MyMedR

Serological types of C. diphtheriae in Malaya

SINGH RB

Med J Malaya, 1955 Sep;10(1):92-7.

PMID: 13287499

Matched MeSH terms: Corynebacterium diphtheriae*

Types of C. diphtheriae in Kuala Lumpur

Loo D

Med J Malaya, 1965 Jun;19(4):259-62.

PMID: 4220849

Matched MeSH terms: Corynebacterium diphtheriae/classification*

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.

Matched MeSH terms: Corynebacterium diphtheriae

Comparative genomic and phylogenetic analysis of a toxigenic clinical isolate of Corynebacterium diphtheriae strain B-D-16-78 from Malaysia

Hong KW, Asmah Hani AW, Nurul Aina Murni CA, Pusparani RR, Chong CK, Verasahib K, et al.

Infect Genet Evol, 2017 Oct;54:263-270.

PMID: 28711373 DOI: 10.1016/j.meegid.2017.07.015

In this study, we report the comparative genomics and phylogenetic analysis of Corynebacterium diphtheriae strain B-D-16-78 that was isolated from a clinical specimen in 2016. The complete genome of C. diphtheriae strain B-D-16-78 was sequenced using PacBio Single Molecule, Real-Time sequencing technology and consists of a 2,474,151-bp circular chromosome with an average GC content of 53.56%. The core genome of C. diphtheriae was also deduced from a total of 74 strains with complete or draft genome sequences and the core genome-based phylogenetic analysis revealed close genetic relationship among strains that shared the same MLST allelic profile. In the context of CRISPR-Cas system, which confers adaptive immunity against re-invading DNA, 73 out of 86 spacer sequences were found to be unique to Malaysian strains which harboured only type-II-C and/or type-I-E-a systems. A total of 48 tox genes which code for the diphtheria toxin were retrieved from the 74 genomes and with the exception of one truncated gene, only nucleotide substitutions were detected when compared to the tox gene sequence of PW8. More than half were synonymous substitution and only two were nonsynonymous substitutions whereby H24Y was predicted to have a damaging effect on the protein function whilst T262V was predicted to be tolerated. Both toxigenic and non-toxigenic toxin-gene bearing strains have been isolated in Malaysia but the repeated isolation of toxigenic strains with the same MLST profile suggests the possibility of some of these strains may be circulating in the population. Hence, efforts to increase herd immunity should be continued and supported by an effective monitoring and surveillance system to track, manage and control outbreak of cases.

Matched MeSH terms: Corynebacterium diphtheriae/classification*; Corynebacterium diphtheriae/genetics*; Corynebacterium diphtheriae/isolation & purification

Misidentification of toxigenic Corynebacterium diphtheriae as a Corynebacterium species with low virulence in a child with endocarditis

Pennie RA, Malik AS, Wilcox L

J Clin Microbiol, 1996 May;34(5):1275-6.

PMID: 8727917

A 6-year-old boy presented to a university hospital in Malaysia with infective endocarditis complicating cyanotic congenital heart disease. Blood cultures showed a gram-positive, aerobic, coryneform-like bacillus identified by the hospital laboratory as Corynebacterium xerosis, but a reference laboratory identified the organism as a toxigenic strain of Corynebacterium diphtheriae. The two laboratories concurred on all biochemical test results except for sucrose fermentation.

Matched MeSH terms: Corynebacterium diphtheriae/classification*; Corynebacterium diphtheriae/isolation & purification; Corynebacterium diphtheriae/pathogenicity

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.

Matched MeSH terms: Corynebacterium diphtheriae/genetics*; Corynebacterium diphtheriae/isolation & purification

Fulltext Diphtheria: experience in a general hospital

Tee LK

Med J Malaysia, 1989 Mar;44(1):41-4.

PMID: 2516602

A review of patients with diphtheria seen in the Paediatric Unit, Alor Star General Hospital, from January 1985-March 1987 is reported. