RESUMEN
Cases of diphtheria, even in immunized individuals, are still reported in several parts of the world, including in Brazil. New outbreaks occur in Europe and other continents. In this context, studies on Corynebacterium diphtheriae infections are highly relevant, both for a better understanding of the pathogenesis of the disease and for controlling the circulation of clones and antimicrobial resistance genes. Here we present a case of cutaneous infection by multidrug-resistant Corynebacterium diphtheriae and provide its whole-genome sequencing. Genomic analysis revealed resistance genes, including tet(W), sul1, cmx, rpoB2, rbpA and mutation in rpoB. We performed phylogenetic analyzes and used the BRIG to compare the predicted resistance genes with those found in genomes from other significant isolates, including those associated with some outbreaks. Virulence factors such as spaD, srtBC, spaH, srtDE, surface-anchored pilus proteins (sapD), nonfimbrial adhesins (DIP0733, DIP1281, and DIP1621), embC and mptC (putatively involved in CdiLAM), sigA, dtxR and MdbA (putatively involved) in post-translational modification, were detected. We identified the CRISPR-Cas system in our isolate, which was classified as Type II-U based on the database and contains 15 spacers. This system functions as an adaptive immune mechanism. The strain was attributed to a new sequence type ST-928, and phylogenetic analysis confirmed that it was related to ST-634 of C. diphtheriae strains isolated in French Guiana and Brazil. In addition, since infections are not always reported, studies with the sequence data might be a way to complement and inform C. diphtheriae surveillance.
Asunto(s)
Sistemas CRISPR-Cas , Corynebacterium diphtheriae , Rifampin , Factores de Virulencia , Corynebacterium diphtheriae/genética , Corynebacterium diphtheriae/patogenicidad , Corynebacterium diphtheriae/efectos de los fármacos , Humanos , Factores de Virulencia/genética , Rifampin/farmacología , Mutación , Filogenia , Difteria/microbiología , Genoma Bacteriano , Proteínas Bacterianas/genética , Farmacorresistencia Bacteriana Múltiple/genéticaRESUMEN
BACKGROUND: Sporadic cases of infection with non-toxigenic Corynebacterium diphtheriae (C. diphtheriae) isolates have been reported in regions covered by the Diphtheria-Tetanus-Pertussis vaccine, but no information describing the whole genome of non-toxigenic strains collected in China is available. Therefore, in this work, the complete genome of a non-toxigenic strain of C. diphtheriae from a hospital located in southeastern China was performed. RESULTS: This non-toxigenic isolate belonged to the belfanti biotype and possessed a unique ST (assigned as ST799 in pubMLST). ErmX was present in the genome sequence and this isolate owned the resistance to erythromycin and clindamycin. Genes coding for virulence factors involved in adherence, iron-uptake and regulation of diphtheria toxin were also found. Two genes were involved in the interaction between pathogen and host. The phylogenetic analysis revealed that this newly isolated strain was similar to the strain NCTC10838, CMCNS703 and CHUV2995. CONCLUSION: Non-toxigenic C. diphtheriae strain contained virulence factors, thus it is able to cause an infectious disease, aspect that could be clarified by performing the whole genome sequencing analysis.
Asunto(s)
Corynebacterium diphtheriae/clasificación , Corynebacterium diphtheriae/genética , Difteria/microbiología , China , Corynebacterium diphtheriae/patogenicidad , Hospitales , Humanos , Persona de Mediana Edad , Filogenia , Factores de Virulencia/genéticaRESUMEN
In 2016, Venezuela faced a large diphtheria outbreak that extended until 2019. Nasopharyngeal or oropharyngeal samples were prospectively collected from 51 suspected cases and retrospective data from 348 clinical records was retrieved from 14 hospitals between November 2017 and November 2018. Confirmed pathogenic Corynebactrium isolates were biotyped. Multilocus Sequence Typing (MLST) was performed followed by next-generation-based core genome-MLST and minimum spanning trees were generated. Subjects between 10 and 19 years of age were mostly affected (n = 95; 27.3%). Case fatality rates (CFR) were higher in males (19.4%), as compared to females (15.8%). The highest CFR (31.1%) was observed among those under 5, followed by the 40 to 49 age-group (25.0%). Nine samples corresponded to C. diphtheriae and 1 to C. ulcerans. Two Sequencing Types (ST), ST174 and ST697 (the latter not previously described) were identified among the eight C. diphtheriae isolates from Carabobo state. Cg-MLST revealed only one cluster also from Carabobo. The Whole Genome Sequencing analysis revealed that the outbreak seemed to be caused by different strains with C. diphtheriae and C. ulcerans coexisting. The reemergence and length of this outbreak suggest vaccination coverage problems and an inadequate control strategy.
