Minnesota, St. Paul, MN, USA
| | - Connie Gebhart
- College of Veterinary Medicine, University of Minnesota, St. Paul, MN, USA
| | - Jennifer Timmerman
- College of Veterinary Medicine, University of Minnesota, St. Paul, MN, USA
| | - Ryan C Fink
- Department of Biology, St. Cloud State University, Saint Cloud, MN, USA,.
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16
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Abbott Y, Efstratiou A, Brennan G, Hallanan S, Leggett B, Leonard FC, Markey BK, Tuite C, Fry NK. Toxigenic Corynebacterium ulcerans associated with upper respiratory infections in cats and dogs. J Small Anim Pract 2020; 61:554-560. [PMID: 32734615 DOI: 10.1111/jsap.13185] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 05/22/2020] [Accepted: 06/01/2020] [Indexed: 01/02/2023]
Abstract
OBJECTIVES To describe infection in companion animals with the zoonotic pathogen Corynebacterium ulcerans and to determine its prevalence in clinically-affected and healthy animals. MATERIALS AND METHODS The clinical presentation and treatment of three cases of C. ulcerans infection is described. Two studies to determine C. ulcerans prevalence rates were undertaken: (a) a prospective study of nasal samples from healthy animals, 479 dogs and 72 cats; (b) a retrospective analysis of records of nasal samples collected over a 10-year period from 189 dogs and 64 cats affected by respiratory signs. RESULTS Toxigenic C. ulcerans was isolated from four cats with nasal discharge while concurrent C. ulcerans and mecC methicillin-resistant S. aureus infection was detected in a dog suffering from chronic nasal discharge. Clinical features were not distinctive and all cases recovered following antimicrobial treatment. Multilocus sequence typing supported a common source for isolates from the shelter cats. Carriage rates of C. ulcerans in healthy animals were 0.42% (2/479) in dogs and 0.00% (0/72) in cats whereas in animals with signs of upper respiratory tract infection prevalence rates were 0.53% (1/189) in dogs and 6.25% (4/64) in cats. CLINICAL SIGNIFICANCE Clinicians should be aware that dogs and cats can be infected with (or carriers of) toxigenic C. ulcerans Considering the potential zoonotic risk, assistance from medical and public health colleagues should be sought in confirmed cases.
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Affiliation(s)
- Y Abbott
- Veterinary Pathobiology Section, School of Veterinary Medicine, University College Dublin, Belfield, Stillorgan Road, Dublin, D04 W6F6, Ireland
| | - A Efstratiou
- WHO Global Reference Centre for Diphtheria and Streptococcal Infections, Public Health England, National Infection Service, 61 Colindale Avenue, London, NW9 5EQ, UK
| | - G Brennan
- National MRSA Reference Laboratory, St. James's Hospital, James's Street, Dublin 8, Ireland
| | - S Hallanan
- Riverforest Veterinary Centre, Riverforest Court, Captain's Hill, Leixlip, Co. Kildare, W23 A5N4, Ireland
| | - B Leggett
- Veterinary Pathobiology Section, School of Veterinary Medicine, University College Dublin, Belfield, Stillorgan Road, Dublin, D04 W6F6, Ireland
| | - F C Leonard
- Veterinary Pathobiology Section, School of Veterinary Medicine, University College Dublin, Belfield, Stillorgan Road, Dublin, D04 W6F6, Ireland
| | - B K Markey
- Veterinary Pathobiology Section, School of Veterinary Medicine, University College Dublin, Belfield, Stillorgan Road, Dublin, D04 W6F6, Ireland
| | - C Tuite
- Fairview Veterinary Hospital, 13 Fairview Strand, Dublin, D03 P27, Ireland
| | - N K Fry
- Vaccine Preventable Bacteria Section, Public Health England, National Infection Service, 61 Colindale Avenue, London, NW9 5EQ, UK.,Immunisation and Countermeasures Division, Public Health England, National Infection Service, 61 Colindale Avenue, London, NW9 5EQ, UK
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17
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Dangel A, Berger A, Rau J, Eisenberg T, Kämpfer P, Margos G, Contzen M, Busse HJ, Konrad R, Peters M, Sting R, Sing A. Corynebacterium silvaticum sp. nov., a unique group of NTTB corynebacteria in wild boar and roe deer. Int J Syst Evol Microbiol 2020; 70:3614-3624. [PMID: 32368999 DOI: 10.1099/ijsem.0.004195] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
A total of 34 Corynebacterium sp. strains were isolated from caseous lymph node abscesses of wild boar and roe deer in different regions of Germany. They showed slow growth on Columbia sheep blood agar and sparse growth on Hoyle's tellurite agar. Cellular fatty acid analysis allocated them in the C. diphtheriae group of genus Corynebacterium. MALDI-TOF MS using specific database extensions and rpoB sequencing resulted in classification as C. ulcerans. Their quinone system is similar to C. ulcerans, with major menaquinone MK-8(H2). Their complex polar lipid profile includes major lipids phosphatidylinositol, phosphatidylinositol-mannoside, diphosphatidylglycerol, but also unidentified glycolipids, distinguishing them clearly from C. ulcerans. They ferment glucose, ribose and maltose (like C. ulcerans), but do not utilise d-xylose, mannitol, lactose, sucrose and glycogen (like C. pseudotuberculosis). They showed activity of catalase, urease and phospholipase D, but variable results for alkaline phosphatase and alpha-glucosidase. All were non-toxigenic, tox gene bearing and susceptible to clindamycin, penicillin and erythromycin. In 16SrRNA gene and RpoB protein phylogenies the strains formed distinct brancheswith C. ulcerans as nearest relative.Whole genome sequencing revealed the unique sequence type 578, a distinctbranch in pangenomic core genome MLST, average nucleotide identities <91%, enhancedgenome sizes (2.55 Mbp) and G/C content (54.4 mol%) compared to related species.These results suggest that the strains represent a novel species, for which wepropose the name Corynebactriumsilvaticum sp. nov., based on their first isolation from forest-dwellinggame animals. The type strain isKL0182T (= CVUAS 4292T = DSM 109166T = LMG 31313T= CIP 111 672T).
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Affiliation(s)
- Alexandra Dangel
- Bavarian Health and Food Safety Authority, Oberschleißheim, Germany
| | - Anja Berger
- Germany National Consiliary Laboratory for Diphtheria, Oberschleißheim, Germany
- Bavarian Health and Food Safety Authority, Oberschleißheim, Germany
| | - Jörg Rau
- Chemisches und Veterinäruntersuchungsamt Stuttgart (CVUAS), Fellbach, Germany
| | | | - Peter Kämpfer
- Institut für Angewandte Mikrobiologie, Justus-Liebig-Universität Gießen, Gießen, Germany
| | - Gabriele Margos
- Bavarian Health and Food Safety Authority, Oberschleißheim, Germany
| | - Matthias Contzen
- Chemisches und Veterinäruntersuchungsamt Stuttgart (CVUAS), Fellbach, Germany
| | - Hans-Jürgen Busse
- Institute of Microbiology, University of Veterinary Medicine Vienna, Austria
| | - Regina Konrad
- Bavarian Health and Food Safety Authority, Oberschleißheim, Germany
| | - Martin Peters
- Chemisches und Veterinäruntersuchungsamt Westfalen, Arnsberg, Germany
| | - Reinhard Sting
- German Consiliary Laboratory for Corynebacterium pseudotuberculosis, Fellbach, Germany
- Chemisches und Veterinäruntersuchungsamt Stuttgart (CVUAS), Fellbach, Germany
| | - Andreas Sing
- Germany National Consiliary Laboratory for Diphtheria, Oberschleißheim, Germany
- Bavarian Health and Food Safety Authority, Oberschleißheim, Germany
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18
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Corynebacterium Total Hip and Knee Arthroplasy Prosthetic Joint Infections. Arthroplast Today 2020; 6:163-168. [PMID: 32368605 PMCID: PMC7184103 DOI: 10.1016/j.artd.2020.03.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 03/08/2020] [Accepted: 03/10/2020] [Indexed: 12/24/2022] Open
Abstract
Prosthetic joint infections (PJIs) are typically caused by Staphylococcus aureus and coagulase-negative Staphylococci species. Corynebacterium species are microorganisms of the human skin and mucous membranes that are often considered contaminants when grown in culture. In the past, Corynebacterium species were often classified as diphtheroids based on growing as gram-positive rods in aerobic environments, but with advances in technology, the identification of Corynebacterium species has improved. Corynebacterium can cause infection, but there are few case reports of orthopaedic infection. We present 3 cases of total hip arthroplasty and 3 cases of total knee arthroplasty PJI caused by Corynebacterium species. We found a high failure rate of surgical treatment of Corynebacterium PJI, defined as reoperation for infection. This information adds to the limited literature on these organisms in total joint arthroplasty PJI.
