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1
Schirmer, Patricia, Cynthia A. Lucero-Obusan, Aditya Sharma, Gina Oda, and Mark Holodniy. "1201. Diphtheria in Veterans Health Administration (VHA), 2000-2021." Open Forum Infectious Diseases 8, Supplement_1 (November 1, 2021): S692. http://dx.doi.org/10.1093/ofid/ofab466.1393.
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Abstract Background Diphtheria is caused by Corynebacterium diphtheriae and can cause respiratory or skin infections. Transmission occurs primarily person-to-person via respiratory tract and rarely from skin lesions or fomites. In the Veterans Health Administration (VHA), we perform surveillance for nationally notifiable diseases such as diphtheria. In early 2021, there were 4 alerts for C. diphtheriae. Therefore, we investigated diphtheria prevalence in VHA over the last 20 years. Methods Isolates of C. diphtheriae were identified from VHA data sources from 1/1/2000-2/28/2021. Patient demographics, co-morbidities, microbiologic data, treatment, outcomes, and vaccination status were obtained via electronic medical record (EMR) review. Results 33 C. diphtheriae isolates were identified representing 32 unique individuals. 17 isolates were identified from 2000-2015 and 16 were identified from 2016-2021. Isolates were from cutaneous (16), blood (10), urine (4), pulmonary (2), and throat (1) specimens. In 11 individuals, clinical significance was unclear (no antibiotics given, note mentioned that it was being considered a contaminant - i.e., isolate may have been incorrectly labeled as “C. diphtheriae” instead of “diphtheroid”). Only 3 isolates had toxin testing documented. One C. diphtheriae biovar gravis blood isolate was associated with sepsis without another source identified. The throat isolate was a nontoxigenic strain. No cutaneous isolates underwent susceptibility testing, but all 15 individuals received antibiotics (1 patient had 2 isolates). 11 had additional organisms identified in addition to C. diphtheriae. Table 1 describes demographics, co-morbidities, and vaccination status of cutaneous cases. Only 1 case (in 2021) had EMR documentation of local public health department reporting. Table 1. Characteristics of Unique Individuals with Cutaneous Diphtheria Isolates in VHA, 2000-2021 Conclusion Nearly as many isolates have been identified in the last 5.5 years compared to the previous 15 years which may be related to more robust molecular identification methods available in VHA. Most C. diphtheriae isolated was from cutaneous sources that were acute in onset. About 33% were identified as C. diphtheriae but were not treated. EMR documentation of toxin production and public health department reporting was lacking. Disclosures All Authors: No reported disclosures
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Chagina, I. A., O. Yu Borisova, L. I. Kafarskaya, S. S. Afanasiev, V. A. Aleshkin, Yu V. Nesvizhsky, M. S. Afanasiev, et al. "COMPOSITION OF POPULATION OF DIPHTHERIA CAUSATIVE AGENT STRAINS IN RUSSIA." Journal of microbiology, epidemiology and immunobiology 93, no. 5 (October 28, 2016): 50–60. http://dx.doi.org/10.36233/0372-9311-2016-5-50-60.
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Aim. Characteristics of clonal composition of Corynebacterium diphtheriae strain populatior in Russia using MLST, as well as evaluation of a possibility of using of this method during execution of monitoring of diphtheria infection causative agent strains. Materials and methods. C. diphtheriae strains, isolated in Russia in 1957 - 2015 and sent to Gabrichevsky MRIEM reference centre for diphtheria and pertussis, were studied. Genotyping of C. diphtheriae using MLST wa: carried out based on sequencing of «housekeeping» gene fragments. ST identification was carriec out according to PubMLST. Results. C. diphtheriae strains of 36 sequence-types (ST) were identified on the territory of Russia - 27 previously known and 9 novel, detected for the first time. 2 sequence types ST25 and ST8 (22% and 18%) dominated. Inter-relation between phenotype properties (toxigenicity and biovar) and membership of C. diphtheriae strains in certain sequence-types was shown - toxigenic and non-toxigenic C. diphtheriae strains of various biovars were characterized by certain sequence-types. Changes of clonal composition of C. diphtheriae population in dynamics of epidemic process of diphtheria infection were shown. Conclusion. Use of MLST allowed to characterized clonal composition of C. diphtheriae strains’ population in Russia and has shown perspectives of use of this method to characterize population of diphtheria causative agent, detect epidemically significant strains and decipher foci of diphtheria infection.
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Alfiansyah, Gamasiano. "PENYELIDIKAN EPIDEMIOLOGI KEJADIAN LUAR BIASA (KLB) DIFTERI DI KABUPATEN BLITAR TAHUN 2015." Preventia : The Indonesian Journal of Public Health 2, no. 1 (June 30, 2017): 37. http://dx.doi.org/10.17977/um044v2i1p37-42.
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ABSTRAK Difteri merupakan penyakit menular mematikan yang menyerang saluran pernapasan atas yang disebabkan oleh bakteri Corynebacterium diphtheriae. Kasus difteri di Kabupaten Blitar cenderung meningkat dari tahun ke tahun. Jumlah kasus tahun 2011 sebanyak 15 kasus, tahun 2012 sebanyak 23 kasus, tahun 2013 sebanyak 17 kasus, tahun 2014 sebanyak 21 kasus, dan tahun 2015 sebanyak 38 kasus dengan jumlah kasus tertinggi di kecamatan Kanigoro sebanyak 9 kasus. Tujuan penyelidikan epidemiologi adalah mengetahui besar masalah KLB difteri dan faktor risiko yang mempengaruhinya.Jenis penelitian adalah deskriptif kualitatif. Informan utama penelitian adalah petugas kesehatan yang menangani KLB difteri baik di Dinas Kesehatan maupun Puskesmas. Informan triangulasi penelitian adalah bidan desa, kepala desa, ketua PKK, dan penderita atau keluarga penderita. Data dikumpulkan dengan cara wawancara mendalam dan observasi, dan dianalisis dengan menggunakan metode analisis isi.Hasilnya adalah 95,55% kasus difteri terjadi pada kelompok umur ≤ 15 tahun dan 91% jumlah kasus difteri dialami oleh masyarakat yang mendapatkan imunisasi lengkap. Selain itu, tingkat pengetahuan masyarakat yang rendah tentang difteri juga merupakan faktor risiko penularan difteri.Penelitian ini merekomendasikan Dinas Kesehatan untuk membuat pola pengawasan kontak erat dan memberikan pelatihan manajemen cold chain. Bagi Puskesmas diharapkan melakukan pengawasan terhadap kontak erat dan meningkatkan cakupan penyuluhan.Kata kunci: KLB, Difteri, Kabupaten BitarABSTRACT Diphtheria is a deadly infectious disease that attacks the upper respiratory tract caused by Corynebacterium diphtheriae. The case of diphtheria in Blitar district tends to increase. The number of cases in 2011 was 15 cases, 23 cases in 2012, 17 cases in 2013, 21 cases in 2014, and 38 cases in 2015 with the highest number of cases in Kanigoro sub-district by 9 cases. The purpose of epidemiological investigation are to determine the extent of diphtheria outbreak and the risk factors that affect it.The kind of research is a qualitative descriptive. Key informants research are health care workers who deal with diphtheria’s outbreaks in both of the Department of Health and Community Health Center. Informants for triangulation research are the midwife of the village, the village’s leader, pkk’s chairman, and the patient or the family of the patient. Data were collected through in-depth interviews and observation, and analyzed using content analysis method.The result is 95.55% of diphtheria cases occured at age ≤15 years old and 91% of diphtheria’s case are suffered by people who get complete immunization. In addition, a low level of community knowledge about diphtheria is also a risk factor for diphtheria transmission.As suggestion, Blitar district health office establish close contact supervision patterns and provide cold chain management training. Health centers are expected to supervise close contacts and increase the coverage education.Keywords: Outbreak, diphtheria, Blitar district
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Tok, Peter Seah Keng, Misbaha Jilani, Nurul Fateha Misnar, Nor Suzila Bidin, Norli Rosli, and Haidar Rizal Toha. "A diphtheria outbreak in Johor Bahru, Malaysia: Public health investigation and response." Journal of Infection in Developing Countries 16, no. 07 (July 28, 2022): 1159–65. http://dx.doi.org/10.3855/jidc.16076.
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Introduction: Diphtheria is an acute infectious disease caused by Corynebacterium diphtheriae. Although the incidence of diphtheria worldwide has rapidly declined following the largely successful diphtheria toxoid-based vaccines, concerns persist for those who were unvaccinated or incompletely vaccinated. In this report, we describe a recent diphtheria outbreak in Malaysia involving four confirmed diphtheria cases.
Methodology: The outbreak investigation efforts and epidemiological characteristics of a diphtheria outbreak in Malaysia are described. For all suspected cases, swabs were taken and sent for isolation of Corynebacterium diphtheriae and confirmation of toxigenic strains.
Results: The index case was a two-year-old child living with his family in a welfare home. Following contact tracing efforts and investigation for suspected cases, seven samples came back as culture positive for Corynebacterium diphtheriae. Confirmation of toxigenic strains was performed using PCR and Elek’s test, which showed 100% correlation in positivity for four of the samples. All four confirmed cases were below 18 years of age, and three of them did not have complete vaccination history (two unvaccinated, one unknown). The index case eventually succumbed due to severe diphtheria with multiorgan failure while all the other cases were discharged healthy.
Conclusions: In Malaysia, despite good vaccination coverage, sporadic diphtheria outbreaks still occur. The rising trend of cases reported over the recent years underscores the need to remain vigilant. Addressing pockets of unvaccinated children and potential waning immunity levels in the population remains pivotal.
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Kostyukova, N. N., and V. A. Bechalo. "Diphtheria Carriage." Epidemiology and Vaccine Prevention 17, no. 5 (October 23, 2018): 60–70. http://dx.doi.org/10.31631/2073-3046-2018-17-5-60-70.
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The diphtheria carriage is a asympthomatic colonization of oro- and nasopharynx by toxigenic and nontoxigenic Corynebacterium diphtheriae. The carriage of toxigenic strains prevents a complete eradication of diphtheria infection in spite of mass toxoid immunization. The contamination by toxigenic diphtheria bacteria leads to the carriage if the person has a protective level of diphtheria antitoxin. Contamination with the toxigenic and nontoxigenic leads to the carriage if the person has no protection to the bacterial colonization factors. Some of them are surface protein structures and may serve as components of the future vaccines against diphtheria bacteria colonization.