Asunto(s)
Corynebacterium diphtheriae/genética , Difteria/epidemiología , Filogenia , Adolescente , Adulto , Niño , Preescolar , Corynebacterium diphtheriae/aislamiento & purificación , Corynebacterium diphtheriae/patogenicidad , Difteria/genética , Difteria/microbiología , Brotes de Enfermedades , Femenino , Humanos , Masculino , Persona de Mediana Edad , Tipificación de Secuencias Multilocus , Estudios Retrospectivos , Venezuela/epidemiología , Adulto JovenRESUMEN
The trehalose biosynthesis pathway has recently received attention for therapeutic intervention combating infectious diseases caused by bacteria, helminths or fungi. Trehalose-6-phosphate phosphatase (TPP) is a key enzyme of the most common trehalose biosynthesis pathway and a particularly attractive target owing to the toxicity of accumulated trehalose-6-phosphate in pathogens. Here, we characterised TPP-like proteins from bacterial pathogens implicated in nosocomial infections in terms of their steady-state kinetics as well as pH- and metal-dependency of their enzymatic activity. Analysis of the steady-state kinetics of recombinantly expressed enzymes from Acinetobacter baumannii, Corynebacterium diphtheriae and Pseudomonas stutzeri yielded similar kinetic parameters as those of other reported bacterial TPPs. In contrast to nematode TPPs, the divalent metal ion appears to be bound only weakly in the active site of bacterial TPPs, allowing the exchange of the resident magnesium ion with other metal ions. Enzymatic activity comparable to the wild-type enzyme was observed for the TPP from P. stutzeri with manganese, cobalt and nickel. Analysis of the enzymatic activity of S. maltophilia TPP active site mutants provides evidence for the involvement of four canonical aspartate residues as well as a strictly conserved histidine residue of TPP-like proteins from bacteria in the enzyme mechanism. That histidine residue is a member of an interconnected network of five conserved residues in the active site of bacterial TPPs which likely constitute one or more functional units, directly or indirectly cooperating to enhance different aspects of the catalytic activity.
Asunto(s)
Infecciones Bacterianas/enzimología , Infecciones Bacterianas/microbiología , Glucosiltransferasas/genética , Trehalosa/biosíntesis , Acinetobacter baumannii/enzimología , Acinetobacter baumannii/patogenicidad , Infecciones Bacterianas/genética , Dominio Catalítico/genética , Corynebacterium diphtheriae/enzimología , Corynebacterium diphtheriae/patogenicidad , Glucosiltransferasas/química , Humanos , Pseudomonas stutzeri/enzimología , Pseudomonas stutzeri/patogenicidad , Fosfatos de Azúcar/genética , Fosfatos de Azúcar/metabolismo , Trehalosa/análogos & derivados , Trehalosa/genética , Trehalosa/metabolismoRESUMEN
The problem of diphtheria infection remains relevant, since the circulation of toxigenic strains of Corynebacterium diphtheriae persists in the body of bacterial carriers, despite ongoing vaccination. The lecture presents modern ideas about the properties of the pathogen, its pathogenicity factors (toxin, pili, surface proteins (67-72P (or DIP0733), DIP1281, etc.) and their role in the pathogenesis of the disease.. Information about the clinical and epidemiological characteristics and modern methods of laboratory diagnostics of diphtheria is presented. The algorithm of bacteriological research and methods for determining the toxigenic properties of the pathogen are described. The basics of diphtheria vaccination as the only effective means of preventing mass outbreaks of this disease are considered in the framework of the proposed lecture. Knowledge of the peculiarities of the circulation of strains of Corynebacterium diphtheria in modern conditions, pathogenetic and clinical-epidemiological features of diphtheria, as well as modern methods of laboratory diagnostics is important and necessary for students of medical schools and infectious diseases doctors, pediatricians, bacteriologists, therapists, pulmonologists, epidemiologists, etc.