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Sharma NC, Efstratiou A, Mokrousov I, Mutreja A, Das B, Ramamurthy T. Diphtheria. Nat Rev Dis Primers 2019; 5:81. [PMID: 31804499 DOI: 10.1038/s41572-019-0131-y] [Citation(s) in RCA: 87] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/25/2019] [Indexed: 01/09/2023]
Abstract
Diphtheria is a potentially fatal infection mostly caused by toxigenic Corynebacterium diphtheriae strains and occasionally by toxigenic C. ulcerans and C. pseudotuberculosis strains. Diphtheria is generally an acute respiratory infection, characterized by the formation of a pseudomembrane in the throat, but cutaneous infections are possible. Systemic effects, such as myocarditis and neuropathy, which are associated with increased fatality risk, are due to diphtheria toxin, an exotoxin produced by the pathogen that inhibits protein synthesis and causes cell death. Clinical diagnosis is confirmed by the isolation and identification of the causative Corynebacterium spp., usually by bacterial culture followed by enzymatic and toxin detection tests. Diphtheria can be treated with the timely administration of diphtheria antitoxin and antimicrobial therapy. Although effective vaccines are available, this disease has the potential to re-emerge in countries where the recommended vaccination programmes are not sustained, and increasing proportions of adults are becoming susceptible to diphtheria. Thousands of diphtheria cases are still reported annually from several countries in Asia and Africa, along with many outbreaks. Changes in the epidemiology of diphtheria have been reported worldwide. The prevalence of toxigenic Corynebacterium spp. highlights the need for proper clinical and epidemiological investigations to quickly identify and treat affected individuals, along with public health measures to prevent and contain the spread of this disease.
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Affiliation(s)
- Naresh Chand Sharma
- Laboratory Department, Maharishi Valmiki Infectious Diseases Hospital, Delhi, India
| | - Androulla Efstratiou
- WHO Collaborating Centre for Diphtheria and Streptococcal Infections, Reference Microbiology Division, Public Health England, London, UK
| | - Igor Mokrousov
- Laboratory of Molecular Epidemiology and Evolutionary Genetics, St. Petersburg Pasteur Institute, St. Petersburg, Russia
| | - Ankur Mutreja
- Global Health-Infectious Diseases, Department of Medicine, University of Cambridge, Cambridge, UK
| | - Bhabatosh Das
- Infection and Immunology Division, Translational Health Science and Technology Institute, Faridabad, India
| | - Thandavarayan Ramamurthy
- Infection and Immunology Division, Translational Health Science and Technology Institute, Faridabad, India.
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Badell E, Guillot S, Tulliez M, Pascal M, Panunzi LG, Rose S, Litt D, Fry NK, Brisse S. Improved quadruplex real-time PCR assay for the diagnosis of diphtheria. J Med Microbiol 2019; 68:1455-1465. [DOI: 10.1099/jmm.0.001070] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Edgar Badell
- Institut Pasteur, National Reference Center for Corynebacteria of the diphtheriae complex, Paris, France
- Institut Pasteur, Biodiversity and Epidemiology of Bacterial Pathogens, Paris, France
| | - Sophie Guillot
- Institut Pasteur, Biodiversity and Epidemiology of Bacterial Pathogens, Paris, France
| | - Marie Tulliez
- Institut Pasteur, Biodiversity and Epidemiology of Bacterial Pathogens, Paris, France
| | - Marine Pascal
- Institut Pasteur, Biodiversity and Epidemiology of Bacterial Pathogens, Paris, France
| | | | - Samuel Rose
- Respiratory and Vaccine Preventable Bacteria Reference Unit, National Infection Service, Public Health England, London, UK
| | - David Litt
- Respiratory and Vaccine Preventable Bacteria Reference Unit, National Infection Service, Public Health England, London, UK
| | - Norman K. Fry
- Immunisation and Countermeasures Division, National Infection Service, Public Health England, London, UK
- Respiratory and Vaccine Preventable Bacteria Reference Unit, National Infection Service, Public Health England, London, UK
| | - 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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21
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From contamination to infective endocarditis-a population-based retrospective study of Corynebacterium isolated from blood cultures. Eur J Clin Microbiol Infect Dis 2019; 39:113-119. [PMID: 31485919 PMCID: PMC6962118 DOI: 10.1007/s10096-019-03698-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 08/30/2019] [Indexed: 12/16/2022]
Abstract
Corynebacterium is a genus that can contaminate blood cultures and also cause severe infections like infective endocarditis (IE). Our purpose was to investigate microbiological and clinical features associated with contamination and true infection. A retrospective population-based study of Corynebacterium bacteremia 2012–2017 in southern Sweden was performed. Corynebacterium isolates were species determined using a matrix-assisted laser desorption/ionization-time-of-flight mass spectrometry (MALDI-TOF MS). Patient were, from the medical records, classified as having true infection or contamination caused by Corynebacterium through a scheme considering both bacteriological and clinical features and the groups were compared. Three hundred thirty-nine episodes of bacteremia with Corynebacterium were identified in 335 patients of which 30 (8.8%) episodes were classified as true infection. Thirteen patients with true bacteremia had only one positive blood culture. Infections were typically community acquired and affected mostly older males with comorbidities. The focus of infection was most often unknown, and in-hospital mortality was around 10% in both the groups with true infection and contamination. Corynebacterium jeikeium and Corynebacterium striatum were significantly overrepresented in the group with true infection, whereas Corynebacterium afermentans was significantly more common in the contamination group. Eight episodes of IE were identified, all of which in patients with heart valve prosthesis. Six of the IE cases affected the aortic valve and six of seven patients were male. The species of Corynebacterium in blood cultures can help to determine if a finding represent true infection or contamination. The finding of a single blood culture with Corynebacterium does not exclude true infection such as IE.
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22
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Rau J, Eisenberg T, Peters M, Berger A, Kutzer P, Lassnig H, Hotzel H, Sing A, Sting R, Contzen M. Reliable differentiation of a non-toxigenic tox gene-bearing Corynebacterium ulcerans variant frequently isolated from game animals using MALDI-TOF MS. Vet Microbiol 2019; 237:108399. [PMID: 31585651 DOI: 10.1016/j.vetmic.2019.108399] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 07/25/2019] [Accepted: 08/22/2019] [Indexed: 01/18/2023]
Abstract
Corynebacterium (C.) ulcerans is a zoonotic member of the C. diphtheriae group and is known to cause abscesses in humans and several animal species. Toxigenic strains, expressing the tox gene encoding diphtheria toxin, are also able to cause diphtheria in humans. In recent years, a non-toxigenic but tox gene-bearing (NTTB) variant of C. ulcerans has been identified that was frequently isolated from clinically healthy as well as from diseased wildlife animals, especially wild boars (Sus scrofa scrofa) in Germany and Austria. The described clinical cases showed similar signs of disease and the isolated corynebacteria displayed common genetic features as well as similar spectroscopic characteristics, therefore being assigned to a so called wild boar cluster (WBC). This study describes the establishment and validation of a method using MALDI-TOF mass spectrometry for a reliable differentiation between various members of the C. diphtheriae group at species level as well as a reliable sub-level identification of C. ulcerans isolates of the WBC variant. For this study 93 C. ulcerans isolates from wildlife animals, 41 C. ulcerans isolates from other animals and humans, and 53 isolates from further representatives of the C. diphtheriae group, as well as 26 non-diphtheriae group Corynebacteria collected via the MALDI user platform from seven MALDI users were used. By assigning 86 C. ulcerans isolates to the WBC the extensive geographical distribution of this previously less noticed variant in two Central European countries could be shown.
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Affiliation(s)
- Jörg Rau
- Chemisches und Veterinäruntersuchungsamt Stuttgart (CVUAS), Schaflandstr. 3/2, 70367 Fellbach, Germany.
| | - Tobias Eisenberg
- Landesbetrieb Hessisches Landeslabor (LHL), Schubertstr. 60 - Haus 13, 35392 Gießen, Germany.
| | - Martin Peters
- Chemisches und Veterinäruntersuchungsamt Westfalen, Zur Taubeneiche 10-12, 59821 Arnsberg, Germany.
| | - Anja Berger
- National Consiliar Laboratory on Diphtheria, Landesamt für Gesundheit und Lebensmittelsicherheit (LGL), Veterinärstr. 2, 85764 Oberschleißheim, Germany.
| | - Peter Kutzer
- Landeslabor Berlin-Brandenburg (LLBB), Gerhard-Neumann-Str. 2, 15236 Frankfurt (Oder), Germany.
| | - Heimo Lassnig
- Österreichische Agentur für Gesundheit und Ernährungssicherheit GmbH (AGES), Beethovenstr. 6, 8010 Graz, Austria.
| | - Helmut Hotzel
- Friedrich-Loeffler-Institut (FLI), Naumburger Str. 96a, 07743 Jena, Germany.
| | - Andreas Sing
- National Consiliar Laboratory on Diphtheria, Landesamt für Gesundheit und Lebensmittelsicherheit (LGL), Veterinärstr. 2, 85764 Oberschleißheim, Germany.
| | - Reinhard Sting
- Chemisches und Veterinäruntersuchungsamt Stuttgart (CVUAS), Schaflandstr. 3/2, 70367 Fellbach, Germany; Consiliar Laboratory for Corynebacterium pseudotuberculosis (DVG).
| | - Matthias Contzen
- Chemisches und Veterinäruntersuchungsamt Stuttgart (CVUAS), Schaflandstr. 3/2, 70367 Fellbach, Germany.