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Truelove, Shaun A., Lindsay T. Keegan, William J. Moss, Lelia H. Chaisson, Emilie Macher, Andrew S. Azman, and Justin Lessler. "Clinical and Epidemiological Aspects of Diphtheria: A Systematic Review and Pooled Analysis." Clinical Infectious Diseases 71, no. 1 (August 19, 2019): 89–97. http://dx.doi.org/10.1093/cid/ciz808.
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Abstract Background Diphtheria, once a major cause of childhood morbidity and mortality, all but disappeared following introduction of diphtheria vaccine. Recent outbreaks highlight the risk diphtheria poses when civil unrest interrupts vaccination and healthcare access. Lack of interest over the last century resulted in knowledge gaps about diphtheria’s epidemiology, transmission, and control. Methods We conducted 9 distinct systematic reviews on PubMed and Scopus (March–May 2018). We pooled and analyzed extracted data to fill in these key knowledge gaps. Results We identified 6934 articles, reviewed 781 full texts, and included 266. From this, we estimate that the median incubation period is 1.4 days. On average, untreated cases are colonized for 18.5 days (95% credible interval [CrI], 17.7–19.4 days), and 95% clear Corynebacterium diphtheriae within 48 days (95% CrI, 46–51 days). Asymptomatic carriers cause 76% (95% confidence interval, 59%–87%) fewer cases over the course of infection than symptomatic cases. The basic reproductive number is 1.7–4.3. Receipt of 3 doses of diphtheria toxoid vaccine is 87% (95% CrI, 68%–97%) effective against symptomatic disease and reduces transmission by 60% (95% CrI, 51%–68%). Vaccinated individuals can become colonized and transmit; consequently, vaccination alone can only interrupt transmission in 28% of outbreak settings, making isolation and antibiotics essential. While antibiotics reduce the duration of infection, they must be paired with diphtheria antitoxin to limit morbidity. Conclusions Appropriate tools to confront diphtheria exist; however, accurate understanding of the unique characteristics is crucial and lifesaving treatments must be made widely available. This comprehensive update provides clinical and public health guidance for diphtheria-specific preparedness and response.
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Ott, Lisa, Jens Möller, and Andreas Burkovski. "Interactions between the Re-Emerging Pathogen Corynebacterium diphtheriae and Host Cells." International Journal of Molecular Sciences 23, no. 6 (March 18, 2022): 3298. http://dx.doi.org/10.3390/ijms23063298.
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Corynebacterium diphtheriae, the etiological agent of diphtheria, is a re-emerging pathogen, responsible for several thousand deaths per year. In addition to diphtheria, systemic infections, often by non-toxigenic strains, are increasingly observed. This indicates that besides the well-studied and highly potent diphtheria toxin, various other virulence factors may influence the progression of the infection. This review focuses on the known components of C. diphtheriae responsible for adhesion, invasion, inflammation, and cell death, as well as on the cellular signaling pathways activated upon infection.
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Prygiel, Marta, Maciej Polak, Ewa Mosiej, Karol Wdowiak, Kamila Formińska, and Aleksandra Anna Zasada. "New Corynebacterium Species with the Potential to Produce Diphtheria Toxin." Pathogens 11, no. 11 (October 30, 2022): 1264. http://dx.doi.org/10.3390/pathogens11111264.
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Only three Corynebacterium species are known to produce a lethal exotoxin called diphtheria toxin. These are C. diphtheriae, C. ulcerans and C. pseudotuberculosis. The diphtheria toxin gene (tox) is carried in a family of closely related corynebacteriophages and therefore the toxin can be produced only through lysogenisation, in which the corynephage encoding tox is stably inserted into the chromosome. However, ‘nontoxigenic tox gene-bearing’ (NTTB) strains, which are genotypically tox-positive but do not express the protein, have been described. The emergence of NTTB strains was first observed during the 1990s diphtheria epidemic in Eastern Europe and nowadays such isolates have been detected in many countries in the world. Recently, novel species of Corynebacterium genus have been described which might have the potential of producing the diphtheria toxin due to the possession of the diphtheria toxin gene but it has not produced toxin in laboratory tests. The circulation of NTTB strains could be related to the increased risk for diphtheria disease arising from the risk of re-emerging toxin expression. The article presents the mechanism of diphtheria toxin expression and action, recently described novel species of NTTB corynebacteria as well as the taxonomic changes within the C. diphtheriae group.
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Efstratiou, Androulla, Kathryn H. Engler, Charlotte S. Dawes, and Dorothea Sesardic. "Comparison of Phenotypic and Genotypic Methods for Detection of Diphtheria Toxin among Isolates of Pathogenic Corynebacteria." Journal of Clinical Microbiology 36, no. 11 (1998): 3173–77. http://dx.doi.org/10.1128/jcm.36.11.3173-3177.1998.
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We have compared molecular, immunochemical, and cytotoxic assays for the detection of diphtheria toxin from 55 isolates ofCorynebacterium diphtheriae and Corynebacterium ulcerans originally isolated in five different countries. The suitabilities and accuracies of these assays for the laboratory diagnosis of diphtheria were compared and evaluated against the “gold standard” in vivo methods. The in vivo and Vero cell cytotoxicity assays were accurate in their abilities to detect diphtheria toxin but were time-consuming; however, the cytotoxicity assay is a suitable in vitro alternative to the in vivo virulence test. There was complete concordance between all the phenotypic methods. Genotypic tests based upon PCR were rapid; however, PCR must be used with caution because some isolates of C. diphtheriae possessed toxin genes but failed to express a biologically active toxin. Therefore, phenotypic confirmation of toxigenicity for the microbiological diagnosis of diphtheria is recommended.
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Febriyana, Dwi, Sunarno Sunarno, Yudi Hartoyo, Sundari Nursofiah, Tati Febrianti, Ratih Dian Saraswati, Nelly Puspandari, et al. "Analisis Gen Tox Corynebacterium Diphtheriae Penyebab Difteri di Beberapa Wilayah Indonesia." Buletin Penelitian Kesehatan 49, no. 1 (May 25, 2021): 63–70. http://dx.doi.org/10.22435/bpk.v0i0.3844.
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Diphtheria is a vaccine-preventable disease. The clinical features and complications of diphtheria are associated with toxins produced by the causative bacteria. Diphtheria toxin synthesis is encoded by tox gene. This study aimed to provide an overview of the DNA sequences of the tox gene of Corynebacterium diphtheriae causing diphtheria in several region of Indonesia. A total of 65 Corynebacterium diphtheriae isolated from several provinces in Indonesia (2010-2017) were used as samples. Isolates recultured on blood agar medium (BA), incubated at 37 0 C overnight. DNA extraction conducted using the QiaAmp DNA Mini Kit. The DNA sequencing was carried out using the Whole Genome Sequencing (WGS) approach. The data conversion and analysis conducted using U-gene and BioEdit programs. Examination of 65 isolate C. diphtheriae with 1683 bp of tox gene sequences showed that there are 3 patterns of gene sequences with 3 mutation site. All mutations were silent mutation. The mutation sites were also not commonly used as 3’end binding site of the PCR primer. We concluded that tox gene of C. diphtheriae that causes diphtheria in some provinces in Indonesia have limited variations and these variations do not encode amino acid changes. This indicates that the vaccines used in Indonesia are still in accordance with the variations in circulating bacteria and PCR can be used for screening and predicting the toxigenicity of diphtheria-causing bacteria. Keywords: C. diphtheriae, gene tox, diphtheria, Indonesia
Abstrak
Difteri merupakan salah satu penyakit yang dapat dicegah dengan imunisasi (PD3I). Gambaran klinis dan komplikasi difteri dikaitkan dengan toksin yang diproduksi oleh bakteri penyebab. Sintesis toksin difteri dikode oleh gen tox. Penelitian ini bertujuan untuk memberikan gambaran sekuens DNA gen tox Corynebacterium diphtheriae penyebab difteri di beberapa wilayah Indonesia. Sebanyak 65 isolat C. diphtheriae tersimpan milik Badan Litbangkes yang diisolasi dari beberapa wilayah Indonesia tahun 2010- 2017 dijadikan sebagai sampel. Rekultur dilakukan pada medium agar darah (BA), diinkubasi pada suhu 37 o C selama sehari semalam. Ekstraksi DNA menggunakan kit QiaAmp DNA Minikit. Sekuensing DNA dilakukan dengan pendekatan Whole Genome Sequencing (WGS). Konversi dan analisis data menggunakan program U-gene dan BioEdit.Pemeriksaan 65 isolat C. diphtheriae dengan 1683 bp sekuens gen tox menunjukkan ada 3 pola sekuens gen dengan 3 lokasi mutasi. Seluruh mutasi bersifat silent mutation. Lokasi mutasi juga bukan merupakan tempat penempelan ujung 3’ primer PCR yang umum digunakan. Berdasarkan hasil penelitian dapat disimpulkan bahwa variasi gen tox yang ditemukan pada C. diphtheriae penyebab difteri di Indonesia memiliki variasi yang terbatas dan mutasi yang ada tidak mengkode perubahan asam amino. Hal ini mengindikasikan bahwa vaksin yang digunakan di Indonesia masih sesuai dengan variasi bakteri yang bersirkulasi. Hasil penelitian juga mengindikasikan bahwa PCR dapat digunakan untuk skrining dan memprediksi toksigenisitas bakteri penyebab difteri.
Kata kunci : C. diphtheriae, gen tox, difteri, Indonesia
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Febriyana, Dwi, Sunarno Sunarno, Yudi Hartoyo, Sundari Nursofiah, Tati Febrianti, Ratih Dian Saraswati, Nelly Puspandari, et al. "Analisis Gen Tox Corynebacterium Diphtheriae Penyebab Difteri di Beberapa Wilayah Indonesia." Buletin Penelitian Kesehatan 49, no. 1 (May 25, 2021): 63–70. http://dx.doi.org/10.22435/bpk.v49i1.3844.