Asunto(s)
Corynebacterium diphtheriae/patogenicidad , Difteria , Técnicas de Laboratorio Clínico , Difteria/diagnóstico , Difteria/epidemiología , Toxina Diftérica , HumanosRESUMEN
Corynebacterium diphtheriae is the leading cause of pharyngeal diphtheria, a respiratory disease characterized by formation of a pseudomembrane at the site of infection. Although outbreaks of C. diphtheriae infections are rare nowadays, the emergence of multidrug-resistant C. diphtheriae strains is one of the most significant public health concerns worldwide. Although C. diphtheriae has been studied for more than a century and diphtheria toxin and pili have been identified as major virulence factors, little is known about factors involved in bacterial colonization and development of disease. Here, we describe the utilization of Caenorhabditis elegans as a cost-effective, versatile model of infection to evaluate C. diphtheriae virulence. We provide detailed protocols for nematode synchronization and for evaluation of nematode survival and formation of a deformed anal region induced by C. diphtheriae infection. These protocols will permit future high-throughput screenings of virulence factors in C. diphtheriae and advance our knowledge of C. diphtheriae pathogenesis. © 2020 Wiley Periodicals LLC. Basic Protocol 1: Synchronization of nematodes Basic Protocol 2: Assay for nematode survival following C. diphtheriae infection Basic Protocol 3: Assays for bacterial colonization and formation of deformed anal region.
Asunto(s)
Caenorhabditis elegans/microbiología , Corynebacterium diphtheriae/patogenicidad , Difteria/microbiología , Modelos Animales , Animales , Tasa de Supervivencia , Factores de Tiempo , VirulenciaRESUMEN
In some parts of the world, Corynebacterium diphtheriae has reemerged as a pathogen, especially as a cause of infections among impoverished and marginalized populations. We performed whole-genome sequencing (WGS) on all cutaneous C. diphtheriae isolates (n = 56) from Vancouver's inner-city population over a 3-year time period (2015 to 2018). All isolates with complete genome assembly were toxin negative, contained a common set of 22 virulence factors, and shared a highly conserved accessory genome. One of our isolates harbored a novel plasmid conferring macrolide and lincosamide resistance. Fifty-two out of 56 isolates were multilocus sequence type 76, and single nucleotide variants (SNV) and core-genome multilocus sequence typing (cgMLST) analysis demonstrated tight clustering of our isolates relative to all publicly available C. diphtheriae genomes. All sequence type 76 (ST76) study isolates were within a median of 22 SNVs and 13 cgMLST alleles of each other, while NCBI genomes were within a median of 17,436 SNVs and 1,552 cgMLST alleles of each other (both P < 2.2 × 10-16). A single strain of C. diphtheriae appears to be causing cutaneous infections in the low-income population of Vancouver. Further research is needed to elucidate transmission networks in our study population and standardize C. diphtheriae epidemiological typing when whole genomes are sequenced.