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23
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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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24
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Berger A, Dangel A, Peters M, Mühldorfer K, Braune S, Eisenberg T, Szentiks CA, Rau J, Konrad R, Hörmansdorfer S, Ackermann N, Sing A. Tox-positive Corynebacterium ulcerans in hedgehogs, Germany . Emerg Microbes Infect 2019; 8:211-217. [PMID: 30866774 PMCID: PMC6455118 DOI: 10.1080/22221751.2018.1562312] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Toxigenic Corynebacterium ulcerans may cause both respiratory and cutaneous diphtheria in humans. As a zoonotic emerging pathogen it has been isolated from a wide variety of animals living in captivity, such as livestock, pet, zoo and research animals and additionally in a large number of different wild animals. Here we report the isolation of tox-positive C. ulcerans in four hedgehogs with cutaneous diphtheria and pneumonia, respectively.
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Affiliation(s)
- Anja Berger
- a National Consiliary Laboratory for Diphtheria , Oberschleißheim , Germany.,b MA DTM&H, National Consiliary Laboratory for Diphtheria , Bavarian Health and Food Safety Authority , Oberschleißheim , Germany
| | - Alexandra Dangel
- b MA DTM&H, National Consiliary Laboratory for Diphtheria , Bavarian Health and Food Safety Authority , Oberschleißheim , Germany
| | - Martin Peters
- c Chemisches und Veterinäruntersuchungsamt Westfalen , Arnsberg , Germany
| | | | - Silke Braune
- e Lower Saxony State Office for Consumer Protection and Food Safety , Food and Veterinary Institute , Hannover , Germany
| | | | | | - Jörg Rau
- g Chemisches und Veterinäruntersuchungsamt Stuttgart , Fellbach , Germany
| | - Regina Konrad
- b MA DTM&H, National Consiliary Laboratory for Diphtheria , Bavarian Health and Food Safety Authority , Oberschleißheim , Germany
| | - Stefan Hörmansdorfer
- b MA DTM&H, National Consiliary Laboratory for Diphtheria , Bavarian Health and Food Safety Authority , Oberschleißheim , Germany
| | - Nikolaus Ackermann
- b MA DTM&H, National Consiliary Laboratory for Diphtheria , Bavarian Health and Food Safety Authority , Oberschleißheim , Germany
| | - Andreas Sing
- a National Consiliary Laboratory for Diphtheria , Oberschleißheim , Germany.,b MA DTM&H, National Consiliary Laboratory for Diphtheria , Bavarian Health and Food Safety Authority , Oberschleißheim , Germany
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25
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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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26
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Monomicrobial bone and joint infection due to Corynebacterium striatum: literature review and amoxicillin-rifampin combination as treatment perspective. Eur J Clin Microbiol Infect Dis 2019; 38:1269-1278. [PMID: 30903537 DOI: 10.1007/s10096-019-03542-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 03/14/2019] [Indexed: 12/18/2022]
Abstract
Corynebacterium striatum is a ubiquitous colonizer of human skin and mucous membranes. It is increasingly involved in infections, especially with prosthetic devices or in immunocompromised individuals. Microbiological diagnosis is challenging and bacterial resistance is a major concern. We performed a retrospective study of monomicrobial bone and joint infections (BJI) due to C. striatum in two referral centers from April 2012 to July 2017. We collected the patients' clinical and microbiological characteristics and outcomes. We also performed a literature review of BJI due to C. striatum. We identified 12 cases (nine prosthetic joint infections, one osteosynthetic device infection, one non-union, and one arthritis) in 11 patients, five of which were immunocompromised. Microbiological diagnosis was performed with prolonged culture media. Ten out of 12 strains were susceptible to aminopenicillin, a drug class not recommended for testing by the EUCAST/CASFM guidelines, and 8/12 patients were treated with amoxicillin-rifampicin. The cure rate was 8/12, after a median follow-up period of 487.5 days (IQR 140.3-1348.5). Twelve cases of BJI due to C. striatum were previously reported. Among them, 5/12 patients were immunocompromised, 3/12 cases were acute BJI, and 2/12 were device-related infections. The diagnosis was performed by PCR in one case, and 10/12 patients were treated with glycolipopeptides, with a cure rate of 11/12. We report the largest cohort of monomicrobial BJI with C. striatum. Determination of aminopenicillin susceptibility is essential since it is frequently active in our experience, even in BJI. The cure rate of this infection seems high.
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27
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Detection and virulence potential of a phospholipase D-negative Corynebacterium ulcerans from a concurrent diphtheria and infectious mononucleosis case. Antonie van Leeuwenhoek 2019; 112:1055-1065. [PMID: 30771116 DOI: 10.1007/s10482-019-01240-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 01/22/2019] [Indexed: 10/27/2022]
Abstract
Diphtheria by Corynebacterium ulcerans is increasingly occurring in children, adolescents and adults. In addition to diphtheria toxin (DT), phospholipase D (PLD) is considered a virulence factor of C. ulcerans. In the present study, a first case of concurrent diphtheria by a PLD-negative C. ulcerans and infectious mononucleosis (IM) was verified. Clinical and microbiological profiles and binding properties to human Fibrinogen (Fbg), Fibronectin (Fn) and type I collagen (col I) biotinylated proteins and virulence to Caenorhabditis elegans were investigated for C. ulcerans strain 2590 (clinical isolate) and two control strains, including PLD-positive BR-AD22 wild type and PLD-negative ELHA-1 PLD mutant strains. MALDI-TOF assays and a multiplex PCR of genes coding for potentially toxigenic corynebacteria identified strain 2590 as non-DT producing. Interestingly, strain 2590 did not express PLD activity in the CAMP test although the presence of the pld gene was verified. PLD-negative 2590 and a PLD-positive 210932 strains showed similar affinity to Fbg, Fn and type I collagen. C. elegans were able to escape from C. ulcerans strains, independent of PLD and DT production. Higher mortality of nematodes was verified for PLD-negative strains. Additional studies concerning multifactorial virulence potential of C. ulcerans, including environmental conditions remain necessary.
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Dangel A, Berger A, Konrad R, Sing A. NGS-based phylogeny of diphtheria-related pathogenicity factors in different Corynebacterium spp. implies species-specific virulence transmission. BMC Microbiol 2019; 19:28. [PMID: 30709334 PMCID: PMC6359835 DOI: 10.1186/s12866-019-1402-1] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 01/25/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Diphtheria toxin (DT) is produced by toxigenic strains of the human pathogen Corynebacterium diphtheriae as well as zoonotic C. ulcerans and C. pseudotuberculosis. Toxigenic strains may cause severe respiratory diphtheria, myocarditis, neurological damage or cutaneous diphtheria. The DT encoding tox gene is located in a mobile genomic region and tox variability between C. diphtheriae and C. ulcerans has been postulated based on sequences of a few isolates. In contrast, species-specific sequence analysis of the diphtheria toxin repressor gene (dtxR), occurring both in toxigenic and non-toxigenic Corynebacterium species, has not been done yet. We used whole genome sequencing data from 91 toxigenic and 46 non-toxigenic isolates of different pathogenic Corynebacterium species of animal or human origin to elucidate differences in extracted DT, DtxR and tox-surrounding genetic elements by a phylogenetic analysis in a large sample set. RESULTS Sequences of both DT and DtxR, extracted from whole genome sequencing data, could be classified in four distinct, nearly species-specific clades, corresponding to C. diphtheriae, C. pseudotuberculosis, C. ulcerans and atypical C. ulcerans from a non-toxigenic toxin gene-bearing wildlife cluster. Average amino acid similarities were above 99% for DT and DtxR within the four groups, but lower between them. For DT, subgroups below species level could be identified, correlating with different tox-comprising mobile genetic elements. In most C. diphtheriae, tox genes were located within known prophages. In contrast, in C. ulcerans diverse tox-including mobile elements could be identified: either prophages differing from C. diphtheriae prophages or an alternative pathogenicity island (PAI) described previously. One isolate showed a different, shorter tox-comprising putative PAI. Beyond the tox-overlapping elements, most isolates harbored a variety of additional prophages. CONCLUSION Our NGS data from 137 isolates indicate the existence of different genetic backgrounds of DT-mediated pathogenicity in different Corynebacterium species and evolution of once acquired pathogenicity features with the strains. Different groups of pathogenicity-related elements within C. ulcerans imply that tox transmission pathways between isolates may differ in the zoonotic species and contribute to their emerging pathogenic potential.