Full textAbstract:
Diphtheria is a vaccine-preventable disease. The clinical features and complications of diphtheria are associated with toxins produced by the causative bacteria. Diphtheria toxin synthesis is encoded by tox gene. This study aimed to provide an overview of the DNA sequences of the tox gene of Corynebacterium diphtheriae causing diphtheria in several region of Indonesia. A total of 65 Corynebacterium diphtheriae isolated from several provinces in Indonesia (2010-2017) were used as samples. Isolates recultured on blood agar medium (BA), incubated at 37 0 C overnight. DNA extraction conducted using the QiaAmp DNA Mini Kit. The DNA sequencing was carried out using the Whole Genome Sequencing (WGS) approach. The data conversion and analysis conducted using U-gene and BioEdit programs. Examination of 65 isolate C. diphtheriae with 1683 bp of tox gene sequences showed that there are 3 patterns of gene sequences with 3 mutation site. All mutations were silent mutation. The mutation sites were also not commonly used as 3’end binding site of the PCR primer. We concluded that tox gene of C. diphtheriae that causes diphtheria in some provinces in Indonesia have limited variations and these variations do not encode amino acid changes. This indicates that the vaccines used in Indonesia are still in accordance with the variations in circulating bacteria and PCR can be used for screening and predicting the toxigenicity of diphtheria-causing bacteria. Keywords: C. diphtheriae, gene tox, diphtheria, Indonesia
Abstrak
Difteri merupakan salah satu penyakit yang dapat dicegah dengan imunisasi (PD3I). Gambaran klinis dan komplikasi difteri dikaitkan dengan toksin yang diproduksi oleh bakteri penyebab. Sintesis toksin difteri dikode oleh gen tox. Penelitian ini bertujuan untuk memberikan gambaran sekuens DNA gen tox Corynebacterium diphtheriae penyebab difteri di beberapa wilayah Indonesia. Sebanyak 65 isolat C. diphtheriae tersimpan milik Badan Litbangkes yang diisolasi dari beberapa wilayah Indonesia tahun 2010- 2017 dijadikan sebagai sampel. Rekultur dilakukan pada medium agar darah (BA), diinkubasi pada suhu 37 o C selama sehari semalam. Ekstraksi DNA menggunakan kit QiaAmp DNA Minikit. Sekuensing DNA dilakukan dengan pendekatan Whole Genome Sequencing (WGS). Konversi dan analisis data menggunakan program U-gene dan BioEdit.Pemeriksaan 65 isolat C. diphtheriae dengan 1683 bp sekuens gen tox menunjukkan ada 3 pola sekuens gen dengan 3 lokasi mutasi. Seluruh mutasi bersifat silent mutation. Lokasi mutasi juga bukan merupakan tempat penempelan ujung 3’ primer PCR yang umum digunakan. Berdasarkan hasil penelitian dapat disimpulkan bahwa variasi gen tox yang ditemukan pada C. diphtheriae penyebab difteri di Indonesia memiliki variasi yang terbatas dan mutasi yang ada tidak mengkode perubahan asam amino. Hal ini mengindikasikan bahwa vaksin yang digunakan di Indonesia masih sesuai dengan variasi bakteri yang bersirkulasi. Hasil penelitian juga mengindikasikan bahwa PCR dapat digunakan untuk skrining dan memprediksi toksigenisitas bakteri penyebab difteri.
Kata kunci : C. diphtheriae, gen tox, difteri, Indonesia
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Mutahhar, Alif, and Dwiyanti Puspitasari. "SENSITIVITY OF ERYTHROMYCIN AGAINST CORYNEBACTERIUM DIPHTHERIAE." Indonesian Journal of Tropical and Infectious Disease 8, no. 1 (March 19, 2020): 16. http://dx.doi.org/10.20473/ijtid.v8i1.11654.
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Diphtheria is an acute infection disease caused by Corynebacterium diphtheriae. It remains a problem in Indonesia in a recent several years especially in East Java Province, which suffered from an outbreak of diphtheria in 2011. Erythromycin is the second line antibiotics therapy for diphteria if the patient is allergic to penicillin, also serving as a prophylactic and carrier therapy for contact diphtheria. Erythromycin has been used for diphtheria for a very long time, but there is little recent data on its sensitivity against C. diphtheriae. The purpose of this study is to identify whether Erythromycin still has a strong antibacterial activity against Corynebacterium diphtheriae by invitro test. This was a descriptive study which observed the sensitivity pattern of erythromycin against Corynebacterium diphtheriae using the Epsilometer test (etest) as a diffusion technique. Samples used in this study were 30 isolates of toxigenic Corynebacterium diphtheriae strain mitis and gravis at the Center for Health Laboratory (BBLK) Surabaya obtained during 2011 until 2014. We retrieved the data based on gender, age, and districts of patients for each of the samples then analyzed them descriptively. In this study, a sensitivity test of 30 toxigenic Corynebacterium diphtheriae isolates revealed that 27 (90%) were sensitive to Erythromycin (average Minimum Inhibitory Concentration/ MIC) <0.016 μg/mL and all were strain mitis, while 3 (10%) had intermediate sensitivity with MIC 1 μg/mL (all were strain gravis). No resistance result was found from the sensitivity test. According to the result, we conclude that Erythromycin still has a strong antibacterial activity against Corynebacterium diphtheriae.
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Sunarno, Sunarno, Yuanita Mulyastuti, Nelly Puspandari, and Kambang Sariadji. "DNA Sequence Analysis of dtxR Gene (Partial) of Corynebacterium diphtheriae Causing Diphtheria in Jawa and Kalimantan Islands, Indonesia." Indonesian Biomedical Journal 9, no. 2 (August 1, 2017): 91. http://dx.doi.org/10.18585/inabj.v9i2.268.
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BACKGROUND: dtxR gene is a global regulator that can be used as a marker for detection of Corynebacterium diphtheriae (C. diphtheriae) and it is also a representative tool for mapping purpose (molecular typing) of this bacteria. The aim of this study was to analyze the DNA sequences of partial dtxR gene of C. diphtheriae causing diphtheria in some region of Indonesia. DNA sequence analysis was used to verify the accuracy of the in-house multiplex polymerase chain reaction (PCR) method that used for detection of C. diphtheriae in the clinical specimen as well as a preliminary study to determine the strain diversity of C. diphtheriae circulating in Indonesia.METHODS:Ten PCR products targeting the dtxR gene that have been detected as positive C. diphtheriae previously by in-house multiplex PCR used as samples in this study. The DNA sequencing carried out by Sanger method and the sequence data was analyzed by Bioedit software offline and basic local alignment sequence typing (BLAST) online.RESULTS: All of DNA sequence analyzed in this study were similar or identical to the dtxR gene sequence data of C. diphtheriae registered in GenBank. Within the 162 nucleotides (base 150-311) of dtxR gene that analyzed, at least 2 clonals were found among 10 samples. Substitutions of 2 nucleotides (base 225 and 273) was detected, both were silent mutation.CONCLUSION:Ten partial DNA sequences of dtxR genes in this study verify the accuracy of in-house multiplex PCR which used to identify the bacteria causing diphtheria in the clinical specimen. The DNA sequences also represent the existing diversity of the bacteria causing diphtheria circulating in Indonesia.KEYWORDS: dtxR, C. diphtheriae, diphtheria, Indonesia
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Dugbor, Muekara Friday. "The Diphtheria Disease." International Journal of Advances in Scientific Research and Engineering 10, no. 02 (2024): 12–28. http://dx.doi.org/10.31695/ijasre.2024.2.2.
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This study, ‘The Diphtheria Disease’ explored the historical significance, etiology, symptoms, transmission, and preventive measures related to diphtheria. The study adopted a qualitative meta-analysis approach. The objectives were threefold, which included to ascertain the cause(s) of diphtheria, to investigate potential cures, and to determine the efficacy of treatments. The narrative unfolded through an examination of historical outbreaks, breakthroughs, and contemporary challenges. The study focused on respiratory, cutaneous, nasal, laryngeal, and pharyngeal diphtheria types, detailing symptoms, and transmission modes. Treatment involves diphtheria antitoxin, antibiotics, and supportive care, with emphasis on early intervention and vaccination. The efficacy of the cure was explored, highlighting the importance of timely diagnosis and treatment, antitoxin administration, antibiotic therapy, supportive care, vaccination, isolation, and public health measures. It was found in the study that diphtheria disease was caused by the bacterium Corynebacterium diphtheriae, the antitoxin, derived from the serum of horses could neutralize the circulating diphtheria toxin, and this cure is effective.
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Ariwinanti, Desy, Nurnaningsih Herya Ulfa, and Lucky Radita Alma. "BONEKA PANGGUNG DAN BUKU SAKU BERGAMBAR SEBAGAI MEDIA PROMOSI KESEHATAN TENTANG DIFTERI DAN IMUNISASI PADA SISWA TK DAN SD DI KOTA MALANG." Preventia : The Indonesian Journal of Public Health 3, no. 2 (December 8, 2018): 136. http://dx.doi.org/10.17977/um044v3i2p136-142.
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Abstrak : Difteri atau Diphtheria adalah suatu penyakit infeksi akut yang disebabkan oleh toksin yang diproduksi oleh Corynebacterium diphtheriae. Angka kejadian difteri di Indonesia terus meningkat, pada 2016 terjadi 415 kasus dengan 24 kematian, Case Fatality Rate (CFR) 5.8%. Di Kota Malang sepanjang 2017 ditemukan 19 kasus terutama di sekolah dasar hingga menengah yang belum mendapat imunisasi (Arifin, 2017). Boneka Panggung dan Buku Saku Bergambar merupakan media promosi kesehatan yang dapat digunakan sebagai media untuk mengenalkan difteri dan meningkatkan sikap positif terhadap imunisasi difteri. Sosialisai dilakukan di TK Laboratorium dan SD Sriwedari. Hasil yang didapatkan adalah terlaksananya kegiatan sosialisai difteri dan vaksinasi diikuti dengan peningkatan pengetahuan tentang difteri dan perubahan sikap siswa menjadi bersikap positif terhadap imunisasi.Kata kunci: difteri, boneka panggung, buku saku Abstract : Diphtheria is an acute infectious disease caused by a toxin produced by Corynebacterium diphtheriae. The incidence of diphtheria in Indonesia has an increase trend, in 2016 there were 415 cases with 24 deaths, Case Fatality Rate (CFR) 5.8%. Furthermore, Malang city, in 2017 was found 19 cases, especially in elementary and secondary schools found that they did not received immunization. Puppet Stage and Picture Pocket Book are health promotion media that can be used as a medium to introduce diphtheria and increase positive attitudes towards diphtheria immunization. This research method was description and involved student at the Laboratory Kindergarten and Sriwedari Elementary School. The results obtained that the successful of diphtheria socialization implementation activities was followed by increased knowledge about diphtheria and student attitudes to be more positive towards immunization.Key words: diphtheria, puppet stage, picture pocket book
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Dragomirescu, Cerasella Cristiana, and Mădălina Preda. "DIPHTHERIA IN EUROPEAN COUNTRIES BY 2010-2022." Romanian Archives of Microbiology and Immunology 82, no. 2 (June 30, 2023): 124–31. http://dx.doi.org/10.54044/rami.2023.02.06.
