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  1. Molecular characterization of Corynebacterium diphtheriae isolates in Malaysia between 1981 and 2016
    Mohd Khalid MKN, Ahmad N, Hii SYF, Abd Wahab MA, Hashim R, Liow YL
    J Med Microbiol, 2019 Jan;68(1):105-110.
    PMID: 30465638 DOI: 10.1099/jmm.0.000881
    Sporadic diphtheria cases in Malaysia have remained low in number since the 1990s. However, in 2016 a total of 31 cases were reported nationwide and to investigate this we performed molecular characterization of 30 Corynebacterium diphtheriae isolates collected from 1981 to 2016 using multilocus sequence typing (MLST). C. diphtheriae isolates were identified and biotyped using the API Coryne kit, while the toxigenicity was determined by PCR and the Elek test. All of the 2016 isolates belonged to biotype mitis, caused respiratory diphtheria and were toxigenic strains. MLST analysis identified 17 sequence types (STs), including 11 new ones. ST453 was the most common clone (7/30, 23.3 %), followed by ST141 (5/30, 16.7 %), ST451 (3/30, 10.0 %) and ST248 (2/30, 6.7 %). The clones identified in 2016 had not been detected in previous isolations and they were phylogenetically distinct. Our results suggest that the diphtheria cases in 2016 were caused by the emergence and spread of new clones in Malaysia.
  2. Fulltext A SNP-based phylogenetic analysis of Corynebacterium diphtheriae in Malaysia
    Hii SYF, Ahmad N, Hashim R, Liow YL, Abd Wahab MA, Mohd Khalid MKN
    BMC Res Notes, 2018 Oct 25;11(1):760.
    PMID: 30359301 DOI: 10.1186/s13104-018-3868-6
    OBJECTIVE: There is a lack of study in Corynebacterium diphtheriae isolates in Malaysia. The alarming surge of cases in year 2016 lead us to evaluate the local clinical C. diphtheriae strains in Malaysia. We conducted single nucleotide polymorphism phylogenetic analysis on the core and pan-genome as well as toxin and diphtheria toxin repressor (DtxR) genes of Malaysian C. diphtheriae isolates from the year 1986-2016.

    RESULTS: The comparison between core and pan-genomic comparison showed variation in the distribution of C. diphtheriae. The local isolates portrayed a heterogenous trait and a close relationship between Malaysia's and Belarus's, Africa's and India's strains were observed. A toxigenic C. diphtheriae clone was noted to be circulating in the Malaysian population for nearly 30 years and from our study, the non-toxigenic and toxigenic C. diphtheriae strains can be differentiated significantly into two large clusters, A and B respectively. Analysis against vaccine strain, PW8 portrayed that the amino acid composition of toxin and DtxR in Malaysia's local strains are well-conserved and there was no functional defect noted. Hence, the change in efficacy of the currently used toxoid vaccine is unlikely to occur.

  3. Fulltext First Draft Genome Sequences of Malaysian Clinical Isolates of Corynebacterium diphtheriae
    Ahmad N, Hii SY, Mohd Khalid MK, Abd Wahab MA, Hashim R, Tang SN, et al.
    Genome Announc, 2017 Mar 02;5(9).
    PMID: 28254972 DOI: 10.1128/genomeA.01670-16
    Corynebacterium diphtheriae has caused multiple isolated diphtheria cases in Malaysia over the years. Here, we report the first draft genome sequences of 15 Malaysia C. diphtheriae clinical isolates collected from the years 1981 to 2016.
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