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Affiliation(s)
- Alexandra Dangel
- Bavarian Health and Food Safety Authority, 85764, Oberschleissheim, Germany.
| | - Anja Berger
- Bavarian Health and Food Safety Authority, 85764, Oberschleissheim, Germany. .,German National Consiliary Laboratory on Diphtheria, 85764, Oberschleissheim, Germany.
| | - Regina Konrad
- Bavarian Health and Food Safety Authority, 85764, Oberschleissheim, Germany
| | - Andreas Sing
- Bavarian Health and Food Safety Authority, 85764, Oberschleissheim, Germany.,German National Consiliary Laboratory on Diphtheria, 85764, Oberschleissheim, Germany
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29
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Berger A, Dangel A, Schober T, Schmidbauer B, Konrad R, Marosevic D, Schubert S, Hörmansdorfer S, Ackermann N, Hübner J, Sing A. Whole genome sequencing suggests transmission of Corynebacterium diphtheriae-caused cutaneous diphtheria in two siblings, Germany, 2018. Euro Surveill 2019; 24:1800683. [PMID: 30646974 PMCID: PMC6337054 DOI: 10.2807/1560-7917.es.2019.24.2.1800683] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 01/10/2019] [Indexed: 11/20/2022] Open
Abstract
In September 2018, a child who had returned from Somalia to Germany presented with cutaneous diphtheria by toxigenic Corynebacterium diphtheriae biovar mitis. The child's sibling had superinfected insect bites harbouring also toxigenic C. diphtheriae. Next generation sequencing (NGS) revealed the same strain in both patients suggesting very recent human-to-human transmission. Epidemiological and NGS data suggest that the two cutaneous diphtheria cases constitute the first outbreak by toxigenic C. diphtheriae in Germany since the 1980s.
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Affiliation(s)
- Anja Berger
- National Consiliary Laboratory for Diphtheria, Oberschleißheim, Germany
- Bavarian Health and Food Safety Authority, Oberschleißheim, Germany
- These authors contributed equally to this paper
| | - Alexandra Dangel
- Bavarian Health and Food Safety Authority, Oberschleißheim, Germany
- These authors contributed equally to this paper
| | - Tilmann Schober
- These authors contributed equally to this paper
- Division of Pediatric Infectious Diseases, Hauner Children's Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
| | | | - Regina Konrad
- National Consiliary Laboratory for Diphtheria, Oberschleißheim, Germany
- Bavarian Health and Food Safety Authority, Oberschleißheim, Germany
| | | | - Sören Schubert
- Max von Pettenkofer-Institute, Ludwig-Maximilians-University Munich, Munich, Germany
| | | | | | - Johannes Hübner
- Division of Pediatric Infectious Diseases, Hauner Children's Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
- These authors contributed equally to this paper
| | - Andreas Sing
- National Consiliary Laboratory for Diphtheria, Oberschleißheim, Germany
- Bavarian Health and Food Safety Authority, Oberschleißheim, Germany
- These authors contributed equally to this paper
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30
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Scheifer C, Rolland-Debord C, Badell E, Reibel F, Aubry A, Perignon A, Patey O, Brisse S, Caumes E. Re-emergence of Corynebacterium diphtheriae. Med Mal Infect 2018; 49:463-466. [PMID: 30583866 DOI: 10.1016/j.medmal.2018.12.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 11/26/2017] [Accepted: 12/04/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Diphtheria is re-emerging in Europe. A total of 36 cases were reported in Europe in 2015 versus 53 cases between 2000 and 2009. PATIENTS We report two cases of Corynebacterium diphtheriae infection in a French hospital in 2016: a cutaneous infection with negative toxin testing in a French traveller, and a respiratory diphtheria carriage with positive toxin testing in an Afghan refugee diagnosed with pulmonary tuberculosis. The vaccination history of the Afghan patient could not be retrieved.
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Affiliation(s)
- C Scheifer
- Groupe hospitalier Pitié-Salpêtrière Charles-Foix, Assistance publique-Hôpitaux de Paris, 73013 Paris, France.
| | - C Rolland-Debord
- Groupe hospitalier Pitié-Salpêtrière Charles-Foix, Assistance publique-Hôpitaux de Paris, 73013 Paris, France; Sorbonne universités, UPMC université Paris 06, 75252 Paris, France.
| | - E Badell
- Centre national de référence des Corynébactéries du complexe diphtheriae, Institut Pasteur, 75015 Paris, France.
| | - F Reibel
- Groupe hospitalier Pitié-Salpêtrière Charles-Foix, Assistance publique-Hôpitaux de Paris, 73013 Paris, France.
| | - A Aubry
- Groupe hospitalier Pitié-Salpêtrière Charles-Foix, Assistance publique-Hôpitaux de Paris, 73013 Paris, France.
| | - A Perignon
- Groupe hospitalier Pitié-Salpêtrière Charles-Foix, Assistance publique-Hôpitaux de Paris, 73013 Paris, France.
| | - O Patey
- Hôpital Villeneuve-Saint-Georges, 94190 Villeneuve-Saint-Georges, France.
| | - S Brisse
- Centre national de référence des Corynébactéries du complexe diphtheriae, Institut Pasteur, 75015 Paris, France.
| | - E Caumes
- Groupe hospitalier Pitié-Salpêtrière Charles-Foix, Assistance publique-Hôpitaux de Paris, 73013 Paris, France.
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García de Hombre AM, Bonadeo A, Suárez-Bordón P, Sánchez-Oñoro M. Tumor cervical de etiología inusual. Enferm Infecc Microbiol Clin 2018; 36:525-526. [DOI: 10.1016/j.eimc.2017.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 07/10/2017] [Accepted: 07/12/2017] [Indexed: 10/19/2022]
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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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Hahne J, Kloster T, Rathmann S, Weber M, Lipski A. Isolation and characterization of Corynebacterium spp. from bulk tank raw cow's milk of different dairy farms in Germany. PLoS One 2018; 13:e0194365. [PMID: 29617406 PMCID: PMC5884509 DOI: 10.1371/journal.pone.0194365] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 03/01/2018] [Indexed: 11/25/2022] Open
Abstract
We detected Corynebacterium spp. in raw milk samples of three farms by means of a selective, tellurite-containing medium. The isolated strains were identified based on full 16S rRNA gene sequences and partial rpoB gene sequences as C. xerosis, C. variabile, C. lactis, C. callunae, C. confusum, C. glutamicum and C. crudilactis. The identification based on 16S rRNA and rpoB sequences was not reliable for isolates of C. xerosis. Chemotaxonomic markers of the isolates, fatty acids, acyl type of peptidoglycan, presence and length of mycolic acids, quinone patterns, and polar lipids, were in accord with the known characteristics of these species. Biochemical profiles, analyzed with the API Coryne system, were able to differentiate all groups, but were unable to identify the strains due to an inappropriate database for raw-milk associated corynebacteria. Most of the tested isolates showed a single-substance resistance against oxacillin, but three single isolates were classified as multidrug resistant.
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Affiliation(s)
- Julia Hahne
- Rheinische Friedrich-Wilhelms-University Bonn, Institution of Nutrition and Food Science, Department of Food Microbiology and Hygiene, Bonn, North Rhine-Westphalia, Germany
| | - Tabea Kloster
- Rheinische Friedrich-Wilhelms-University Bonn, Institution of Nutrition and Food Science, Department of Food Microbiology and Hygiene, Bonn, North Rhine-Westphalia, Germany
| | - Sandra Rathmann
- Rheinische Friedrich-Wilhelms-University Bonn, Institution of Nutrition and Food Science, Department of Food Microbiology and Hygiene, Bonn, North Rhine-Westphalia, Germany
| | - Mareike Weber
- Rheinische Friedrich-Wilhelms-University Bonn, Institution of Nutrition and Food Science, Department of Food Microbiology and Hygiene, Bonn, North Rhine-Westphalia, Germany
| | - André Lipski
- Rheinische Friedrich-Wilhelms-University Bonn, Institution of Nutrition and Food Science, Department of Food Microbiology and Hygiene, Bonn, North Rhine-Westphalia, Germany
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Rajamani Sekar S, Veeraraghavan B, Anandan S, Devanga Ragupathi N, Sangal L, Joshi S. Strengthening the laboratory diagnosis of pathogenicCorynebacteriumspecies in the Vaccine era. Lett Appl Microbiol 2017; 65:354-365. [DOI: 10.1111/lam.12781] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2017] [Revised: 07/06/2017] [Accepted: 07/20/2017] [Indexed: 01/06/2023]
Affiliation(s)
- S.K. Rajamani Sekar
- Department of Clinical Microbiology; Christian Medical College; Vellore India
| | - B. Veeraraghavan
- Department of Clinical Microbiology; Christian Medical College; Vellore India
| | - S. Anandan
- Department of Clinical Microbiology; Christian Medical College; Vellore India
| | | | - L. Sangal
- World Health Organization (WHO) Country Office; New Delhi India
| | - S. Joshi
- World Health Organization (WHO) Country Office; New Delhi India
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35
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Bao R, Gao X, Hu B, Zhou Z. Matrix-assisted laser desorption ionization time-of-flight mass spectrometry: a powerful tool for identification of Corynebacterium species. J Thorac Dis 2017; 9:3239-3245. [PMID: 29221301 DOI: 10.21037/jtd.2017.09.69] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) is a powerful tool that has initiated a revolution in the clinical microbiology laboratory for identification of nosocomial pathogens. The efficacy of MALDI-TOF MS produced by bioMerieux, Marcy l'Etoile, France (VITEK MS) for detecting Corynebacterium remains unknown. Methods Corynebacterium isolates were isolated from clinical specimen in a tertial teaching hospital from 2012 to 2013. All strains confirmed by rpoB sequencing were identified by API Coryne (bioMerieux), Phoenix (BD) and VITEK MS, respectively. The coincidence rate was used to evaluate the consistency and accuracy across three methods. Results In all, 75 Corynebacterium isolates were collected in this study. The dominant isolates were Corynebacterium striatum (58.7%), Corynebacterium jeikeium (16.0%), Corynebacterium amycolatum (5.3%), Corynebacterium urealyticum (5.3%), Corynebacterium glucuronolyticum (2.7%) and Corynebacterium minutissimum (2.7%). We found that there was no significant difference in the identification of corynebacterium to genus level by MS (100%, 75/75) or Phoenix (93.3%, 70/75) (P=0.058). However, 92.0% (69/75) strains were successfully identified to species by MS while which by Phoenix and API was 78.7% and 65.3% respectively. Compared with gene sequencing, the coincidence rate of identification by MS was significantly higher than Phoenix (P=0.036) and API (P<0.001). Compared with API Coryne (bioMerieux) and Phoenix, VITEK MS shown significant shorter detecting period and less cost. Conclusions VITEK MS was a powerful tool, which could be applied in clinical laboratory, improving the diagnosis for Corynebacterium infection.