Asunto(s)
Corynebacterium diphtheriae/clasificación , Genoma Bacteriano , Filogenia , Pobreza/estadística & datos numéricos , Secuenciación Completa del Genoma , Técnicas de Tipificación Bacteriana , Canadá/epidemiología , Ciudades/epidemiología , Corynebacterium diphtheriae/aislamiento & purificación , Corynebacterium diphtheriae/patogenicidad , Difteria/epidemiología , Difteria/transmisión , Humanos , Tipificación de Secuencias Multilocus , Piel/microbiología , Factores de VirulenciaRESUMEN
When the nasopharynx is colonized with toxigenic strains of the diphtheria pathogen, toxin is released, which contributes to the death of epithelial cells. But in bacterial carriers, the development of the clinical picture of the disease does not occur. This is due to the peculiarities of the state of their immune system, as well as the peculiarities of the production of diphtheria exotoxin by corynebacteria in the biofilm. Goal. Determining the nature of the cytopathic effect of C. diphtheriae as part of a biofilm in CHO-K1 cell culture. The planktonic and biofilm (120- and 720-hour) cultures of the strains were studied: C. diphtheriae gravis tox+ â 665, C. diphtheriae gravis tox+ â 6765, C. diphtheriae mitis tox+ â 269, C. diphtheriae gravis tox+ isolated from a patient with a diagnosis Localized oropharyngeal diphtheria C. diphtheriae gravis with a silent tox-gene. Biofilm (120- and 720-hour) cultures of diphtheria pathogen strains were obtained according to the Watnik method. The cytopathic effect of corynebacterial strains was studied on a CHO-K1 cell culture, taking into account in an inverted microscope. When studying the cytopathic effect of planktonic cultures of toxigenic strains of corynebacteria, it was found that the number of living CHO-K1 cells after 24 hours was insignificant (25.3±1.2%) and sharply decreased (2.5±0.5%) after 72 hours of cultivation. Under the influence of biofilm and, especially, 720-hour cultures, a different cytopathic effect dynamics was found: the number of living cells after 24 hours remained significant (82.5±2.2%), while at 72-hour it decreased to 25.0±3.0%. In the study of filtrates of planktonic and biofilm cultures of C. diphtheriae strain with a «silent¼ tox-gene, similar patterns were revealed. However, the number of live CHO-K1 cells when exposed to the filtrate of a 720-hour biofilm culture was significantly higher (p≤0.05) than when studying toxigenic strains of corynebacteria. Considering the nature of the cytopathic action, it was found that planktonic cultures of toxigenic strains of corynebacteria are characterized by a change in the cell monolayer, manifested by their thinning and elongation. The study of 720-hour biofilm cultures at 72-hour exposure revealed the appearance of a large number of rounded cells (63-69%). The cytopathic effect, formed under the influence of filtrates of planktonic and biofilm cultures of C. diphtheriae with a «silent¼ tox-gene, as well as strains of non-diphtheria corynebacteria, is characterized by rounding of cells and the formation of symplasts. In the biofilm, the intensity of the cytopathic effect of toxigenic C. diphtheriae strains and C. diphtheriae strain with a silent tox-gene decreased. CPD, manifested by thinning and lengthening of CHO-K1 cells, is associated with the action of diphtheria exotoxin, and rounding is associated with corynebacterial enzymes and, apparently, fragments of surface structures - adhesins. Decreased release of toxin and enzymes beyond the C. bihfilm matrix is a significant cause of the «asymptomatic¼ carriage of diphtheria.
Asunto(s)
Biopelículas , Corynebacterium diphtheriae/patogenicidad , Difteria , Animales , Infecciones Asintomáticas , Células CHO , Cricetulus , Toxina Diftérica , HumanosRESUMEN
OBJECTIVES: In frame of a study to characterize the interaction of human macrophage-like cells with pathogenic corynebacteria, Corynebacterium diphtheriae and Corynebacterium ulcerans, live cell imaging experiments were carried out and time lapse fluorescence microscopy videos were generated, which are presented here. DATA DESCRIPTION: The time lapse fluorescence microscopy data revealed new insights in the interaction of corynebacteria with human macrophage-like THP-1 cells. In contrast to uninfected cells and infections with non-pathogenic C. glutamicum used as a control, pathogenic C. diphtheriae and C. ulcerans showed highly detrimental effects towards human cells and induction of cell death of macrophages.