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Diphtheria is a serious, potentially fatal infectious disease in susceptible individuals. Diphtheria is caused by the toxin produced by strains of Corynebacterium diphtheriae and/or C. ulcerans or C. pseudotuberculosis. The number of cases of diphtheria is relatively low in many European countries due to the functioning of vaccination programs, but diphtheria may now return due to the increase in the number of unvaccinated people, largely due to the increase in refusal and population migration. We would like to draw attention to the phenomenon described in Europe that can also manifest itself in our country, namely the increase in the number of diphtheria cases in the context of population migration induced by the war in Ukraine.
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Kharseeva, Galina Georgievna, A. A. Alieva, L. P. Alekseeva, Ye O. Mangutov, and L. A. Shovkun. "CYPOPATHIC EFFECT OF DIPHTHERIA PATHOGEN IN THE COMPOSITION OF BIOFILM." Russian Clinical Laboratory Diagnostics 64, no. 11 (November 15, 2019): 681–85. http://dx.doi.org/10.18821/0869-2084-2019-64-11-681-685.
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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+ № 665, C. diphtheriae gravis tox+ № 6765, C. diphtheriae mitis tox+ № 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 «silent» 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 «silent» 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 «asymptomatic» carriage of diphtheria.
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Tchorbanov, Andrey I., Jordan D. Dimitrov, and Tchavdar L. Vassilev. "Optimization of casein-based semisynthetic medium for growing of toxigenic Corinebacterium diphtheriae in a fermenter." Canadian Journal of Microbiology 50, no. 10 (October 1, 2004): 821–26. http://dx.doi.org/10.1139/w04-061.
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Diphtheria toxin is produced by growing Corinebacterium diphtheriae either in a semisynthetic casein-based medium or in the Pope–Lingood meat extract based medium. The World Health Organization advises the use of the semisynthetic one, as it has important advantages. Data on the composition of casein-based media and their ability to support high toxin production are not freely available. Important factors affecting toxin production during C. diphtheriae cultivation are the pH of the culture medium and the concentration of casein hydrolysate and of Fe2+. We established that the optimal pH for toxin production is 7.2. The highest yield of toxin was obtained using a casein hydrolysate concentration of 35.0 g/L and a Fe2+ concentration of 0.05–0.41 µg/mL. Under these conditions, diphtheria toxin with higher purity and yield compared with the batches obtained using the meat-based medium of Pope–Lingood was produced.Key words: diphtheria toxin, diphtheria toxoid, cultivation, semisynthetic medium.
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Poudel, Binod, Aastha Lamsal, and Chandra M. Poudel. "High mortality diphtheritic myocarditis with conduction disturbance, case series, and review of literature." Annals of Medicine & Surgery 85, no. 8 (July 3, 2023): 3797–800. http://dx.doi.org/10.1097/ms9.0000000000001037.
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Introduction: Diphtheria cases are still being reported in various parts of the globe. Although complete heart block resulting from diphtheric myocarditis is infrequent, it can lead to fatality. Awareness and recognition of this help strengthen the importance of vaccines and their proper management. Case presentation: The authors report two young patients who presented in the interval of a month, to the emergency department with signs and symptoms of diphtheria. Both developed diphtheric myocarditis with complete heart block and severe left ventricular systolic dysfunction, which did not respond to temporary pacing. Discussion: Diphtheria remains rare but few cases continue to emerge, especially in developing countries. Those who develop it have high mortality, particularly from cardiomyopathy, airway compromise, and organ failure. Conduction abnormalities are diagnostic of diphtheric myocarditis and have a grim prognosis and treatment options are limited. Conclusion: Diphtheric myocarditis has a poor prognosis and is an independent predictor of mortality. Since aggressive invasive treatment has not been shown to improve survival, early recognition along with antitoxin at the earliest suspicion and proper supportive care are the current best available options.
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Oram, Diana Marra, Ana Avdalovic, and Randall K. Holmes. "Construction and Characterization of Transposon Insertion Mutations in Corynebacterium diphtheriae That Affect Expression of the Diphtheria Toxin Repressor (DtxR)." Journal of Bacteriology 184, no. 20 (October 15, 2002): 5723–32. http://dx.doi.org/10.1128/jb.184.20.5723-5732.2002.
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ABSTRACT Transcription of the bacteriophage-borne diphtheria toxin gene tox is negatively regulated, in response to intracellular Fe2+ concentration, by the chromosomally encoded diphtheria toxin repressor (DtxR). Due to a scarcity of tools, genetic analysis of Corynebacterium diphtheriae has primarily relied on analysis of chemically induced and spontaneously occurring mutants and on the results of experiments with C. diphtheriae genes cloned in Escherichia coli or analyzed in vitro. We modified a Tn5-based mutagenesis technique for use with C. diphtheriae, and we used it to construct the first transposon insertion libraries in the chromosome of this gram-positive pathogen. We isolated two insertions that affected expression of DtxR, one 121 bp upstream of dtxR and the other within an essential region of the dtxR coding sequence, indicating for the first time that dtxR is a dispensable gene in C. diphtheriae. Both mutant strains secrete diphtheria toxin when grown in medium containing sufficient iron to repress secretion of diphtheria toxin by wild-type C. diphtheriae. The upstream insertion mutant still produces DtxR in decreased amounts and regulates siderophore secretion in response to iron in a manner similar to its wild-type parent. The mutant containing the transposon insertion within dtxR does not produce DtxR and overproduces siderophore in the presence of iron. Differences in the ability of the two mutant strains to survive oxidative stress also indicated that the upstream insertion retained slight DtxR activity, whereas the insertion within dtxR abolished DtxR activity. This is the first evidence that DtxR plays a role in protecting the cell from oxidative stress.
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Schlez, Karen, Tobias Eisenberg, Jörg Rau, Sabine Dubielzig, Matthias Kornmayer, Georg Wolf, Anja Berger, et al. "Corynebacterium rouxii, a recently described member of the C. diphtheriae group isolated from three dogs with ulcerative skin lesions." Antonie van Leeuwenhoek 114, no. 9 (June 25, 2021): 1361–71. http://dx.doi.org/10.1007/s10482-021-01605-8.
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AbstractCorynebacterium (C.) diphtheriae is one of the two etiological pathogens for human diphtheria with significant morbidity and mortality. Recently, members of its biovar Belfanti have been described as two novel species, C. belfantii and C. rouxii. The most important virulence factor and also the premise to cause diphtheria is the isolate’s capacity to encode and express the diphtheria toxin (DT). In contrast to C. ulcerans, which represents a potentially zoonotic pathogen, C. diphtheriae (incl. the novel deduced species) has almost exclusively been found to comprise a human pathogen. We here report three rare cases of C. rouxii isolation from dogs suffering from disseminated poly-bacterial exsudative to purulent dermatitis and a traumatic labial defect, respectively. The isolates were identified as C. diphtheriae based on commercial biochemistry and matrix-assisted laser desorption/ionisation–time of flight mass spectrometry (MALDI-TOF MS) analysis. However, recently described specific spectral peaks were highly similar to spectra of C. rouxii, which was confirmed by whole genome sequencing. Further investigations of the dog isolates for the presence of DT by tox gene qPCR revealed negative results. The findings from this study point out that skin infections in companion animals can be colonized by uncommon and so believed human specific pathogens, thereby resembling the clinical signs of cutaneous diphtheria.
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Devanga Ragupathi, Naveen Kumar, Dhiviya Prabaa Muthuirulandi Sethuvel, Dhivya Murugan, Ranjini Ranjan, Vikas Gautam, Prashanth Gupta, Jaichand Johnson, et al. "Divergent evolution of Corynebacterium diphtheriae in India: An update from National Diphtheria Surveillance network." PLOS ONE 16, no. 12 (December 15, 2021): e0261435. http://dx.doi.org/10.1371/journal.pone.0261435.
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Diphtheria is caused by a toxigenic bacterium Corynebacterium diphtheria which is being an emerging pathogen in India. Since diphtheria morbidity and mortality continues to be high in the country, the present study aimed to study the molecular epidemiology of C. diphtheriae strains from India. A total of 441 diphtheria suspected specimens collected as part of the surveillance programme between 2015 and 2020 were studied. All the isolates were confirmed as C. diphtheriae with standard biochemical tests, ELEK’s test, and real-time PCR. Antimicrobial susceptibility testing for the subset of isolates showed intermediate susceptibility to penicillin and complete susceptible to erythromycin and cefotaxime. Isolates were characterized using multi locus sequence typing method. MLST analysis for the 216 C. diphtheriae isolates revealed major diversity among the sequence types. A total of 34 STs were assigned with majority of the isolates belonged to ST466 (30%). The second most common ST identified was ST405 that was present in 14% of the isolates. The international clone ST50 was also seen. The identified STs were grouped into 8 different clonal complexes (CC). The majority belongs to CC5 followed by CC466, CC574 and CC209, however a single non-toxigenic strain belongs to CC42. This epidemiological analysis revealed the emergence of novel STs and the clones with better dissemination properties. This study has also provided information on the circulating strains of C. diphtheriae among the different regions of India. The molecular data generated through surveillance system can be utilized for further actions in concern.
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Prygiel, Marta, Ewa Mosiej, Maciej Polak, Katarzyna Krysztopa-Grzybowska, Karol Wdowiak, Kamila Formińska, and Aleksandra A. Zasada. "Challenges of Diphtheria Toxin Detection." Toxins 16, no. 6 (May 26, 2024): 245. http://dx.doi.org/10.3390/toxins16060245.