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Affiliation(s)
- Rong Bao
- Department of Clinical Microbiology Laboratory, Respiratory, Zhongshan Hospital, Fudan University, Shanghai 20032, China
| | | | | | - Zhaoyan Zhou
- Department of Clinical Microbiology Laboratory, Respiratory, Zhongshan Hospital, Fudan University, Shanghai 20032, China
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36
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Poor AP, Moreno LZ, Matajira CEC, Parra BM, Gomes VTM, Silva APS, Dutra MC, Christ APG, Barbosa MRF, Sato MIZ, Moreno AM. Characterization of Corynebacterium diphtheriae, C. confusum and C. amycolatum isolated from sows with genitourinary infection. Vet Microbiol 2017; 207:149-152. [PMID: 28757016 DOI: 10.1016/j.vetmic.2017.06.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 06/07/2017] [Accepted: 06/08/2017] [Indexed: 10/19/2022]
Abstract
Porcine Corynebacterium infection is still poorly studied, even though the pig has been described as an asymptomatic carrier of Corynebacterium species, including the zoonotic species C. ulcerans, C. confusum and C. amycolatum. Here we present the identification, molecular and antimicrobial susceptibility characterization of coryneform bacteria isolated from sows with urinary tract infection. C. diphtheriae, C. confusum and C. amycolatum were isolated from sows with urinary infection and metritis. Corynebacterium species were identified by MALDI-TOF MS and confirmed by 16S rRNA and rpoB sequencing. All porcine C. diphtheriae strains were further characterized as non-toxigenic (tox-). SE-AFLP genotyping was also performed and enabled not only Corynebacterium species differentiation but also the assessment of C. amycolatum genetic heterogeneity. All studied porcine Corynebacterium strains presented alarming resistance profiles with high MIC values for macrolides/lincosamide, tetracyclines and quinolones, which can be related with high usage in both veterinary and human medicine. Isolation of zoonotic Corynebacterium species from commercial swine is important for assessing the potential zoonotic risk for farmers and further implication for both human and animal treatment.
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Affiliation(s)
- André P Poor
- Departamento de Medicina Veterinária Preventiva e Saúde Animal, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo. Av Prof Dr Orlando Marques de Paiva, 87; Cidade Universitária. São Paulo/SP, Brazil
| | - Luisa Z Moreno
- Departamento de Medicina Veterinária Preventiva e Saúde Animal, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo. Av Prof Dr Orlando Marques de Paiva, 87; Cidade Universitária. São Paulo/SP, Brazil
| | - Carlos E C Matajira
- Departamento de Medicina Veterinária Preventiva e Saúde Animal, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo. Av Prof Dr Orlando Marques de Paiva, 87; Cidade Universitária. São Paulo/SP, Brazil
| | - Beatriz M Parra
- Departamento de Medicina Veterinária Preventiva e Saúde Animal, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo. Av Prof Dr Orlando Marques de Paiva, 87; Cidade Universitária. São Paulo/SP, Brazil
| | - Vasco T M Gomes
- Departamento de Medicina Veterinária Preventiva e Saúde Animal, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo. Av Prof Dr Orlando Marques de Paiva, 87; Cidade Universitária. São Paulo/SP, Brazil
| | - Ana Paula S Silva
- Departamento de Medicina Veterinária Preventiva e Saúde Animal, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo. Av Prof Dr Orlando Marques de Paiva, 87; Cidade Universitária. São Paulo/SP, Brazil
| | - Mauricio C Dutra
- Departamento de Medicina Veterinária Preventiva e Saúde Animal, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo. Av Prof Dr Orlando Marques de Paiva, 87; Cidade Universitária. São Paulo/SP, Brazil
| | - Ana Paula G Christ
- Companhia Ambiental do Estado de São Paulo (CETESB). Av Prof Frederico Hermann Jr, 345; Pinheiros. São Paulo/SP, Brazil
| | - Mikaela R F Barbosa
- Companhia Ambiental do Estado de São Paulo (CETESB). Av Prof Frederico Hermann Jr, 345; Pinheiros. São Paulo/SP, Brazil
| | - Maria Inês Z Sato
- Companhia Ambiental do Estado de São Paulo (CETESB). Av Prof Frederico Hermann Jr, 345; Pinheiros. São Paulo/SP, Brazil
| | - Andrea M Moreno
- Departamento de Medicina Veterinária Preventiva e Saúde Animal, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo. Av Prof Dr Orlando Marques de Paiva, 87; Cidade Universitária. São Paulo/SP, Brazil.
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37
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Teutsch B, Berger A, Marosevic D, Schönberger K, Lâm TT, Hubert K, Beer S, Wienert P, Ackermann N, Claus H, Drayß M, Thiel K, van der Linden M, Vogel U, Sing A. Corynebacterium species nasopharyngeal carriage in asymptomatic individuals aged ≥ 65 years in Germany. Infection 2017; 45:607-611. [PMID: 28429151 DOI: 10.1007/s15010-017-1017-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 04/07/2017] [Indexed: 01/23/2023]
Abstract
PURPOSE The prevalence of protective anti-diphtheria toxin antibodies decreases with age. Therefore, the elderly might serve as reservoir for potentially toxigenic Corynebacterium (C.) species (C. diphtheriae, C. ulcerans, and C. pseudotuberculosis). This study aimed to examine the colonization rate of the nasopharynx with corynebacteria of individuals aged 65 years and older. METHODS In the period from October 2012 to June 2013, nasal and throat swabs were taken from 714 asymptomatic subjects aged 65-106 years (average age 77.2) at three regions in Germany and investigated for Corynebacterium species. RESULTS A total of 402 strains of Corynebacterium species were isolated from 388 out of 714 asymptomatic subjects (carriage rate 54.3%). The carriage rate was significantly higher in study participants living in retirement homes (68.4%) compared to those living autonomously at home (51.1%). Strains were isolated mostly from the nose (99%). Corynebacterium accolens was the most often isolated species (39.8%), followed by C. propinquum (24.1%), C. pseudodiphtheriticum (19.4%), and C. tuberculostearicum (10.2%). No C. diphtheriae, C. ulcerans, and C. pseudotuberculosis strains were isolated. A subsample of 74 subjects was tested serologically for anti-diphtheria antibodies. Protective anti-diphtheria toxin antibodies were found in 29.7% of the subjects; 70.3% showed no protective immunity. CONCLUSIONS These results suggest that carriage of potentially toxigenic corynebacteria is very rare among people aged 65 and older in Germany. However, the low prevalence of protective anti-diphtheria toxin antibodies might pose a risk for acquiring diphtheria especially for the elderly.