Asunto(s)
Corynebacterium diphtheriae/patogenicidad , Corynebacterium/patogenicidad , Macrófagos/microbiología , Microscopía Fluorescente/métodos , Imagen de Lapso de Tiempo/métodos , Muerte Celular/fisiología , Corynebacterium glutamicum/fisiología , Interacciones Huésped-Patógeno , Humanos , Especificidad de la Especie , Células THP-1 , VirulenciaRESUMEN
Diphtheria toxin is one of the best investigated bacterial toxins and the major virulence factor of toxigenic Corynebacterium diphtheriae and Corynebacterium ulcerans strains. However, also diphtheria toxin-free strains of these two species can cause severe infections in animals and humans, indicating the presence of additional virulence factors. In this study, we present a first characterization of two proteins with cytotoxic effect in corynebacteria. A putative ribosome-binding protein (AEG80717, CULC809_00177), first annotated in a genome sequencing project of C. ulcerans strain 809, was investigated in detail together with a homologous protein identified in C. diphtheriae strain HC04 (AEX80148, CDHC04_0155) in this study. The corresponding proteins show striking structural similarity to Shiga-like toxins. Interaction of wild-type, mutant and complementation as well as overexpression strains with invertebrate model systems and cell lines were investigated. Depending on the presence of the corresponding genes, detrimental effects were observed in vivo in two invertebrate model systems, Caenorhabditis elegans and Galleria mellonella, and on various animal and human epithelial and macrophage cell lines in vitro. Taken together, our results support the idea that pathogenicity of corynebacteria is a multifactorial process and that new virulence factors may influence the outcome of potentially fatal corynebacterial infections.
Asunto(s)
Corynebacterium diphtheriae/genética , Corynebacterium/genética , Citotoxinas/biosíntesis , Exotoxinas/genética , Factores de Virulencia/genética , Animales , Proteínas Bacterianas/biosíntesis , Corynebacterium/patogenicidad , Infecciones por Corynebacterium/microbiología , Corynebacterium diphtheriae/patogenicidad , Citotoxinas/genética , Difteria/microbiología , Toxina Diftérica , Exotoxinas/biosíntesis , Humanos , Factores de Virulencia/biosíntesisRESUMEN
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.
Asunto(s)
Corynebacterium diphtheriae/patogenicidad , Toxina Diftérica/genética , Difteria/transmisión , Filogenia , Factores de Virulencia/genética , Animales , Corynebacterium diphtheriae/clasificación , ADN Bacteriano/genética , Islas Genómicas , Humanos , Especificidad de la Especie , Virulencia , Secuenciación Completa del GenomaRESUMEN
Denileukin diftitox (DAB-IL-2, Ontak) is a diphtheria-toxin-based fusion protein that depletes CD25-positive cells including regulatory T cells and has been approved for the treatment of persistent or recurrent cutaneous T cell lymphoma. However, the clinical use of denileukin diftitox was limited by vascular leak toxicity and production issues related to drug aggregation and purity. We found that a single amino acid substitution (V6A) in a motif associated with vascular leak induction yields a fully active, second-generation biologic, s-DAB-IL-2(V6A), which elicits 50-fold less human umbilical vein endothelial cell monolayer permeation and is 3.7-fold less lethal to mice by LD50 analysis than s-DAB-IL-2. Additionally, to overcome aggregation problems, we developed a production method for the fusion toxin using Corynebacterium diphtheriae that secretes fully folded, biologically active, monomeric s-DAB-IL-2 into the culture medium. Using the poorly immunogenic mouse B16F10 melanoma model, we initiated treatment 7 days after tumor challenge and observed that, while both s-DAB-IL-2(V6A) and s-DAB-IL-2 are inhibitors of tumor growth, the capacity to treat with higher doses of s-DAB-IL-2(V6A) could provide a superior activity window. In a sequential dual-therapy study in tumors that have progressed for 10 days, both s-DAB-IL-2(V6A) and s-DAB-IL-2 given before checkpoint inhibition with anti-programmed cell death-1 (anti-PD-1) antibodies inhibited tumor growth, while either drug given as monotherapy had less effect. s-DAB-IL-2(V6A), a fully monomeric protein with reduced vascular leak, is a second-generation diphtheria-toxin-based fusion protein with promise as a cancer immunotherapeutic both alone and in conjunction with PD-1 blockade.