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Diphtheria toxin (DT) is the main virulence factor of Corynebacterium diphtheriae, C. ulcerans and C. pseudotuberculosis. Moreover, new Corynebacterium species with the potential to produce diphtheria toxin have also been described. Therefore, the detection of the toxin is the most important test in the microbiological diagnosis of diphtheria and other corynebacteria infections. Since the first demonstration in 1888 that DT is a major virulence factor of C. diphtheriae, responsible for the systemic manifestation of the disease, various methods for DT detection have been developed, but the diagnostic usefulness of most of them has not been confirmed on a sufficiently large group of samples. Despite substantial progress in the science and diagnostics of infectious diseases, the Elek test is still the basic recommended diagnostic test for DT detection. The challenge here is the poor availability of an antitoxin and declining experience even in reference laboratories due to the low prevalence of diphtheria in developed countries. However, recent and very promising assays have been developed with the potential for use as rapid point-of-care testing (POCT), such as ICS and LFIA for toxin detection, LAMP for tox gene detection, and biosensors for both.
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Hamabata, Takashi, Mitsutoshi Senoh, Masaaki Iwaki, Ayae Nishiyama, Akihiko Yamamoto, and Keigo Shibayama. "Induction and Resuscitation of Viable but Nonculturable Corynebacterium diphtheriae." Microorganisms 9, no. 5 (April 26, 2021): 927. http://dx.doi.org/10.3390/microorganisms9050927.
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Many pathogenic bacteria, including Escherichia coli and Vibrio cholerae, can become viable but nonculturable (VBNC) following exposure to specific stress conditions. Corynebacterium diphtheriae, a known human pathogen causing diphtheria, has not previously been shown to enter the VBNC state. Here, we report that C. diphtheriae can become VBNC when exposed to low temperatures. Morphological differences in culturable and VBNC C. diphtheriae were examined using scanning electron microscopy. Culturable cells presented with a typical rod-shape, whereas VBNC cells showed a distorted shape with an expanded center. Cells could be transitioned from VBNC to culturable following treatment with catalase. This was further evaluated via RNA sequence-based transcriptomic analysis and reverse-transcription quantitative PCR of culturable, VBNC, and resuscitated VBNC cells following catalase treatment. As expected, many genes showed different behavior by resuscitation. The expression of both the diphtheria toxin and the repressor of diphtheria toxin genes remained largely unchanged under all four conditions (culturable, VBNC, VBNC after the addition of catalase, and resuscitated cells). This is the first study to demonstrate that C. diphtheriae can enter a VBNC state and that it can be rescued from this state via the addition of catalase. This study helps to expand our general understanding of VBNC, the pathogenicity of VBNC C. diphtheriae, and its environmental survival strategy.
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Hutauruk, Syahrial Marsinta, Fauziah Fardizza, and Sevi Aristya. "Tonsilitis difteri dengan sumbatan jalan napas atas." Oto Rhino Laryngologica Indonesiana 48, no. 1 (June 28, 2018): 95. http://dx.doi.org/10.32637/orli.v48i1.260.
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Latar belakang: Difteri adalah penyakit infeksi yang disebabkan oleh kuman bacillus grampositif Corynebacterium diphtheriae. Bakteri ini terutama menyebabkan infeksi pada saluran napasberupa tonsilofaringitis, laringitis, maupun keduanya secara bersamaan, ditandai dengan terbentuknyapseudomembran. Kematian pada anak dengan penyakit ini umumnya terjadi karena sumbatan jalannapas atas, ataupun efek sistemik toksin difteri. Tujuan: Melaporkan dan menganalisis kasus tonsilitisdifteri yang berakhir dengan kematian meskipun telah mendapat tatalaksana sumbatan jalan napas atas.Laporan kasus: Kasus anak perempuan usia 4 tahun, dan anak laki-laki usia 5 tahun dengan tonsilitisdifteri disertai sumbatan jalan napas atas. Metode: Telaah literatur berbasis bukti mengenai tonsilitisdifteri, komplikasi, dan status imunisasi melalui database Cochrane, Pubmed Medline, dan EBSCOHost Medline. Berdasarkan kriteria inklusi dan eksklusi didapatkan 3 jurnal yang relevan dengan kasusyang dilaporkan. Hasil: Studi tersebut menyatakan tonsilitis difteri sebagai penyakit dengan komplikasisumbatan jalan napas dan jantung. Komplikasi jantung adalah penyebab kematian tertinggi pada tonsilitisdifteri. Status imunisasi pada kasus meninggal sebagian besar tidak lengkap, dan cakupan imunisasi totalmasih rendah. Kesimpulan: Tonsilitis difteri merupakan kasus jarang dengan tingkat kematian tinggiakibat komplikasi sumbatan jalan napas dan jantung. Kematian dapat terjadi akibat efek sistemik toksindifteri, meskipun sumbatan jalan napas telah diatasi. Status imunisasi yang tidak lengkap dan rendahnyacakupan imunisasi pada wilayah tempat tinggal penderita meningkatkan mortalitas kasus tonsilitis difteri. Kata kunci: tonsilitis difteri, sumbatan jalan napas atas, imunisasi difteri, toksin sistemik ABSTRACTBackground: Diphtheria is an acute infectious disease caused by Corynebacterium diphtheriae, a gram-positive bacillus. The organism infects primarily the respiratory tract, where it causestonsillopharyngitis, laryngitis, or both, typically marked by the forming of pseudomembrane. In children,either the upper respiratory tract obstruction or the effects of diphtheria toxin are the most common causeof death. Purpose: To report and analyze tonsillitis diphtheria cases that ended up in fatality, althoughthe upper airway obstruction had been managed. Case report: Two cases of a 4-years girl and 5-yearsold boy with tonsillitis diphtheria with upper respiratory tract obstruction. Method: The evidence basedliterature regarding tonsillitis diphtheria, its complication and diphtheria immunization status wereconducted on Cochrane database, Pubmed Medline, and EBSCO Host Medline. Based on the inclusionand exclusion criteria, three studies were found relevant to our cases. Result: These studies stated thattonsillitis diphtheria is a disease with upper airway obstruction and cardiac complications. Cardiaccomplications are the leading cause of death. Immunization status in fatal cases was largely incompleteand total immunization coverage was still low. Conclusion: Tonsillitis diphtheria is a rare case with highmortality rate due to upper airway obstruction and cardiac complication. Systemic effect of diphtheriatoxin can lead to fatality although the airway obstruction had been managed. The incomplete immunizationstatus and the low immunization coverage increased the mortality of tonsillitis diphtheria. Keywords: tonsillitis diphtheria, upper airway obstruction, diphtheria immunization, systemic toxin
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MAHOMED, S., M. ARCHARY, P. MUTEVEDZI, Y. MAHABEER, P. GOVENDER, G. NTSHOE, W. KUHN, et al. "An isolated outbreak of diphtheria in South Africa, 2015." Epidemiology and Infection 145, no. 10 (May 8, 2017): 2100–2108. http://dx.doi.org/10.1017/s0950268817000851.
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SUMMARYAn outbreak of respiratory diphtheria occurred in two health districts in the province of KwaZulu-Natal in South Africa in 2015. A multidisciplinary outbreak response team was involved in the investigation and management of the outbreak. Fifteen cases of diphtheria were identified, with ages ranging from 4 to 41 years. Of the 12 cases that were under the age of 18 years, 9 (75%) were not fully immunized for diphtheria. The case fatality was 27%. Ninety-three household contacts, 981 school or work contacts and 595 healthcare worker contacts were identified and given prophylaxis against Corynebacterium diphtheriae infection. A targeted vaccination campaign for children aged 6–15 years was carried out at schools in the two districts. The outbreak highlighted the need to improve diphtheria vaccination coverage in the province and to investigate the feasibility of offering diphtheria vaccines to healthcare workers.
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Simonova, Maria A., Vyacheslav G. Melnikov, Olga E. Lakhtina, Ravilya L. Komaleva, Anja Berger, Andreas Sing, and Sergey K. Zavriev. "Determination of Diphtheria Toxin in Bacterial Cultures by Enzyme Immunoassay." Diagnostics 12, no. 9 (September 11, 2022): 2204. http://dx.doi.org/10.3390/diagnostics12092204.
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Since diphtheria toxin (DT) is the main virulence factor of Corynebacterium diphtheriae and C. ulcerans, the detection of DT in corynebacterial cultures is of utmost importance in the laboratory diagnosis of diphtheria. The need to measure the level of DT production (LTP) arises when studying the virulence of a strain for the purpose of diphtheria agent monitoring. To determine the LTP of diphtheria agents, an immunoassay based on monoclonal antibodies (mAbs) has been developed. A pair of mAbs specific to the fragment B of DT was selected, which makes it possible to detect DT in a sandwich ELISA with a detection limit of DT less than 1 ng/mL. Sandwich ELISA was used to analyze 218 liquid culture supernatants of high-, low- and non-toxigenic strains of various corynebacteria. It was shown that the results of ELISA are in good agreement with the results of PCR and the Elek test for the tox gene and DT detection, respectively. The diagnostic sensitivity of the assay was approximately 99%, and specificity was 100%. It has been found that strains of C. ulcerans, on average, produce 10 times less DT than C. diphtheriae. The mAbs used in the ELISA proved to be quite discriminatory and could be further used for the design of the LFIA, a method that can reduce the labor and cost of laboratory diagnosis of diphtheria.
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Vernanda, Elisa Pingky, Julia Afianti, Diana Claudya Gustafiani, and Tukiman Tukiman. "Efektivitas Sosialisasi Outbreak Response Immunization (ORI) Terhadap Pelajar di Desa Laweyan Kecamatan Sumberasih Kabupaten Probolinggo." Jurnal Administrasi Pemerintahan Desa 5, no. 1 (December 11, 2023): 11. http://dx.doi.org/10.47134/villages.v5i1.79.
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Diphtheria is a highly contagious disease, and is caused by the gram-positive bacteria Corynebacterium diphtheriae toxin strain. This disease is characterized by inflammation at the site of infection, especially the mucous membranes of the pharynx, larynx, tonsils, nose and also the skin. The number of diphtheria cases in East Java as of March 2023 is 51 cases spread across 26 districts/cities with a total of 4 deaths. DPT immunization in Indonesia began in 1976 and was given 3 times, namely to babies aged 2, 3 and 4 months. Furthermore, DPT immunization was included in the School Children's Immunization Month (BIAS) program in 1984 with the aim of further increasing protection against diphtheria. The method used is socialization. Socialization was carried out through the delivery of material related to the meaning of diphtheria, symptoms of contracting diphtheria, solutions for preventing diphtheria, as well as breaking the chain of diphtheria spread through Outbreak Response Immunization (ORI). The service carried out in the form of socialization aims to increase knowledge and break the chain of diphtheria spread. The research method used in the success of this service activity is descriptive qualitative using four theories of effectiveness, namely: target accuracy, program socialization, achievement of program objectives, and program monitoring. This activity shows an increase in the knowledge of elementary school students in Laweyan regarding knowledge and prevention of diphtheria disease.
