Household transmission of non-toxigenic diphtheria toxin gene-bearing following a cluster of cutaneous cases in a specialist outpatient setting.

Combination of PCR and Elek testing to identify toxigenic corynebacteria has revealed organisms described as non-toxigenic toxin-gene bearing (NTTB) or (i.e. PCR positive; Elek negative).

Detection of Diabetes by Macrovascular Tortuosity of Superior Bulbar Conjunctiva.

More than 8% of world population have diabetes which causes long term complications such as retinopathy, neuropathy, nephropathy and foot ulcers. Growing patient numbers has prompted large scale screening methods to detect early symptoms of diabetes (rather than elevated blood glucose levels which is a late symptom). Vascular tortuosity (twisted and curved nature of blood vessels) in retinal fundus images has proven to reflect the effect of diabetes on macrovasculature.

Development, validation and implementation of a quadruplex real-time PCR assay for identification of potentially toxigenic corynebacteria.

Toxigenic corynebacteria are uncommon in the UK; however, laboratory confirmation by the national reference laboratory can inform public health action according to national guidelines. Standard phenotypic tests for identification and toxin expression of isolates can take from ≥24 to ≥48 h from receipt. To decrease the time to result, a real-time PCR (qPCR) assay was developed for confirmation of both identification of Corynebacterium diphtheriae and Corynebacterium ulcerans/Corynebacterium pseudotuberculosis and detection of the diphtheria toxin gene.

Molecular and epidemiological review of toxigenic diphtheria infections in England between 2007 and 2013.

Human 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.

External quality assessments for microbiologic diagnosis of diphtheria in Europe.

The European Diphtheria Surveillance Network (EDSN) ensures the reliable epidemiological and microbiologic assessment of disease prevalence in the European Union. Here, we describe a survey of current diagnostic techniques for diphtheria surveillance conducted across the European Union and report the results from three external quality assessment (EQA) schemes performed between 2010 and 2014.

Synchronous recurrence of group B streptococcal late-onset sepsis in twins.

Group B Streptococcus (GBS) remains the leading cause of neonatal sepsis and meningitis in industrialized countries. Whereas the use of intrapartum antibiotic prophylaxis has led to a significant decline in early-onset sepsis, the incidence of late-onset sepsis has remained unchanged. Whether late-onset sepsis usually originates from established mucocutaneous GBS colonization of the infant or whether it results from an acute exogenous GBS infection remains controversial.

A three year descriptive study of early onset neonatal sepsis in a refugee population on the Thailand Myanmar border.

Background: Each year an estimated four million neonates die, the majority in the first week of life. One of the major causes of death is sepsis. Proving the incidence and aetiology of neonatal sepsis is difficult, particularly in resource poor settings where the majority of the deaths occur.

Non-culture detection of Streptococcus agalactiae (Lancefield group B Streptococcus) in clinical samples by real-time PCR.

A real-time PCR assay targeting the cylB gene was developed to detect Streptococcus agalactiae [Lancefield group B Streptococcus (GBS)] from clinical samples. A total of 110 blood culture-negative samples [75 cerebrospinal fluid (CSF) and 35 EDTA blood samples] from neonates with probable GBS sepsis or meningitis were analysed. Among these, 16 of the 75 CSF samples were positive [21.

Group B streptococcal carriage, serotype distribution and antibiotic susceptibilities in pregnant women at the time of delivery in a refugee population on the Thai-Myanmar border.

Background: Group B Streptococcus (GBS) is the leading cause of neonatal sepsis in the developed world. Little is known about its epidemiology in the developing world, where the majority of deaths from neonatal infections occur. Maternal carriage of GBS is a prerequisite for the development of early onset GBS neonatal sepsis but there is a paucity of carriage data published from the developing world, in particular South East Asia.

Two Japanese Corynebacterium ulcerans isolates from the same hospital: ribotype, toxigenicity and serum antitoxin titre.

Two toxigenic Corynebacterium ulcerans isolates recovered from pharyngeal swabs of two patients from the same hospital in Japan during 2001-2002 were characterized by PFGE and ribotyping. Toxin production in different culture media was examined and serological analysis of patient sera was performed. The two isolates could not be distinguished by PFGE; however, their ribotypes were distinguishable.

Comparison of four molecular typing methods for characterization of Corynebacterium diphtheriae and determination of transcontinental spread of C. diphtheriae based on BstEII rRNA gene profiles.

The diphtheria epidemic in the Russian Federation in the 1990s made diphtheria a focus of global concern once again. The development of rapid and reproducible typing methods for the molecular characterization of Corynebacterium diphtheriae has become a priority in order to be able to monitor the spread of this important pathogen on a global scale. We report on a comparison of four molecular typing methods (ribotyping, pulsed-field gel electrophoresis [PFGE], random amplification of polymorphic DNA [RAPD], and amplified fragment length polymorphism [AFLP]) for the characterization of C.

Characterization of toxigenic Corynebacterium ulcerans strains isolated from humans and domestic cats in the United Kingdom.

In the United Kingdom there has been a marked increase in the number of human infections caused by toxigenic Corynebacterium ulcerans. During 2002 and 2003 the organism was also isolated from several domestic cats with bilateral nasal discharge. As C.