Asunto(s)
Toxina Diftérica/administración & dosificación , Interleucina-2/administración & dosificación , Melanoma Experimental/tratamiento farmacológico , Receptor de Muerte Celular Programada 1/genética , Sustitución de Aminoácidos/genética , Anticuerpos/administración & dosificación , Proliferación Celular/efectos de los fármacos , Corynebacterium diphtheriae/química , Corynebacterium diphtheriae/patogenicidad , Toxina Diftérica/química , Células Endoteliales de la Vena Umbilical Humana/efectos de los fármacos , Humanos , Inmunosupresores/administración & dosificación , Inmunotoxinas/administración & dosificación , Interleucina-2/química , Subunidad alfa del Receptor de Interleucina-2/efectos de los fármacos , Melanoma Experimental/genética , Melanoma Experimental/inmunología , Melanoma Experimental/patología , Receptores de Interleucina-2/genética , Receptores de Interleucina-2/inmunología , Proteínas Recombinantes de Fusión/administración & dosificación , Proteínas Recombinantes de Fusión/química , Linfocitos T Reguladores/efectos de los fármacosRESUMEN
BACKGROUND: Corynebacterium diphtheriae is the etiologic agent of diphtheria and different systemic infections. The bacterium has been classically described as an extracellular pathogen. However, a number of studies revealed its ability to invade epithelial cells, indicating a more complex pathogen-host interaction. The molecular mechanisms controlling and facilitating internalization of C. diphtheriae still remains unclear. Recently, the DIP0733 transmembrane protein was found to play an important role in the interaction with matrix proteins and cell surfaces, nematode colonization, cellular internalization and induction of cell death. RESULTS: In this study, we identified a number of short linear motifs and structural elements of DIP0733 with putative importance in virulence, using bioinformatic approaches. A C-terminal coiled-coil region of the protein was considered particularly important, since it was found only in DIP0733 homologs in pathogenic Corynebacterium species but not in non-pathogenic corynebacteria. Infections of epithelial cells and transepithelial resistance assays revealed that bacteria expressing the truncated form of C. diphtheriae DIP0733 and C. glutamicum DIP0733 homolog are less virulent, while the fusion of the coiled-coil sequence to the DIP0733 homolog from C. glutamicum resulted in increased pathogenicity. These results were supported by nematode killing assays and experiments using wax moth larvae as invertebrate model systems. CONCLUSIONS: Our data indicate that the coil-coiled domain of DIP0733 is crucial for interaction with epithelial cells and pathogenicity in invertebrate animal model systems.
Asunto(s)
Proteínas Bacterianas/química , Proteínas Bacterianas/metabolismo , Infecciones por Corynebacterium/microbiología , Corynebacterium diphtheriae/patogenicidad , Células Epiteliales/microbiología , Animales , Proteínas Bacterianas/genética , Caenorhabditis elegans/microbiología , Corynebacterium diphtheriae/genética , Corynebacterium diphtheriae/fisiología , Modelos Animales de Enfermedad , Humanos , Mariposas Nocturnas/microbiología , VirulenciaRESUMEN
Toxigenic strains of Corynebacterium diphtheriae cause the majority of respiratory diphtheria cases. However, nontoxigenic strains of C. diphtheriae can also cause diseases, and have become increasingly common. Infection that is limited to the anterior nares (nasal diphtheria) is a well-described but rare condition, even for toxigenic C. diphtheriae. We report a case involving chronic carriage of nasal diphtheria caused by nontoxigenic C. diphtheriae, as well as a review of other reported nontoxigenic C. diphtheriae cases in Japan. Mild or asymptomatic nasal diphtheria involving nontoxigenic strains, which can be the source of transmission, may be underrecognized. Our case highlights the importance of awareness regarding nontoxigenic diphtheria among clinicians, especially in the era of improved diphtheria vaccination coverage.