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Mustika, Diva Arum, Rani Nooraeni, and Indonesian Journal of Statistics and Its Applications IJSA. "KAJIAN EFEK SPASIAL KASUS DIFTERI DENGAN GEOGRAPHICALLY WEIGHTED NEGATIVE BINOMIAL REGRESSION (GWNBR)." Indonesian Journal of Statistics and Its Applications 3, no. 1 (February 28, 2019): 91–104. http://dx.doi.org/10.29244/ijsa.v3i1.185.
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Diphtheria is an infectious disease caused by the Corynebacterium diphtheriae bacteria. Indonesia is the country with the most cases of diphtheria in Southeast Asia and ranks third in the world. In 2016, cases of diphtheria increased by 65 percent and became Extraordinary Events (KLB) in Indonesia, even though during 2013 to 2015 the number of cases of diphtheria has decreased. The province that has the highest number of diphtheria cases in Indonesia in 2016 is East Java. Diphtheria is centered and spread in certain districts / cities in East Java Province so that there are indications of spatial effects in the spread of diphtheria. Because data on the number of diphtheria cases overdispersed and indicated spatial effects in its spread, the main method used in this study was Geographically Weighted Negative Binomial Regression (GWNBR). This method will be compared with other alternative methods namely Poisson regression method and Negative Binomial Regression to get the best modeling. Based on the AIC value of each model it can be concluded that the best method for modeling the number of diphtheria cases is GWNBR. The modeling results with GWNBR show that there is indeed a spatial influence on the number of diphtheria cases and risk factors in East Java Province in 2016. The percentage of DPT-HB3 / DPT-HB-Hib3 immunization coverage is not significant in all observation areas, while the percentage of drug and vaccine availability is significant at entire observation area.
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Fajriyah, Ishmatul. "The Relationship Between Knowledge of Mother and Family Support with Immunization Status Td in Sub PIN Difteri." Jurnal Berkala Epidemiologi 2, no. 3 (September 1, 2014): 404. http://dx.doi.org/10.20473/jbe.v2i3.2014.404-415.
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ABSTRACTThe number cases of diphtheria in East Java have increased more years. Surabaya is one of cities that implemented the Sub Pekan Imunisasi Nasional (PIN) Diphtheria. Sub PIN Diphtheria is a program that aims to break the chain of diphtheria transmission. Children aged > 7–15 years are one of the program’s targets Sub PIN Diphtheria. Sub PIN coverage for groups of children aged > 7–15 years in Kalijudan Public Health Center (PHC) only 79.15%, while the predetermined minimum target is 95%. This study was conducted to determine the relationship between knowledge and support from family with immunization status Td in Sub PIN diphtheriae. The research used case kontrol design by using a quantitative approach. The population case is all children aged > 7–15 years in Kalijudan PHC the immunization status Td in Sub PIN program is incomplete. Number of respondents by 60 people. The selection of the sample with simple random sampling. The variabels studied were the characteristics, knowledge, and family support. The results showed that there is a relationship between the level of knowledge of mothers (p = 0.038). There is a relationship between support from family with immunization status Td in sub PIN diphtheria (p = 0.030). It is expected that cross-sector cooperation in the implementation of sub PIN diphtheria and increase knowledge related maternal sub PIN diphtheria and diphtheria by counseling.Keywords: family support, immunization, knowledge, Sub PIN diphtheria
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Fajriyah, Ishmatul. "The Relationship Between Knowledge of Mother and Family Support with Immunization Status Td in Sub PIN Difteri." Jurnal Berkala Epidemiologi 2, no. 3 (September 1, 2014): 404. http://dx.doi.org/10.20473/jbe.v2i32014.404-415.
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ABSTRACTThe number cases of diphtheria in East Java have increased more years. Surabaya is one of cities that implemented the Sub Pekan Imunisasi Nasional (PIN) Diphtheria. Sub PIN Diphtheria is a program that aims to break the chain of diphtheria transmission. Children aged > 7–15 years are one of the program’s targets Sub PIN Diphtheria. Sub PIN coverage for groups of children aged > 7–15 years in Kalijudan Public Health Center (PHC) only 79.15%, while the predetermined minimum target is 95%. This study was conducted to determine the relationship between knowledge and support from family with immunization status Td in Sub PIN diphtheriae. The research used case kontrol design by using a quantitative approach. The population case is all children aged > 7–15 years in Kalijudan PHC the immunization status Td in Sub PIN program is incomplete. Number of respondents by 60 people. The selection of the sample with simple random sampling. The variabels studied were the characteristics, knowledge, and family support. The results showed that there is a relationship between the level of knowledge of mothers (p = 0.038). There is a relationship between support from family with immunization status Td in sub PIN diphtheria (p = 0.030). It is expected that cross-sector cooperation in the implementation of sub PIN diphtheria and increase knowledge related maternal sub PIN diphtheria and diphtheria by counseling.Keywords: family support, immunization, knowledge, Sub PIN diphtheria
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Sutton-Fitzpatrick, Una, Conor Grant, Dimitar Nashev, and Catherine Fleming. "Corynebacterium diphtheriae bloodstream infection: the role of antitoxin." BMJ Case Reports 12, no. 11 (November 2019): e231914. http://dx.doi.org/10.1136/bcr-2019-231914.
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A 65-year-old male patient presented with fever, fast atrial fibrillation and frank haematuria on return to Ireland from travel in East Africa. He had a systolic murmur leading to a clinical suspicion of endocarditis. He had no specific clinical features of diphtheria. Blood cultures were taken and empiric therapy commenced with benzylpenicillin, vancomycin and gentamicin. Corynebacterium diphtheriae was detected on blood culture. The isolate was submitted to a reference laboratory for evaluation of toxigenicity. While initially there was concern regarding the possibility of myocarditis, a clinical decision was made not to administer diphtheria antitoxin in the absence of clinical features of respiratory diphtheria, in the presence of invasive infection and with presumptive previous immunisation. There is no specific guidance on the role of antitoxin in this setting. The issue is not generally addressed in previous reports of C. diphtheriae blood stream infection.
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He, Qing, Yejian Wu, Shuiping Hou, Lei Luo, and Zhoubin Zhang. "Seroprevalence of Diphtheria and Tetanus Immunoglobulin G among the General Health Population in Guangzhou, China." Vaccines 12, no. 4 (April 4, 2024): 381. http://dx.doi.org/10.3390/vaccines12040381.
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A seroepidemiological study was conducted in 2018 to assess diphtheria and tetanus antibodies in Guangzhou, China. Diphtheria and tetanus antibody concentrations were measured with an enzyme-linked immunosorbent assay. A total of 715 subjects were enrolled in the study. The overall diphtheria and tetanus toxoid IgG-specific antibody levels were 0.126 IU/mL (95% CI: 0.115, 0.137) and 0.210 IU/mL (95% CI: 0.185, 0.240), respectively; the overall positivity rate was 61.82% (95% CI: 58.14, 65.39) and 71.61% (95% CI: 68.3, 74.92), respectively. The diphtheria and tetanus antibody concentration was decreased by age and increased by doses. The geometric mean concentrations and positivity rate of diphtheria and tetanus antibodies were lowest and below the essential protection level in people over 14 years of age. Compared to children and adolescents, middle-aged people and the aged are at much higher risk of infection with Corynebacterium diphtheriae and Clostridium tetani. The current diphtheria and tetanus immunization schedule does not provide persistent protection after childhood. There is an urgent need to adjust the current immunization schedule.
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Egbune, Ngozika J., Eloho B. Akponana, Eirene O. Arierhie, and Akindele M. Okedoye. "Mathematical Analysis of Spread and Control of Diphtheria with Emphasis on Diphtheria Antitoxin Efficiency." European Journal of Theoretical and Applied Sciences 2, no. 3 (May 1, 2024): 152–72. http://dx.doi.org/10.59324/ejtas.2024.2(3).14.
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Diphtheria, a bacterial infection caused by Corynebacterium diphtheriae, remains a significant public health concern worldwide. In this study, we employ mathematical modeling to analyze the spread and control of diphtheria, focusing on the efficacy of Diphtheria Antitoxin in mitigating the disease's impact. Through the development of compartmental models, system of differential equations governing the dynamics was formulated. Due to the complexity and non-linearity of the dynamics, a numerical solutions that utilizes Runge-Kutta Fehlberg order 4 and 5 method. The dynamics of diphtheria transmission and the potential impact of DAT administration on disease outcomes was investigate. Our findings highlight the critical role of Antitoxin efficiency in reducing disease burden, preventing severe cases, and containing epidemic spread. By exploring various scenarios and parameter sensitivities, we provide insights into optimal control strategies and intervention measures to combat diphtheria outbreaks effectively. This research contributes to a better understanding of diphtheria epidemiology and informs public health policies aimed at enhancing vaccination coverage and DAT availability to achieve sustainable disease control and prevention.
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Borisova, O. Yu, N. T. Gadua, A. S. Pimenova, A. P. Shepelin, L. V. Domotenko, A. Yu Mironov, S. S. Afanasiev, M. S. Afanasiev, and V. A. Aleshkin. "Comparative tests of quality of bacteriological investigation with Corynebacterium diphtheriae isolation." Russian Clinical Laboratory Diagnostics 66, no. 8 (August 13, 2021): 509–12. http://dx.doi.org/10.51620/0869-2084-2021-66-8-509-512.
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The results of comparative experimental studies of identification of nontoxigenic C. diphtheriae strain by three different commercial laboratories are presented. A typical nontoxigenic strain of C. diphtheriae biovar mitis was used. For the studies, three lines of ten-fold dilutions of bacterial culture were prepared, followed by control planting on the medium and counting CFU/ml. In the experiment, tampons were pooled with a 24-hour bacterial culture of a nontoxigenic C. diphtheriae strain. Tampons were provided from three different laboratories - ∑-Transwab® with Ames liquid medium (from the first and second laboratories) and a viscose tampon with coal medium (from the third laboratory). After pooled, tampons were delivered to commercial laboratories. And as a result of the experiment, Corynebacterium spp. was identified in first laboratory (103 CFU/tamp), S. epidermidis (102 CFU/ml) - in second laboratory and nontoxigenic C. diphtheriae biovar gravis - in third laboratory. The study indicates that there is a need to the supervision of bacteriological investigations conducted in various laboratories. This will improve the quality of investigations on diphtheria infection and identify of diphtheria carrier, which is a reservoir of the causative agent of diphtheria, and will contribute to the maintenance of sanitary and epidemiological well-being in our country.
