Cutaneous Diphtheria in the Urban Poor Population of Vancouver, British Columbia, Canada: a 10-Year Review

Lowe, Christopher F.; Bernard, Kathryn; Romney, Marc G.

doi:10.1128/jcm.00362-11

Cited by 75 publications

(95 citation statements)

References 26 publications

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“…In another report, a 71-year-old man with chronic nonhealing ulcers of the right leg was diagnosed with toxigenic C. ulcerans (Wagner et al, 2001). The lesions resembled those of cutaneous diphtheria, a well-recognized clinical entity caused by non-toxigenic C. diphtheriae (Lowe et al, 2011). Similar skin lesions have been reported in the C. pseudotuberculosis-associated diseases, oedematous skin disease of buffalo and ulcerative lymphangitis of horses (Selim, 2001).…”

Section: Discussionmentioning

confidence: 54%

Characterization of Corynebacterium species in macaques

Venezia

Cassiday

Marini

et al. 2012

Journal of Medical Microbiology

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Bacteria of the genus Corynebacterium are important primary and opportunistic pathogens. Many are zoonotic agents. In this report, phenotypic (API Coryne analysis), genetic (rpoB and 16S rRNA gene sequencing), and physical methods (MS) were used to distinguish the closely related diphtheroid species Corynebacterium ulcerans and Corynebacterium pseudotuberculosis, and to definitively diagnose Corynebacterium renale from cephalic implants of rhesus (Macaca mulatta) and cynomolgus (Macaca fascicularis) macaques used in cognitive neuroscience research. Throat and cephalic implant cultures yielded 85 isolates from 43 macaques. Identification by API Coryne yielded C. ulcerans (n574), Corynebacterium pseudotuberculosis (n52), C. renale or most closely related to C. renale (n53), and commensals and opportunists (n56). The two isolates identified as C. pseudotuberculosis by API Coryne required genetic and MS analysis for accurate characterization as C. ulcerans. Of three isolates identified as C. renale by 16S rRNA gene sequencing, only one could be confirmed as such by API Coryne, rpoB gene sequencing and MS. This study emphasizes the importance of adjunct methods in identification of coryneforms and is the first isolation of C. renale from cephalic implants in macaques.

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Section: Discussionmentioning

confidence: 54%

Characterization of Corynebacterium species in macaques

Venezia

Cassiday

Marini

et al. 2012

Journal of Medical Microbiology

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“…However, ribotyping depends very much upon the use of a rigid standardized method, and without this, there might be difficulties in reproducibility. MLST overcomes some problems observed with ribotyping, previously considered the gold standard, by directly indexing nucleotide variation within several core metabolic genes, thereby providing high-resolution data appropriate for evolutionary and epidemiological investigations (17,18). The extended MLST scheme incorporating both C. diphtheriae and C. ulcerans provides a valuable tool for monitoring and characterizing circulating strains in the United Kingdom and abroad.…”

Section: Discussionmentioning

confidence: 99%

Molecular and Epidemiological Review of Toxigenic Diphtheria Infections in England between 2007 and 2013

et al. 2015

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bHuman infections caused by toxigenic corynebacteria occur sporadically across Europe. In this report, we undertook the epidemiological and molecular characterization of all toxigenic corynebacterium strains isolated in England between January 2007 and December 2013. Epidemiological aspects include case demographics, risk factors, clinical presentation, treatment, and outcome. Molecular characterization was performed using multilocus sequence typing (MLST) alongside traditional phenotypic methods. In total, there were 20 cases of toxigenic corynebacteria; 12 (60.0%) were caused by Corynebacterium ulcerans, where animal contact was the predominant risk factor. The remaining eight (40.0%) were caused by Corynebacterium diphtheriae strains; six were biovar mitis, which were associated with recent travel abroad. Adults 45 years and older were particularly affected (55.0%; 11/20), and typical symptoms included sore throat and fever. Respiratory diphtheria with the absence of a pharyngeal membrane was the most common presentation (50.0%; 10/20). None of the eight C. diphtheriae cases were fully immunized. Diphtheria antitoxin was issued in two (9.5%) cases; both survived. Two (9.5%) cases died, one due to a C. diphtheriae infection and one due to C. ulcerans. MLST demonstrated that the majority (87.5%; 7/8) of C. diphtheriae strains represented new sequence types (STs). By adapting several primer sequences, the MLST genes in C. ulcerans were also amplified, thereby providing the basis for extension of the MLST scheme, which is currently restricted to C. diphtheriae. Despite high population immunity, occasional toxigenic corynebacterium strains are identified in England and continued surveillance is required.

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“…Bacterial skin copathogens, such as Staphylococcus aureus, Streptococcus pyogenes, and Arcanobacterium haemolyticum, were isolated from every specimen. A. haemolyticum (previously a member of the corynebacterium group, Corynebacterium haemolyticum) has been previously associated with cutaneous diphtheria isolates (10). Eighteen patients had three skin pathogens isolated: C. diphtheriae, S. aureus, and beta-hemolytic streptococci.…”

mentioning

confidence: 99%

“…Cutaneous diphtheria, caused by toxigenic strains, can act as a reservoir for respiratory diphtheria (1,8). Infections with nontoxigenic C. diphtheriae occur in patients subsisting in low socioeconomic conditions, regardless of the climate (10,15,18).…”

mentioning

confidence: 99%