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Affiliation(s)
- Barbara Teutsch
- Bavarian Health and Food Safety Authority, Veterinärstraße 2, 85764, Oberschleißheim, Germany
| | - Anja Berger
- Bavarian Health and Food Safety Authority, Veterinärstraße 2, 85764, Oberschleißheim, Germany.,National Consiliary Laboratory for Diphtheria, Oberschleißheim, Germany
| | - Durdica Marosevic
- Bavarian Health and Food Safety Authority, Veterinärstraße 2, 85764, Oberschleißheim, Germany.,European Programme for Public Health Microbiology Training, European Centre of Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Katharina Schönberger
- Bavarian Health and Food Safety Authority, Veterinärstraße 2, 85764, Oberschleißheim, Germany
| | - Thiên-Trí Lâm
- National Reference Center for Meningococci and Haemophilus Influenzae, Institute for Hygiene and Microbiology, University of Würzburg, Würzburg, Germany
| | - Kerstin Hubert
- National Reference Center for Meningococci and Haemophilus Influenzae, Institute for Hygiene and Microbiology, University of Würzburg, Würzburg, Germany
| | - Steffi Beer
- Sanitätsdienst der Bundeswehr, Koblenz, Germany
| | | | - Nikolaus Ackermann
- Bavarian Health and Food Safety Authority, Veterinärstraße 2, 85764, Oberschleißheim, Germany
| | - Heike Claus
- National Reference Center for Meningococci and Haemophilus Influenzae, Institute for Hygiene and Microbiology, University of Würzburg, Würzburg, Germany
| | - Maria Drayß
- National Reference Center for Meningococci and Haemophilus Influenzae, Institute for Hygiene and Microbiology, University of Würzburg, Würzburg, Germany
| | - Kathrin Thiel
- National Reference Center for Meningococci and Haemophilus Influenzae, Institute for Hygiene and Microbiology, University of Würzburg, Würzburg, Germany
| | - Mark van der Linden
- National Reference Center for Streptococci, Institut für Medizinische Mikrobiologie des UKA, RWTH Aachen, Aachen, Germany
| | - Ulrich Vogel
- National Reference Center for Meningococci and Haemophilus Influenzae, Institute for Hygiene and Microbiology, University of Würzburg, Würzburg, Germany
| | - Andreas Sing
- Bavarian Health and Food Safety Authority, Veterinärstraße 2, 85764, Oberschleißheim, Germany. .,National Consiliary Laboratory for Diphtheria, Oberschleißheim, Germany.
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Development, validation and implementation of a quadruplex real-time PCR assay for identification of potentially toxigenic corynebacteria. J Med Microbiol 2016; 65:1521-1527. [DOI: 10.1099/jmm.0.000382] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Meinel DM, Kuehl R, Zbinden R, Boskova V, Garzoni C, Fadini D, Dolina M, Blümel B, Weibel T, Tschudin-Sutter S, Widmer AF, Bielicki JA, Dierig A, Heininger U, Konrad R, Berger A, Hinic V, Goldenberger D, Blaich A, Stadler T, Battegay M, Sing A, Egli A. Outbreak investigation for toxigenic Corynebacterium diphtheriae wound infections in refugees from Northeast Africa and Syria in Switzerland and Germany by whole genome sequencing. Clin Microbiol Infect 2016; 22:1003.e1-1003.e8. [PMID: 27585943 DOI: 10.1016/j.cmi.2016.08.010] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2016] [Revised: 07/28/2016] [Accepted: 08/19/2016] [Indexed: 01/28/2023]
Abstract
Toxigenic Corynebacterium diphtheriae is an important and potentially fatal threat to patients and public health. During the current dramatic influx of refugees into Europe, our objective was to use whole genome sequencing for the characterization of a suspected outbreak of C. diphtheriae wound infections among refugees. After conventional culture, we identified C. diphtheriae using matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) and investigated toxigenicity by PCR. Whole genome sequencing was performed on a MiSeq Illumina with >70×coverage, 2×250 bp read length, and mapping against a reference genome. Twenty cases of cutaneous C. diphtheriae in refugees from East African countries and Syria identified between April and August 2015 were included. Patients presented with wound infections shortly after arrival in Switzerland and Germany. Toxin production was detected in 9/20 (45%) isolates. Whole genome sequencing-based typing revealed relatedness between isolates using neighbour-joining algorithms. We detected three separate clusters among epidemiologically related refugees. Although the isolates within a cluster showed strong relatedness, isolates differed by >50 nucleotide polymorphisms. Toxigenic C. diphtheriae associated wound infections are currently observed more frequently in Europe, due to refugees travelling under poor hygienic conditions. Close genetic relatedness of C. diphtheriae isolates from 20 refugees with wound infections indicates likely transmission between patients. However, the diversity within each cluster and phylogenetic time-tree analysis suggest that transmissions happened several months ago, most likely outside Europe. Whole genome sequencing offers the potential to describe outbreaks at very high resolution and is a helpful tool in infection tracking and identification of transmission routes.
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Affiliation(s)
- D M Meinel
- Clinical Microbiology, University Hospital Basel, Basel, Switzerland; Bavarian Health and Food Safety Authority (LGL), Oberschleissheim, Germany; Applied Microbiology Research, Department of Biomedicine, University Basel, Basel, Switzerland
| | - R Kuehl
- Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
| | - R Zbinden
- Institute for Medical Microbiology, University of Zurich, Zurich, Switzerland
| | - V Boskova
- Computational Evolution, D-BSSE, ETH Zurich, Basel, Switzerland
| | - C Garzoni
- Department of Internal Medicine and Infectious Diseases, Clinica Luganese, Lugano, Switzerland
| | - D Fadini
- Internal Medicine, Ospedale di Mendrisio, Mendrisio, Switzerland
| | - M Dolina
- Clinical Microbiology, EOLAB, Bellinzona, Switzerland
| | - B Blümel
- Institute of Medical Microbiology and Hygiene, University Medical Centre Freiburg, Freiburg, Germany
| | - T Weibel
- Clinical Microbiology, Labor Team W, Saint Gallen, Switzerland
| | - S Tschudin-Sutter
- Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
| | - A F Widmer
- Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
| | - J A Bielicki
- Paediatric Infectious Diseases, University of Basel Children's Hospital, Basel, Switzerland
| | - A Dierig
- Paediatric Infectious Diseases, University of Basel Children's Hospital, Basel, Switzerland
| | - U Heininger
- Paediatric Infectious Diseases, University of Basel Children's Hospital, Basel, Switzerland
| | - R Konrad
- Bavarian Health and Food Safety Authority (LGL), Oberschleissheim, Germany; German National Consiliary Laboratory on Diphtheria, Oberschleissheim, Germany
| | - A Berger
- Bavarian Health and Food Safety Authority (LGL), Oberschleissheim, Germany; German National Consiliary Laboratory on Diphtheria, Oberschleissheim, Germany
| | - V Hinic
- Clinical Microbiology, University Hospital Basel, Basel, Switzerland
| | - D Goldenberger
- Clinical Microbiology, University Hospital Basel, Basel, Switzerland
| | - A Blaich
- Clinical Microbiology, University Hospital Basel, Basel, Switzerland
| | - T Stadler
- Computational Evolution, D-BSSE, ETH Zurich, Basel, Switzerland
| | - M Battegay
- Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
| | - A Sing
- Bavarian Health and Food Safety Authority (LGL), Oberschleissheim, Germany; German National Consiliary Laboratory on Diphtheria, Oberschleissheim, Germany
| | - A Egli
- Clinical Microbiology, University Hospital Basel, Basel, Switzerland; Applied Microbiology Research, Department of Biomedicine, University Basel, Basel, Switzerland.
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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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41
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Dilger T, Melzl H, Gessner A. Rapid and reliable identification of waterborne Legionella species by MALDI-TOF mass spectrometry. J Microbiol Methods 2016; 127:154-159. [PMID: 27260989 DOI: 10.1016/j.mimet.2016.05.028] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 05/29/2016] [Accepted: 05/30/2016] [Indexed: 10/21/2022]
Abstract
Detection and enumeration of Legionella bacteria in drinking water is regulated in Germany by ISO 11731-2. The mandatory method for species identification employs parallel subculturing of suspicious colonies on selective media requiring the handling of a large number of cultivation plates. After changes to the drinking water quality regulation in Germany in 2012 the demand for Legionella contamination testing increased drastically. A more reliable, faster and less laborious method for species identification is therefore desirable. Matrix-assisted laser desorption ionization followed by time of flight detection mass spectrometry (MALDI-TOF MS) promises an accelerated identification of bacteria with high reliability and reduced expenditure. Our study shows that MS-based species identification results are in full concordance with cultural and biochemical detection and differentiation and that valuable additional information can be gained, even though the ISO regulation demands an extended incubation period for primary bacterial cultures that is actually in contrast to the prerequisites of the MALDI Biotyper system. In addition, the established identification algorithm is very economical and improves time-to-result. Based on our findings, the amendment of MALID-TOF MS identification to ISO11731-2 as an alternative identification method should be taken into consideration.
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Affiliation(s)
| | - Holger Melzl
- Institute of Clinical Microbiology and Hygiene, University Hospital Regensburg, Germany
| | - André Gessner
- Institute of Clinical Microbiology and Hygiene, University Hospital Regensburg, Germany
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Zhao YQ, Song J, Wang HL, Xu B, Liu F, He K, Wang N. Rapid Detection of Ricin in Serum Based on Cu-Chelated Magnetic Beads Using Mass Spectrometry. JOURNAL OF THE AMERICAN SOCIETY FOR MASS SPECTROMETRY 2016; 27:748-751. [PMID: 26873724 DOI: 10.1007/s13361-016-1340-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 01/02/2016] [Accepted: 01/09/2016] [Indexed: 06/05/2023]
Abstract
The protein toxin ricin obtained from castor bean plant (Ricinus communis) seeds is a potent biological warfare agent due to its ease of availability and acute toxicity. In this study, we demonstrated a rapid and simple method to detect ricin in serum in vitro. The ricin was mixed with serum and digested by trypsin, then all the peptides were efficiently extracted using Cu-chelated magnetic beads and were detected with matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. The specific ricin peptides were identified by Nanoscale Ultra Performance liquid chromatography coupled to tandem mass spectrometry according to their sequences. The assay required 2.5 hours, and a characteristic peptide could be detected down to 4 ng/μl and used as a biomarker to detect ricin in serum. The high sensitivity and simplicity of the procedure makes it valuable in clinical practice. Graphical Abstract ᅟ.