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Nastiti, Hilari Rio Rosa, and Rachmad Bayu Kuncara. "Desain Primer untuk Deteksi Gen Diphtheria Toxin Repressor (dtxR) sebagai Biomarker Bakteri Corynebacterium diphtheriae Menggunakan In Silico PCR." Jaringan Laboratorium Medis 5, no. 2 (November 1, 2023): 136–43. http://dx.doi.org/10.31983/jlm.v5i2.10588.
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Corynebacterium diphtheriae is the bacteria that causes diphtheria. The virulence factor of C. diphtheriae comes from the bacteria's ability to produce bacterial toxins. Toxin production is regulated by a set of genes called tox/dtx genes and is regulated by the dtxR gene. The aim of this study was to design primers used to evaluate the dtxR gene using bacterial DNA sequences. This research is experimental research with a literature study approach using the In silico Polymerase Chain Reaction (PCR), NCBI (National Center for Biotechnology Information), Primer3Plus, and Oligo Calculator applications. The sample obtained from genbank NCBI was C. diphtheriae dtxR gene M80337.1. In silico PCR examination was carried out using newly designed primers from Primer3Plus with 50 genomic DNA of Corynebacterium spp. taken from the In silico PCR database. The dtxR primer pair: '5-ACAGTTAGCCAAACCGTTGC-3' and 5'-TGCGTTCAACTTCGTCACTC-3' can produce a single DNA amplicon measuring 226 bp specifically for C. diphtheria types and no amplicon bands were generated from other Corynebacterium genomes. Based on the study results, this pair of specific primers can be used for in vitro PCR testing and can be used to develop rapid detection of diphtheria.
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Annamalai, Medeshni. "Diphtheria and the respiratory system: Lessons from 2015 Outbreak." South African Respiratory Journal 22, no. 2 (July 1, 2016): 38. http://dx.doi.org/10.7196/sarj.2016.v22i2.75.
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<p> </p><p align="left">South Africa experienced a diphtheria outbreak in KwaZulu-Natal Province between March and August 2015. Diphtheria is a contagious and potentially life-threatening bacterial disease caused by the toxigenic strains of <em><span style="font-family: MinionPro-It; font-size: xx-small;">Corynebacterium diphtheriae.</span></em> </p>
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K. R., Sachin, Ramesh H., Sachin K. G., and Siddharth E. S. "The outcome of resurgence of diphtheria in older children in a tertiary care hospital." International Journal of Contemporary Pediatrics 6, no. 2 (February 23, 2019): 607. http://dx.doi.org/10.18203/2349-3291.ijcp20190696.
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Background: Diphtheria is a fatal bacterial infection which affects the mucous membranes of oropharyngeal and nasal cavity, caused by aerobic gram-positive bacteria Corynebacterium diphtheriae. With the advent of universal immunization against diphtheria the incidence of this infectious disease has declined dramatically with few developed nations having eradicated the disease. No large outbreaks have been reported in India in recent times.Methods: In present study, authors reviewed an outbreak of diphtheria in Davangere between the months of June 2017 and July 2018. Case records of children suspected to have diphtheria, admitted to hospitals affiliated to JJM Medical College, Davangere were retrospectively analysed.Results: 15 cases were suspected to have diphtheria on clinical examination. The mean age of presentation was 7.5 years. Fever, sore throat, difficulty in swallowing, neck swelling and patch in oral cavity were the common signs and symptoms. Airway compromise, myocarditis and neurological complications were noted. Antidiphtheritic serum (ADS) was tried in all 15 cases. Case fatality rate was 40%.Conclusions: Diphtheria is a resurgent problem in India. Prompt identification and early appropriate treatment is essential to prevent morbidity and mortality. Strict adherence to the national immunisation schedule should also be emphasized.
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Wijayanti, Siwi Pramatama Mars, and Alfianti Nur Fadillah. "EPIDEMIOLOGY OF DIPHTERIA IN PURWAKARTA REGENCY INDONESIA." Epidemiology and Society Health Review (ESHR) 1, no. 1 (September 9, 2019): 9. http://dx.doi.org/10.26555/eshr.v1i1.935.
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Background: Diphtheria is considered as a neglected disease since it was successfully eliminated in many countries. However, there were several sporadic re-emergence cases of Diphtheria and the peak was outbreak in Indonesia in 2017. This research was a descriptive study aimed to explore epidemiology of diphtheria by person, time and place in one of diphtheria endemic area.Methods: This was a descriptive study with cross sectional design in Purwakarta Regency, West Java, Indonesia in 2018. Several data were collected in this study such as diphtheria cases by age, time of occurrence, gender, place and immunization status. The data was collected from Purwakarta Health Office. It was the data from the year of 2015-2017. The data was analysed by using descriptive analysis with percentages displayed in graphs and tables.Results: This study reveals that Purwakarta regency is an endemic area of diphtheria with fluctuated cases since 2015-2017. More cases of diphtheria occurred from September to December in rainy season. More cases suffered by children in 5-9 years old, however, this disease also infected adult population. The area with high diphtheria cases in this study also areas with high population densities which is conducive for C diphteriae transmission. Low coverage of immunization is highlighted in the result of this study, which could explain why diphtheria cases occurred continuously in this area.Conclusions: High number of diphtherias in this area should be an awareness for local health officer to do an effective preventive effort such as increasing the coverage of vaccination. Furthermore, optimizing the role of religious and community leader should be made to support diphtheria vaccination programs.
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Johnson, Shessy, and Resmi C.R. "Diphtheria." Community and Public Health Nursing 1, no. 2 (2016): 155–58. http://dx.doi.org/10.21088/cphn.2455.8621.1216.15.
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Ningsih, Retno. "Epidemiological Investigation of Diphtheria Extraordinary Events (KLB) In Gili Ketapang Village, Probolinggo Regency In 2022." Asian Journal of Healthy and Science 2, no. 12 (December 26, 2023): 912–26. http://dx.doi.org/10.58631/ajhs.v2i12.23.
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Diphtheria infection is caused by a toxigenic strain of Corynebacterium diphtheriae with humans as the only reservoir. Diphtheria attacks children under 10 years old and is highly contagious, especially in susceptible populations. Diphtheria can cause an outbreak although it can be prevented by immunization. In 2022, 3 cases of diphtheria were reported in Gili Ketapang Village, Probolinggo Regency. Objective: to describe the epidemiology of the outbreak and identify the risk factors for countermeasures. Methods: This research is a descriptive study with an outbreak investigation report design. Results: There were 3 cases of diphtheria within 7 months (February-August 2022) in Gili Ketapang Village with a CFR of 100% and the highest attack rate in the toddler age group (0-4 years) of 0.5%. There were 2 positive contacts (close contacts of 2nd Case) who were asymptomatic. Transmission is strongly suspected to be caused by the carrier. The identified risk factors were low IDL coverage, limited health facilities and availability of ADS, sociodemographic conditions, and population mobility at risk of diphtheria transmission. The problems found were the absence of PMO in providing prophylaxis and ORI coverage was still low and incomplete. Conclusions and suggestions: The diphtheria outbreak in Gili Ketapang Village has been confirmed by the laboratory test. The increase in the incidence and mortality from diphtheria is caused by multi factors. The government's role in increasing immunization coverage, early warning through active case finding surveillance, monitoring, and evaluation of obstacles in prevention is urgently needed.
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Pracoyo, Noer Endah. "FAKTOR PENYEBAB TERJADINYA KEJADIAN LUAR BIASA (KLB) DIFTERI PADA ANAK DI INDONESIA." JURNAL EKOLOGI KESEHATAN 19, no. 3 (December 31, 2020): 184–95. http://dx.doi.org/10.22435/jek.v19i3.4018.
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ABSTRACT
The diphtheria is pathogen re-emerging diseases caused by Corynebacterium diphtheriae. In 1920 that were pandemic outbreak that caused of the death a thousand of children and there still was found fluctuated cases until 2018. The diphtheria could be prevented by immunization but still to be causing disease as an outbreak (KLB). The article is a review of several articles that aim to analyze the factors causing diphtheria in Indonesia. The number of selected articles were 25 with diphtheria incidence variables and risk factors for diphtheria causes. The result shown that the risk factors which was caused of the diphtheria outbreak i.e; children not to get immunization properly, incomplete basic immunization in children under 5 years old, the lack of parents knowledge about the importance of vaccinations in children and and environmental conditions that are less hygiene sanitation in residential areas. From the results was concluded that immunization is very important in the prevention of diphtheria Education is needed to public about the importance of vaccination, and the importance of maintaining healthy environment.
Keywords: Diphtheria, immunization, outbreaks
ABSTRAK
Difteri adalah penyakit pathogen re-emerging yang disebabkan oleh Corynebacterium diphtheriae. Pada tahun 1920 terjadi pandemic yang menyebabkan kematian pada ribuan anak-anak dan sampai dengan tahun 2018 masih ditemukan kasus yang berfluktuatif. Penyakit difteri ini dapat dicegah dengan imunisasi namun masih dapat menyebabkan Kejadian Luar Biasa (KLB). Artikel ini merupakan review dari penelusuran beberapa artikel yang bertujuan untuk melakukan analisis faktor penyebab kejadian difteri di Indonesia. Jumlah artikel terpilih sebanyak 25 artikrl dengan variabel kejadian difteri dan faktor risiko penyebab difteri. Hasil analisa menunjukkan bahwa beberapa faktor risiko yang dapat menimbulkan kejadian difteri antara lain pada anak-anak yang tidak mendapatkan imunisasi, pemberian imunisasi dasar pada anak di bawah lima tahun yang tidak lengkap, kurangnya pengetahuan orang tua tentang pentingnya melakukan imunisasi dan kondisi lingkungan tempat tinggal yang kurang bersih pada pemukiman padat penduduk. Dari hasil tersebut dapat disimpulkan bahwa pemberian imunisasi merupakan hal yang sangat penting dalam pencegahan penyakit difteri. Diperlukan edukasi pada masyarakat tentang pentingnya vaksinasi dan pentingnya menjaga kebersihan lingkungan.
