Contributing members of the Diphtheria Surveillance Network included: S. Dauksiene (Lithuania), I. Donchenko (Estonia), A. Pangalis (Greece), J. Kremastinou (Greece), S. Cotter (Ireland) and C. Rota (Italy).
Screening for Corynebacterium diphtheriae and Corynebacterium ulcerans in patients with upper respiratory tract infections 2007–2008: a multicentre European study
Article first published online: 19 MAY 2010
© 2010 The Authors. Journal Compilation © 2010 European Society of Clinical Microbiology and Infectious Diseases
Clinical Microbiology and Infection
Volume 17, Issue 4, pages 519–525, April 2011
How to Cite
Wagner, K. S., White, J. M., Neal, S., Crowcroft, N. S., Kuprevičiene, N., Paberza, R., Lucenko, I., Jõks, U., Akbaş, E., Alexandrou-Athanassoulis, H., Detcheva, A., Vuopio, J., von Hunolstein, C., Murphy, P. G., Andrews, N., Members of the Diphtheria Surveillance Network (DIPNET) and Efstratiou, A. (2011), Screening for Corynebacterium diphtheriae and Corynebacterium ulcerans in patients with upper respiratory tract infections 2007–2008: a multicentre European study. Clinical Microbiology and Infection, 17: 519–525. doi: 10.1111/j.1469-0691.2010.03269.x
- Issue published online: 17 MAR 2011
- Article first published online: 19 MAY 2010
- Original Submission: 31 January 2010; Revised Submission: 27 April 2010; Accepted: 9 May 2010 Editor: S. Cutler Article published online: 19 May 2010
Clin Microbiol Infect 2011; 17: 519–525
Diphtheria is now rare in most European countries but, when cases do arise, the case fatality rate is high (5–10%). Because few countries continue to routinely screen for the causative organisms of diphtheria, the extent to which they are circulating amongst different European populations is largely unknown. During 2007–2008, ten European countries each screened between 968 and 8551 throat swabs from patients with upper respiratory tract infections. Six toxigenic strains of Corynebacterium diphtheriae were identified: two from symptomatic patients in Latvia (the country with the highest reported incidence of diphtheria in the European Union) and four from Lithuania (two cases, two carriers); the last reported case of diphtheria in Lithuania was in 2002. Carriage rates of non-toxigenic organisms ranged from 0 (Bulgaria, Finland, Greece, Ireland, Italy) to 4.0 per 1000 (95% CI 2.0–7.1) in Turkey. A total of 28 non-toxigenic strains were identified during the study (26 C. diphtheriae, one Corynebacterium ulcerans, one Corynebacterium pseudotuberculosis). The non-toxigenic C. ulcerans strain was isolated from the UK, the country with the highest reported incidence of cases due to C. ulcerans. Of the eleven ribotypes detected, Cluj was seen most frequently in the non-toxigenic isolates and, amongst toxigenic isolates, the major epidemic clone, Sankt-Petersburg, is still in circulation. Isolation of toxigenic C. diphtheriae and non-toxigenic C. diphtheriae and C. ulcerans in highly-vaccinated populations highlights the need to maintain microbiological surveillance, laboratory expertise and an awareness of these organisms amongst public health specialists, microbiologists and clinicians.