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Affiliation(s)
- Yong-Qiang Zhao
- The Institute of Basic Medical Sciences, National Center of Biomedical Analysis, Beijing, China, 100850
| | - Jian Song
- The School of Pharmacy, Jilin University, Changchun, China, 130021
| | - Hong-Li Wang
- The Institute of Basic Medical Sciences, National Center of Biomedical Analysis, Beijing, China, 100850
| | - Bin Xu
- The Institute of Basic Medical Sciences, National Center of Biomedical Analysis, Beijing, China, 100850
| | - Feng Liu
- The Institute of Basic Medical Sciences, National Center of Biomedical Analysis, Beijing, China, 100850
| | - Kun He
- The Institute of Basic Medical Sciences, National Center of Biomedical Analysis, Beijing, China, 100850.
| | - Na Wang
- The Institute of Basic Medical Sciences, National Center of Biomedical Analysis, Beijing, China, 100850.
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43
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Berger A, Meinel DM, Schaffer A, Ziegler R, Pitteroff J, Konrad R, Sing A. A case of pharyngeal diphtheria in Germany, June 2015. Infection 2016; 44:673-5. [PMID: 26883545 DOI: 10.1007/s15010-016-0882-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 02/03/2016] [Indexed: 10/22/2022]
Abstract
BACKGROUND In June 2015, a 45-year-old man suffering from acute necrotic tonsillitis and throat phlegmon was hospitalized in Nuremberg, Germany. After emergency surgery the patient was initially treated with antibiotics. RESULTS A throat swab grew a toxigenic Corynebacterium diphtheriae biovar mitis strain. The patient's vaccination status was not documented and the patient was tested serologically for anti-diphtheria antibodies showing no protective immunity. Extensive control investigations were performed by the local health department showing no likely source of his infection. CONCLUSION No secondary cases were found and the patient completely recovered.
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Affiliation(s)
- A Berger
- National Consiliary Laboratory for Diphtheria, 85764, Oberschleißheim, Germany.,Bavarian Health and Food Safety Authority, Veterinärstraße 2, 85764, Oberschleißheim, Germany
| | - D M Meinel
- Bavarian Health and Food Safety Authority, Veterinärstraße 2, 85764, Oberschleißheim, Germany
| | - A Schaffer
- Public Health Authority, City of Nuremberg, Nuremberg, Germany
| | - R Ziegler
- Institute for Clinical Hygiene, Microbiology and Infectiology, Klinikum Nürnberg, Nuremberg, Germany
| | - J Pitteroff
- Otorhinolaryngology Clinic, Klinikum Nürnberg, Nuremberg, Germany
| | - R Konrad
- National Consiliary Laboratory for Diphtheria, 85764, Oberschleißheim, Germany.,Bavarian Health and Food Safety Authority, Veterinärstraße 2, 85764, Oberschleißheim, Germany
| | - Andreas Sing
- National Consiliary Laboratory for Diphtheria, 85764, Oberschleißheim, Germany. .,Bavarian Health and Food Safety Authority, Veterinärstraße 2, 85764, Oberschleißheim, Germany.
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44
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Suwantarat N, Weik C, Romagnoli M, Ellis BC, Kwiatkowski N, Carroll KC. Practical Utility and Accuracy of Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry for Identification of Corynebacterium Species and Other Medically Relevant Coryneform-Like Bacteria. Am J Clin Pathol 2016; 145:22-8. [PMID: 26712867 DOI: 10.1093/ajcp/aqv006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Corynebacterium species and gram-positive coryneform-like bacteria (coryneforms) are increasingly reported causes of opportunistic infections in immunocompromised patients. Biochemical identification methods for these bacteria are often inaccurate. We evaluated matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) for routine Corynebacterium and coryneform identification. METHODS A total of 286 Corynebacterium species and coryneforms recovered from patients were identified by MALDI-TOF MS analysis using the Bruker Microflex instrument, Biotyper software version 3.0, and database version 3.1.66 (Bruker Daltonics, Billerica, MA) following formic acid-based, direct on-plate extraction. The spectral cutoff scores used for interpretation were 2.0 or more for species-level identification and 1.7 or more for genus level. Scores lower than 1.7 were considered as no reliable identification. The results were compared with API Coryne (bioMérieux, Durham, NC) and sequencing of 16S ribosomal RNA genes. RESULTS Of the 231 Corynebacterium (19 species), 99.6% were correctly identified to the genus level and 88.7% to the species level. Of the 55 coryneforms (14 genera), 90.9% were correctly identified to the genus level and 67.3% to the species level. API Coryne was able to identify 89.2% of Corynebacterium species (species level) and 63.6% of coryneforms (genus level). CONCLUSIONS Rapid on-plate testing yielded identification of more Corynebacterium species and related bacteria than biochemical methods.
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Affiliation(s)
| | - Chelsea Weik
- Microbiology Laboratory, Johns Hopkins Hospital, Baltimore, MD
| | - Mark Romagnoli
- Microbiology Laboratory, Johns Hopkins Hospital, Baltimore, MD
| | - Brandon C Ellis
- Microbiology Laboratory, Johns Hopkins Hospital, Baltimore, MD
| | | | - Karen C Carroll
- From the Division of Medical Microbiology, Microbiology Laboratory, Johns Hopkins Hospital, Baltimore, MD
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45
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Sing A, Konrad R, Meinel DM, Mauder N, Schwabe I, Sting R. Corynebacterium diphtheriae in a free-roaming red fox: case report and historical review on diphtheria in animals. Infection 2015; 44:441-5. [PMID: 26424684 DOI: 10.1007/s15010-015-0846-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Accepted: 09/18/2015] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Corynebacterium diphtheriae, the classical causative agent of diphtheria, is considered to be nearly restricted to humans. Here we report the first finding of a non-toxigenic C. diphtheriae biovar belfanti strain in a free-roaming wild animal. METHODS The strain obtained from the subcutis and mammary gland of a dead red fox (Vulpes vulpes) was characterized by biochemical and molecular methods including MALDI-TOF and Multi Locus Sequence Typing. Since C. diphtheriae infections of animals, usually with close contact to humans, are reported only very rarely, an intense review comprising also scientific literature from the beginning of the 20th century was performed. RESULTS Besides the present case, only 11 previously reported C. diphtheriae animal infections could be verified using current scientific criteria. CONCLUSIONS Our report is the first on the isolation of C. diphtheriae from a wildlife animal without any previous human contact. In contrast, the very few unambiguous publications on C. diphtheriae in animals referred to livestock or pet animals with close human contact. C. diphtheriae carriage in animals has to be considered as an exceptionally rare event.
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Affiliation(s)
- Andreas Sing
- National Consiliary Laboratory for Diphtheria, Bavarian Health and Food Safety Authority, Veterinärstraße 2, 85764, Oberschleißheim, Germany. .,Bavarian Health and Food Safety Authority, Oberschleißheim, Germany.
| | - Regina Konrad
- National Consiliary Laboratory for Diphtheria, Bavarian Health and Food Safety Authority, Veterinärstraße 2, 85764, Oberschleißheim, Germany.,Bavarian Health and Food Safety Authority, Oberschleißheim, Germany
| | - Dominik M Meinel
- Bavarian Health and Food Safety Authority, Oberschleißheim, Germany
| | - Norman Mauder
- Chemical and Veterinary Investigations Office Stuttgart, Fellbach, Germany
| | - Ingo Schwabe
- Chemical and Veterinary Investigations Office Stuttgart, Fellbach, Germany
| | - Reinhard Sting
- Chemical and Veterinary Investigations Office Stuttgart, Fellbach, Germany
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46
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Corynebacterium ulcerans cutaneous diphtheria. THE LANCET. INFECTIOUS DISEASES 2015; 15:1100-1107. [PMID: 26189434 DOI: 10.1016/s1473-3099(15)00225-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Revised: 02/12/2015] [Accepted: 03/10/2015] [Indexed: 11/21/2022]
Abstract
We describe the case of a patient with cutaneous diphtheria caused by toxigenic Corynebacterium ulcerans who developed a right hand flexor sheath infection and symptoms of sepsis such as fever, tachycardia, and elevated C-reactive protein, after contact with domestic cats and dogs, and a fox. We summarise the epidemiology, clinical presentation, microbiology, diagnosis, therapy, and public health aspects of this disease, with emphasis on improving recognition. In many European countries, C ulcerans has become the organism commonly associated with cutaneous diphtheria, usually seen as an imported tropical disease or resulting from contact with domestic and agricultural animals. Diagnosis relies on bacterial culture and confirmation of toxin production, with management requiring appropriate antimicrobial therapy and prompt administration of antitoxin, if necessary. Early diagnosis is essential for implementation of control measures and clear guidelines are needed to assist clinicians in managing clinical diphtheria. This case was a catalyst to the redrafting of the 2014 national UK interim guidelines for the public health management of diphtheria, released as final guidelines in March, 2015.