Kata kunci: Difteri, imunisasi, Kejadian Luar Biasa (KLB)
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Kharseeva, G. G., S. Yu Tyukavkina, and A. Yu Mironov. "Diphtheria: characteristics of the pathogen and laboratory diagnostics (lecture)." Russian Clinical Laboratory Diagnostics 65, no. 11 (December 4, 2020): 699–706. http://dx.doi.org/10.18821/0869-2084-2020-65-11-699-706.
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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.
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Pipaliya, Binda, Pranay Shah, M. M. Vegad, Sumeeta Soni, Anokhi Goswami, and Khusbhu Vagadiya. "A study of cases of Diphtheria diagnosed at Civil Hospital, Ahmedabad, India." Journal of Medical Research and Innovation 2, S1 (November 3, 2018): e000156. http://dx.doi.org/10.32892/jmri.156.
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Aims and Objectives: Most of the vaccine preventable diseases have shown a decline with advent of National immunization schedule but Diphtheria is still present in some region of India. The purpose of this study is to diagnose cases of Diphtheria.
Methods and Materials: This study was performed during August- 2017 to October- 2017 at Bacteriology Laboratory of Microbiology Department, Civil Hospital, Ahmedabad. Two throat swab received from each suspected patient with detailed clinical and immunization history. One swab was inoculated in selective and enrichment culture media while another was used for microscopic examination for isolation of Corynebacterium diphtheria.
Results: Out of total 118 samples, Corynebacterium diphtheriae was isolated in 35 samples. Among 35 cases, 16 patients belong to under 5 yr, while 19 belonged to 6-20 yr of age group.
Conclusion: The majority of cases are reported from children who were non- immunized or partially immunized against Diphtheria. Persistance or resurgence of Diphtheria is mainly due to low coverage of primary immunization as well as booster doses and inaccessible areas. Targeted immunization coverage is required specifically in inaccessible areas.
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Mangion, J. P., S. Mancini, C. Bachy, A. de Weggheleire, and F. Zamatto. "Diphtheria in Europe." Public Health Action 13, no. 2 (June 21, 2023): 31–33. http://dx.doi.org/10.5588/pha.23.0011.
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A rising number of diphtheria cases were recorded in Europe in 2022, including in Belgium, within the newly arriving young migrant population. In October 2022, Médecins Sans Frontières (MSF) opened a temporary roadside container-clinic offering free medical consultations. Over 3 months of activity, the temporary clinic detected 147 suspected cases of cutaneous diphtheria with 8 laboratory-confirmed cases growing toxigenic Corynebacterium diphtheriae. This was followed by a mobile vaccination campaign, during which 433 individuals living rough in squats and informal shelters were vaccinated. This intervention has shown how even in Europe’s capital, access to preventive and curative medical services remains difficult for those who need it the most. Appropriate access to health services, including routine vaccination, are crucial to improve the health status among migrants.
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Sari, Nofita. "EPIDEMIOLOGICAL INVESTIGATION DIPTHERIA CASES IN KEDIRI DISTRICT IN 2022." Jurnal Wiyata: Penelitian Sains dan Kesehatan 10, no. 1 (June 15, 2023): 82. http://dx.doi.org/10.56710/wiyata.v10i1.714.
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Background: Diphtheria is a type of infectious disease that can be prevented by immunization. The cause of diphtheria is the toxigenic strain of Corynebacterium diphtheriae. East Java is the province with the most diphtheria cases in Indonesia. The number of diphtheria cases in East Java increased in 2018 by 695 cases. In 2019 diphtheria cases decreased to 358 cases, in 2020 to 94 cases, and in 2021 by 45 cases. Objective: Knowing the number of diphtheria cases and their prevention. Method: descriptive qualitative research with a case study approach. The definition of a case is a person with symptoms of fever, sore throat, swelling in the neck, and pseudomembranes. Data collection was conducted in five villages, namely Keling Village, Kanigoro Village, Kras Village, Jemekan Village, and Bogem Village in the period from October to November 2022. Results: Clinical symptoms, 100% or all five patients experienced symptoms of fever and sore throat as initial symptoms. Four patients had a fever as the initial symptom, and one started with a sore throat. 40% of patients had symptoms of neck swelling and shortness of breath. The five patients were also found to have pseudomembranes. Conclusion: There were 5 diphtheria suspects found in Kediri District in 2022. The clinical symptoms experienced by the five patients were fever, sore throat, neck swelling, shortness of breath, and pseudomembranes.
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Revenko, G. O., I. V. Budayeva, and V. V. Mavrutenkov. "SEROLOGICAL MONITORING OF POPULATION ANTITOXIC ANTI-DIPHTHERIA IMMUNITY IN RESIDENTS OF DNIPROPETROVSK REGION." Клінічна та профілактична медицина 4, no. 9-10 (October 17, 2019): 128–33. http://dx.doi.org/10.31612/2616-4868.4(10).2019.07.
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The goal of the work – to present the analysis of epidemiological monitoring of anti-diphtheria protection of the population of Dnepropetrovsk region, to show the generalizing epidemiological situation of diphtheria, to substantiate the need for the development of tools to improve vaccination and to prove the feasibility of regular epidemiology.
Material and methods. Epidemiological analysis of anti-diphtheria immunity (2016-2017) was performed on the basis of the results of the enzyme-linked immunosorbent assay of antibody-IgG against diphtheria toxin (RIDASCREEN Diphtherie IgG (Germany)) in 185 residents of the age from 1 year to 60 years, from them 166 people were included into representative group.
Results. An analysis of the results revealed that only 34.05% (n =63) of the population have antitoxic antibody titers of 1.0 IU/ml or more, providing these residents with adequate protection against diphtheria in the next 5-7 years of life. , most of the population (65.95%) requires immediate single booster vaccination (n=91; 49.19%) or immediate baseline vaccination (n=31; 16.76%). Overall, the results suggest that if diphtheria may occur in country: the disease is likely to be epidemiological or epidemic in nature, as 66% (n=122) of the population do not have sufficient immunological anti-diphtheria protection and require immediate baseline or booster vaccination; children under 15 years of age and adults over 27 will be the most vulnerable to diphtheria.
Conclusions. There are the need to develop strategic measures for mass vaccination of the population (children and adults) against diphtheria, mechanisms for government control over the effectiveness of vaccination, mechanisms of civil or legal liability for voluntary refusal of vaccination without medical indications. It is appropriate and necessary to conduct regular epidemiological monitoring of the intensity of post-vaccination protection of the population against vaccine-preventable infections, in general, including diphtheria.
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Nurhana, Inas Dafa, and Abadi Abadi. "ANALISIS KESTABILAN MODEL SVIQR PADA PENYEBARAN PENYAKIT DIFTERI DENGAN PENGARUH VAKSINASI DAN KARANTINA." MATHunesa: Jurnal Ilmiah Matematika 11, no. 2 (August 31, 2023): 265–73. http://dx.doi.org/10.26740/mathunesa.v11n2.p265-273.
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Diphtheria is an acute disease caused by bacteria (Corynebacterium Diphtheriae). This disease is transmitted through the air and droplets (very small drops of fluid) from infected individuals. Vaccination can be carried out as a preventive measure so as not to be infected with bacteria (Corynebacterium Diphtheriae) and quarantine is carried out as a healing process because this disease is one type of disease included in the hospital-based STP (Integrated Disease Surveillance) data source. This study aims to compile and analyze a model of the spread of diphtheria using the SVIQR model. This model contains five subpopulations, namely susceptible (S), infected (I), cured (R), quarantined (Q) and vaccinated (V). Then determine the numerical simulation by estimating the parameters. From the results of numerical simulations of the mathematical model of diphtheria transmission under the influence of vaccination and quarantine, it shows that by selecting the vaccination fade rate parameter, =0.3795491181<1, which means that the disease-free equilibrium point is stable. The asymptotically stable endemic equilibrium point obtained is =1.207495030>1. The smaller the value of the vaccination fading rate parameter ε, the more asymptotically stable the disease-free point means that the spread of disease or endemic disease can be prevented if the vaccine given does not fade easily.
Keywords: Stability Analysis, Mathematical Models, Diphtheria, Quarantine, Vaccination.
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Amalia, Putri, and Syamsuddin Toaha. "Optimal Control of Mathematical Model of Diphtheria Spreading." Daya Matematis: Jurnal Inovasi Pendidikan Matematika 10, no. 2 (June 24, 2022): 138. http://dx.doi.org/10.26858/jdm.v10i2.35776.
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This article examines optimal control model for the spread of diphtheria disease. Diphtheria is an infectious disease caused by the bacterium Corynebacterium diphtheriae. This model is divided into six compartments, namely population of susceptibles (𝑆), population of latent (L), population of infected with symptoms (Is), population of infected without symptoms (Ia), population of recovered with full immunity (Rf) and population of recovered with partial immunity (Rp). Two optimal controls are applied in the model, namely vaccination and treatment. The problem of optimal control is solved by using Pontryagin's minimal principle, which consists in solving a set of necessary conditions that must be satisfied by the optimal control and its associated state. The numerical method used to solve the optimal control problem is the forward-backward sweep method. Based on the results of numerical simulations, both controls should be administered in large numbers and continuously since the beginning of observation in order to reduce the number of diphtheria infected population and to control the spread of diphtheria.
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Avinash, Srikakulapu, Tessa Antony, Lakshmanan Somu, and Shiny Queensty Selvin Gnanadas. "Diphtheritic tonsillitis in an immunized adult: A case report." Sri Ramachandra Journal of Health Sciences 3 (September 2, 2023): 25–27. http://dx.doi.org/10.25259/srjhs_7_2023.
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Corynebacterium diphtheriae is a Gram-positive bacillus which can be either toxigenic or non-toxigenic depending on the production of the diphtheria exotoxin. Diphtheria is a potentially fatal infectious disease caused by toxigenic strains of C. diphtheriae. Despite the national immunization program, India accounts for approximately 20% of the total cases according to the recent World Health Organization reports. Even though it is a vaccine preventable disease, cases are being reported, which may be due to lack of booster doses or waning of immunity with increasing age. Here, we report a case of diphtheritic tonsillitis in a 30-year-old immunized adult who came to the otorhinolaryngology outpatient department with acute onset of throat pain and difficulty in swallowing. C. diphtheriae was isolated from bacteriological culture of throat swab. The patient was symptomatically better with 2 weeks of treatment with oral erythromycin 500 mg twice a day.