Molecular characterization of diphtheria toxin repressor (dtxR) genes present in nontoxigenic Corynebacterium diphtheriae strains isolated in the United Kingdom.

Nontoxigenic strains of Corynebacterium diphtheriae represent a potential reservoir for the emergence of toxigenic C. diphtheriae strains if they possessed functional diphtheria toxin repressor (dtxR) genes. We studied the predominant strain of nontoxigenic C.

Eighth International Meeting of the European Laboratory Working Group on Diphtheria and the Diphtheria Surveillance Network--June 2004: progress is needed to sustain control of diphtheria in European Region.

The Eighth International Meeting of the European Laboratory Working Group on Diphtheria (ELWGD) and the Diphtheria Surveillance Network (DIPNET) was held and co-organised with the WHO Regional Office for Europe, Copenhagen, Denmark, in June 2004. This article provides an international updated review of progress in clinical, epidemiological and microbiological aspects of diphtheria in the European region as presented at the meeting. It highlights the need for improved immunisation coverage, surveillance and epidemiological studies to sustain control of diphtheria in European Region.

Eighth International Meeting of the European Laboratory Working Group on Diphtheria and the Diphtheria Surveillance Network - June 2004: Progress is needed to sustain control of diphtheria in European Region.

The Eighth International Meeting of the European Laboratory Working Group on Diphtheria (ELWGD) and the Diphtheria Surveillance Network (DIPNET) was held and co-organised with the WHO Regional Office for Europe, Copenhagen, Denmark, in June 2004. This article provides an international updated review of progress in clinical, epidemiological and microbiological aspects of diphtheria in the European region as presented at the meeting. It highlights the need for improved immunisation coverage, surveillance and epidemiological studies to sustain control of diphtheria in European Region.

International nomenclature for Corynebacterium diphtheriae ribotypes.

The nomenclature of Corynebacterium diphtheriae ribotypes is presented. A total of 86 ribotypes obtained after BstEII digestion were given a geographic name chosen to reflect the place where one of the strains was isolated or studied.

The complete genome sequence and analysis of Corynebacterium diphtheriae NCTC13129.

Corynebacterium diphtheriae is a Gram-positive, non-spore forming, non-motile, pleomorphic rod belonging to the genus Corynebacterium and the actinomycete group of organisms. The organism produces a potent bacteriophage-encoded protein exotoxin, diphtheria toxin (DT), which causes the symptoms of diphtheria. This potentially fatal infectious disease is controlled in many developed countries by an effective immunisation programme.

Genotypic and phenotypic characteristics of Corynebacterium diphtheriae strains isolated from patients in belarus during an epidemic period.

One hundred two Corynebacterium diphtheriae strains (93 of the gravis biotype and nine of the mitis biotype) isolated from clinical cases during the Belarus diphtheria epidemic were characterized by biotyping, toxigenicity testing by the Elek test and an indirect hemagglutination assay, phage typing, and ribotyping. The gravis biotype strains were characterized as high and medium toxin producers, and strains of biotype mitis were characterized as low and medium toxin producers. Most strains (82 of 102) were distributed among five phage types.

Molecular epidemiology and characteristics of Corynebacterium diphtheriae and Corynebacterium ulcerans strains isolated in Italy during the 1990s.

Five cases of diphtheria were reported in Italy between January 1990 and June 2001. Three cases were confirmed microbiologically by the isolation of toxigenic Corynebacterium diphtheriae (two cases) and Corynebacterium ulcerans (one case). Over the same period, 11 cases of non-toxigenic C.

Nontoxigenic corynebacterium diphtheriae: an emerging pathogen in England and Wales?

Confirmed isolates of nontoxigenic Corynebacterium diphtheriae in England and Wales increased substantially from 1986 to 1994. Ribotyping of 121 isolates confirmed in 1995 showed that 90 were of a single strain isolated exclusively from the throat; none had previously been identified in toxigenic strains from U.K.

Use of amplified fragment length polymorphisms for typing Corynebacterium diphtheriae.

Amplified fragment length polymorphism (AFLP) was investigated for the differentiation of Corynebacterium diphtheriae isolates. Analysis using Taxotron revealed 10 distinct AFLP profiles among 57 isolates. Strains with ribotype patterns D1, D4, and D12 could not be distinguished; however, the technique discriminated isolates of ribotype patterns D3, D6, and D7 further.

Molecular epidemiology of diphtheria.

Molecular subtyping of Corynebacterium diphtheriae identified significant genetic diversity within the species and led to the identification of a unique clonal group that emerged in Russia in 1990 at the beginning of the current epidemic. Strains of this group belong to a distinct electrophoretic type complex and are of ribotypes D1 and D4. Identification of the group allowed for precise monitoring of the epidemic's progression and for rapid detection of cases imported to other countries.

PCR typing of Corynebacterium diphtheriae by random amplification of polymorphic DNA.

The usefulness of random amplification of polymorphic DNA (RAPD) analysis with Ready-To-Go RAPD beads was investigated for the rapid differentiation of Corynebacterium diphtheriae isolates from Eastern Europe and neighbouring countries. A selection of 45 C. diphtheriae isolates of known origin, biotype, toxigenicity status and ribotype were examined by RAPD.