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

Viguetti, S. Z.; Pacheco, Luis Gustavo Carvalho; Santos, Louisy Sanches dos; Soares, Siomar C.; Bolt, Frances; Baldwin, Amy; Dowson, Christopher G.; Rosso, Marie-Laure; Guiso, Nicole; Miyoshi, Anderson; Hirata, Raphael; Mattos‐Guaraldi, Ana Luíza; Azevedo, Vasco

doi:10.1017/s0950268811000963

Cited by 22 publications

(14 citation statements)

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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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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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“…Allelic numbers were assigned to each locus, creating a unique numerical profile, which was compared with C. diphtheriae sequences posted at http: //pubmlst.org/cdiphtheriae/. The profile obtained was 3, 2, 4, 1, 3, 3, 13, which was assigned sequence type 136 (ST136), a type unique among NML data and, to date, from published literature (3,11,18).…”

Section: Case Reportmentioning

confidence: 99%

Canada's First Case of a Multidrug-Resistant Corynebacterium diphtheriae Strain, Isolated from a Skin Abscess

et al. 2011

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A toxigenic Corynebacterium diphtheriae biovar mitis sequence type 136 (ST136) strain was recovered from a toe infection of an unvaccinated patient recently returned from India. The isolate was resistant to clindamycin, erythromycin (ermX positive), tetracycline, and trimethoprim-sulfamethoxazole, intermediate to ceftriaxone and cefotaxime, and had high MICs for telithromycin and chloramphenicol but was sensitive to other drugs. CASE REPORTA 38-year-old male was seen by a family physician in a city located in a western Canadian province for an evaluation of an abscess on his left second toe which started 3 days prior while the patient was visiting family and friends in India. The patient had no history of traumatic injury, denied contact with sick persons, and had an unknown vaccination history. A swab of the left second toe was sent within hours to a private laboratory for bacterial culture and drug sensitivity testing. The patient was prescribed 500 mg of cephalexin three times a day for 10 days, and he recovered uneventfully. Patient consent to describe this case was obtained for the purpose of this study.The direct Gram stain of the specimen revealed Gram-positive cocci and Gram-positive bacilli. After ϳ48 h of incubation under facultatively anaerobic conditions at 35°C on 5% sheep blood agar, the culture grew colonies which were identified as group A streptococci and Staphylococcus aureus. In addition, the culture also grew creamy, opaque, slightly raised nonhemolytic colonies; Gram smear of the isolate revealed Grampositive bacilli with club-shaped ends and occasional V forms. This strain was urease negative and facultatively anaerobic. Colonies were black with dark halos on Tinsdale medium (17). The isolate was referred to the BC Center for Disease Control Laboratory for confirmation and identification as Corynebacterium diphtheriae. This strain fermented glucose and maltose but not lactose, mannitol, glycogen, or xylose. When studied by conventional methods, this strain reduced nitrate to nitrite and was catalase positive. Black colonies typical for C. diphtheriae grew on freshly prepared cystine-tellurite blood agar (17). Albert's staining (18a) was performed after 24 h of growth on Loeffler's medium (PML Microbiologicals, bioMérieux), where typical blue-black metachromatic granules against a green cytoplasm were observed, consistent with C. diphtheriae (6). The strain was forwarded to the Canadian National Microbiology Laboratory (NML) for further characterization and toxigenicity testing (NML identifier 090066).Growth in brain heart infusion broth was not enhanced by the addition of ϳ1% (vol/vol) sterile Tween 80, a feature that, if present, is suggestive of C. diphtheriae biovar intermedius (9). Using conventional carbohydrate broth sugars (2), the strain was corroborated as being positive for catalase, reduction of nitrate, and fermentation of glucose, fructose, galactose, maltose, mannose, and ribose but not glycerol, glycogen, lactose, mannitol, raffinose, sucrose, trehalose, or xylose. Oxidase wa...

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“…These infections have a high mortality rate (up to 40%), which can be explained by the presence of comorbidity (cardiac valvulopathy) (7) and predisposing conditions (intravenous drug use, skin lesions, and socioeconomic disadvantage) (4,10). Several studies using ribotyping have suggested the invasive isolates to be clonal (4, 6, 10) whereas others have found multiple types of C. diphtheriae bacteria (11).…”

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confidence: 99%

“…A single isolate collected in 1991 was ST39. Notably, ST39 was also recovered in 1999 in the United States (in California and Maine), where it caused at least two other bacteremias, one case of arthritis and one upper respiratory tract infection (11).…”

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confidence: 99%

Characterization and Comparison of Invasive Corynebacterium diphtheriae Isolates from France and Poland

et al. 2012

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

Cited by 22 publications

References 12 publications

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

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

Canada's First Case of a Multidrug-Resistant Corynebacterium diphtheriae Strain, Isolated from a Skin Abscess

Characterization and Comparison of Invasive Corynebacterium diphtheriae Isolates from France and Poland

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