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Konrad R, Hörmansdorfer S, Sing A. Possible human-to-human transmission of toxigenic Corynebacterium ulcerans. Clin Microbiol Infect 2015; 21:768-71. [PMID: 26027917 DOI: 10.1016/j.cmi.2015.05.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Revised: 05/15/2015] [Accepted: 05/18/2015] [Indexed: 10/23/2022]
Abstract
Toxigenic Corynebacterium ulcerans is an emerging cause of diphtheria. In contrast to the classical diphtheria pathogen C. diphtheriae, human-to-human transmission of this primarily zoonotic pathogen has not been clearly documented. Here we report on a two-person cluster suggesting an initial zoonotic and a subsequent human-to-human transmission event.
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Affiliation(s)
- R Konrad
- Bavarian Health and Food Safety Authority, Oberschleißheim, Germany; Consiliary Laboratory on Diphtheria, Oberschleißheim, Germany
| | - S Hörmansdorfer
- Bavarian Health and Food Safety Authority, Oberschleißheim, Germany
| | - A Sing
- Bavarian Health and Food Safety Authority, Oberschleißheim, Germany; Consiliary Laboratory on Diphtheria, Oberschleißheim, Germany.
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48
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Salem N, Salem L, Saber S, Ismail G, Bluth MH. Corynebacterium urealyticum: a comprehensive review of an understated organism. Infect Drug Resist 2015; 8:129-45. [PMID: 26056481 PMCID: PMC4445954 DOI: 10.2147/idr.s74795] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Corynebacterium urealyticum is a Gram positive, slow-growing, lipophilic, multi-drug resistant, urease positive micro-organism with diphtheroid morphology. It has been reported as an opportunistic nosocomial pathogen and as the cause of a variety of diseases including but not limited to cystitis, pyelonephritis, and bacteremia among others. This review serves to describe C. urealyticum with respect to its history, identification, laboratory investigation, relationship to disease and treatment in order to allow increased familiarity with this organism in clinical disease.
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Affiliation(s)
- Nagla Salem
- Department of Pathology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Lamyaa Salem
- Department of Clinical and Chemical Pathology, Ain Shams University, Cairo, Egypt
| | - Sally Saber
- Department of Clinical and Chemical Pathology, Ain Shams University, Cairo, Egypt
| | - Ghada Ismail
- Department of Clinical and Chemical Pathology, Ain Shams University, Cairo, Egypt
| | - Martin H Bluth
- Department of Pathology, Wayne State University School of Medicine, Detroit, MI, USA
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49
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Gherardi G, Di Bonaventura G, Pompilio A, Savini V. Corynebacterium glucuronolyticum causing genitourinary tract infection: Case report and review of the literature. IDCases 2015; 2:56-8. [PMID: 26793456 PMCID: PMC4672622 DOI: 10.1016/j.idcr.2015.03.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Revised: 03/08/2015] [Accepted: 03/08/2015] [Indexed: 12/30/2022] Open
Abstract
Corynebacterium species are increasingly recognized as opportunistic pathogens. A growing number of taxonomic studies has yielded a description of numerous new Corynebacterium species, such as those related to the urogenital tract, with Corynebacterium glucuronolyticum found to be rarely involved in genitourinary tract infections, particularly in male individuals. In this report, we describe a urethritis case caused by C. glucuronolyticum in a 37-year-old, apparently healthy male, who complained mild pain in the lower abdomen, with several urinary symptoms. While urethral and semen specimens did not yield positive results for microbiological evaluation, cultures of urine samples revealed the monomicrobial growth on blood-containing media of tiny colonies after 24 h of incubation, clearly evident only after 48 h of incubation under CO2-enriched atmosphere. Colonies were identified as C. glucuronolyticum both by matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) and 16S rRNA gene sequencing. Oral ciprofloxacin gradually led to clinical improvement and, finally, to a complete recovery, in accordance with microbiological findings. In spite of its infrequent detection, C. glucuronolyticum might be a potential urogenital pathogen in males more commonly that what believed, perhaps due to slow growth leading to underrecognition; we suggest therefore to consider the organism in the differential diagnostics of bacterial diseases of the urinary tract.
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Affiliation(s)
- G Gherardi
- Integrated Research Centre (CIR), University Campus Biomedico, Via Alvaro del Portillo 200, 00128 Rome, Italy
| | - G Di Bonaventura
- Department of Medical, Oral and Biotechnological Sciences, "G. d'Annunzio" University of Chieti-Pescara, Via Vestini 31, 66100 Chieti, Italy; Center of Excellence on Aging, "G. d'Annunzio" University Foundation, Via Luigi Polacchi 11, 66100 Chieti, Italy
| | - A Pompilio
- Department of Medical, Oral and Biotechnological Sciences, "G. d'Annunzio" University of Chieti-Pescara, Via Vestini 31, 66100 Chieti, Italy; Center of Excellence on Aging, "G. d'Annunzio" University Foundation, Via Luigi Polacchi 11, 66100 Chieti, Italy
| | - V Savini
- Clinical Microbiology and Virology, Spirito Santo Hospital, Via Fonte Romana 8, 65124 Pescara, Italy
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50
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Eisenberg T, Mauder N, Contzen M, Rau J, Ewers C, Schlez K, Althoff G, Schauerte N, Geiger C, Margos G, Konrad R, Sing A. Outbreak with clonally related isolates of Corynebacterium ulcerans in a group of water rats. BMC Microbiol 2015; 15:42. [PMID: 25887321 PMCID: PMC4342102 DOI: 10.1186/s12866-015-0384-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Accepted: 02/11/2015] [Indexed: 11/23/2022] Open
Abstract
Background The zoonotic bacterium Corynebacterium ulcerans may be pathogenic both in humans and animals: toxigenic strains can cause diphtheria or diphtheria-like disease in humans via diphtheria toxin, while strains producing the dermonecrotic exotoxin phospholipase D may lead to caseous lymphadenitis primarily in wild animals. Diphtheria toxin-positive Corynebacterium ulcerans strains have been isolated mainly from cattle, dogs and cats. Results Here, we report a series of ten isolations of Corynebacterium ulcerans from a group of water rats (Hydromys chrysogaster) with ulcerative skin lesions, which were kept in a zoo. The isolates were clearly assigned to species level by biochemical identification systems, Fourier-transform infrared-spectroscopy, Matrix-assisted laser desorption/ionization-time of flight mass spectrometry and partial rpoB sequencing, respectively. All ten isolates turned out to represent the same sequence type, strongly indicating a cluster of infections by clonally-related isolates as could be demonstrated for the first time for this species using multilocus sequence typing. Unequivocal demonstration of high relatedness of the isolates could also be demonstrated by Fourier-transform infrared-spectroscopy. All isolates were lacking the diphtheria toxin encoding tox-gene, but were phospholipase D-positive. Conclusions Our results indicate that water rats represent a suitable new host species that is prone to infection and must be regarded as a reservoir for potentially zoonotic Corynebacterium ulcerans. Furthermore, the applied methods demonstrated persistent infection as well as a very close relationship between all ten isolates.
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Affiliation(s)
- Tobias Eisenberg
- Landesbetrieb Hessisches Landeslabor, Schubertstr. 60, 35392, Gießen, Germany.
| | - Norman Mauder
- Chemisches und Veterinäruntersuchungsamt Stuttgart, Schaflandstr. 3/2, 70736, Fellbach, Germany.
| | - Matthias Contzen
- Chemisches und Veterinäruntersuchungsamt Stuttgart, Schaflandstr. 3/2, 70736, Fellbach, Germany.
| | - Jörg Rau
- Chemisches und Veterinäruntersuchungsamt Stuttgart, Schaflandstr. 3/2, 70736, Fellbach, Germany.
| | - Christa Ewers
- Institute of Hygiene and Infectious Diseases of Animals, Justus Liebig University Giessen, Frankfurter Strasse 85-89, 35392, Giessen, Germany.
| | - Karen Schlez
- Landesbetrieb Hessisches Landeslabor, Schubertstr. 60, 35392, Gießen, Germany.
| | - Gisa Althoff
- Landesbetrieb Hessisches Landeslabor, Schubertstr. 60, 35392, Gießen, Germany.
| | - Nicole Schauerte
- Zoo Frankfurt, Bernhard-Grzimek-Allee 1, 60316, Frankfurt, Germany.
| | - Christina Geiger
- Zoo Frankfurt, Bernhard-Grzimek-Allee 1, 60316, Frankfurt, Germany.
| | - Gabriele Margos
- National Consiliary Laboratory on Diphtheria, Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit, Veterinärstraße 2, 85764, Oberschleißheim, Germany.
| | - Regina Konrad
- National Consiliary Laboratory on Diphtheria, Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit, Veterinärstraße 2, 85764, Oberschleißheim, Germany.
| | - Andreas Sing
- National Consiliary Laboratory on Diphtheria, Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit, Veterinärstraße 2, 85764, Oberschleißheim, Germany.
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