Asunto(s)
Infecciones por Corynebacterium/microbiología , Corynebacterium diphtheriae/patogenicidad , Difteria/microbiología , Nariz/microbiología , Adulto , Humanos , Japón , Masculino , Adulto JovenRESUMEN
BACKGROUND: Corynebacterium diphtheriae is a re-emerging pathogen in Europe causing invasive infections in vaccinated persons and classical diphtheria in unvaccinated persons. In the presented study we analysed genetic changes in C. diphtheriae isolates collected in Poland from the period before the introduction of the mass anti-diphtheria vaccination to the present time when over 98% of the population is vaccinated. METHODS: A total of 62 C. diphtheriae isolates collected in the 1950s-1960s, 1990s and 2000-2016 in Poland were investigated. Examined properties of the isolates included toxigenic status, presence of tox gene, biotype, MLST type (ST) and type of infection. RESULTS: A total of 12 sequence types (STs) were identified among the analysed C. diphtheriae isolates. The highest variability of STs was observed among isolates from diphtheria and asymptomatic carriers collected in the XX century. Over 95% of isolates collected from invasive and wound infections in 2004-2016 belonged to ST8. Isolates from the XX century represented all four biotypes: mitis, gravis, intermedius and belfanti, but the belfanti biotype appeared only after the epidemic in the 1990s. All except three isolates from the XXI century represented the biotype gravis. CONCLUSIONS: During a diphtheria epidemic period, non-epidemic clones of C. diphtheriae might also disseminate and persist in a particular area after the epidemic. An increase of the anti-diphtheria antibody level in the population causes not only the elimination of toxigenic strains from the population but may also influence the reduction of diversity of C. diphtheriae isolates. MLST types do not reflect the virulence of isolates. Each ST can be represented by various virulent variants representing various pathogenic capacities, for example toxigenic non-invasive, nontoxigenic invasive and nontoxigenic non-invasive.
Asunto(s)
Corynebacterium diphtheriae/clasificación , Corynebacterium diphtheriae/aislamiento & purificación , Difteria/epidemiología , Técnicas de Tipificación Bacteriana , Corynebacterium diphtheriae/genética , Corynebacterium diphtheriae/patogenicidad , Difteria/microbiología , Brotes de Enfermedades , Humanos , Tipificación de Secuencias Multilocus , Polonia/epidemiologíaRESUMEN
Corynebacterium diphtheriae is a globally important Gram-positive aerobic Actinobacterium capable of causing the toxin-mediated disease, diphtheria. Diphtheria was a major cause of childhood mortality prior to the introduction of the toxoid vaccine, yet it is capable of rapid resurgence following the breakdown of healthcare provision, vaccination or displacement of people. The mechanism and treatment of toxin-mediated disease is well understood, however there are key gaps in our knowledge on the basic biology of C. diphtheriae particularly relating to host colonisation, the nature of asymptomatic carriage, population genomics and host adaptation.
Asunto(s)
Corynebacterium diphtheriae , Difteria/epidemiología , Difteria/microbiología , Brotes de Enfermedades/prevención & control , Antibacterianos/uso terapéutico , Corynebacterium diphtheriae/clasificación , Corynebacterium diphtheriae/patogenicidad , Corynebacterium diphtheriae/fisiología , Difteria/tratamiento farmacológico , Difteria/prevención & control , Antitoxina Diftérica/uso terapéutico , Toxina Diftérica/biosíntesis , Toxina Diftérica/envenenamiento , Toxoide Diftérico/administración & dosificación , Toxoide Diftérico/efectos adversos , Brotes de Enfermedades/estadística & datos numéricos , Genoma Bacteriano , Humanos , Filogenia , Vacunación/normasRESUMEN
Thirteen Corynebacterium pseudotuberculosis biotype ovis strains isolated from clinical cases of caseous lymphadenitis in Hungary were characterised using multilocus sequencing and their phylogenetic comparison was carried out on the basis of four housekeeping genes (groEL1, infB, dnaK, and leuA). The in silico analysis of the 16 frequently studied housekeeping genes showed that C. pseudotuberculosis strains could be readily distinguished from C. diphtheriae and C. ulcerans strains; however, sequences of the same genes in the two biotypes of the C. pseudotuberculosis were highly similar; the heterogeneity values were low. Genes dnaK, infB, groEL1, and leuA showed marked genetic variation within C. pseudotuberculosis, and strains of the two biotypes of C. pseudotuberculosis could be differentiated. Analysis of the individual genes showed a fairly conservative nature of C. pseudotuberculosis biotype ovis strains. The greatest genetic differentiation was seen in the dnaK and infB genes and concatenations of these two genes were very useful in the genetic separation of the studied strains.
Asunto(s)
Corynebacterium diphtheriae/genética , Corynebacterium pseudotuberculosis/genética , Genes Esenciales/genética , Linfadenitis/genética , Adenosina Trifosfatasas/genética , Animales , Bacteriocinas/genética , Chaperonina 60/genética , Corynebacterium diphtheriae/patogenicidad , Corynebacterium pseudotuberculosis/patogenicidad , Variación Genética , Humanos , Hungría/epidemiología , Linfadenitis/epidemiología , Linfadenitis/microbiología , Filogenia , Factor 2 Procariótico de Iniciación/genética , Ovinos/genética , Ovinos/microbiologíaRESUMEN
La difteria es una enfermedad infecciosa grave, con potencial epidémico, para la que existe una vacuna eficaz. Es una infección bacteriana aguda causada por la liberación de una exotoxina específica, producida por el bacilo gram positivo, Corynebacterium diphtheriae. Sólo las cepas toxigénicas causan enfermedad. La enfermedad se presenta principalmente en menores de 15 años de edad sin vacunación o con vacunación incompleta; no obstante puede presentarse en adultos en áreas con baja cobertura de vacunación. En este informe se presentan distintos aspectos de la enfermedad y la situación epidemiológica en las Américas y en Argentina: definiciones de caso, medidas de prevención y de control
Asunto(s)
Argentina , Vigilancia Sanitaria , Américas , Inmunización , Vacunación , Notificación de Enfermedades , Corynebacterium diphtheriae/patogenicidad , Corynebacterium diphtheriae/virología , Difteria/diagnóstico , Difteria/prevención & control , Difteria/transmisión , Difteria/epidemiologíaAsunto(s)
Anticuerpos/sangre , Corynebacterium diphtheriae/patogenicidad , Difteria/epidemiología , Adolescente , Adulto , Niño , Difteria/sangre , Difteria/microbiología , Difteria/patología , Femenino , Humanos , India/epidemiología , Masculino , Persona de Mediana Edad , Vacunación , Adulto JovenRESUMEN
Corynebacterium diphtheriae (Cd) is a Gram-positive human pathogen responsible for diphtheria infection and once regarded for high mortalities worldwide. The fatality gradually decreased with improved living standards and further alleviated when many immunization programs were introduced. However, numerous drug-resistant strains emerged recently that consequently decreased the efficacy of current therapeutics and vaccines, thereby obliging the scientific community to start investigating new therapeutic targets in pathogenic microorganisms. In this study, our contributions include the prediction of modelome of 13 C. diphtheriae strains, using the MHOLline workflow. A set of 463 conserved proteins were identified by combining the results of pangenomics based core-genome and core-modelome analyses. Further, using subtractive proteomics and modelomics approaches for target identification, a set of 23 proteins was selected as essential for the bacteria. Considering human as a host, eight of these proteins (glpX, nusB, rpsH, hisE, smpB, bioB, DIP1084, and DIP0983) were considered as essential and non-host homologs, and have been subjected to virtual screening using four different compound libraries (extracted from the ZINC database, plant-derived natural compounds and Di-terpenoid Iso-steviol derivatives). The proposed ligand molecules showed favorable interactions, lowered energy values and high complementarity with the predicted targets. Our proposed approach expedites the selection of C. diphtheriae putative proteins for broad-spectrum development of novel drugs and vaccines, owing to the fact that some of these targets have already been identified and validated in other organisms.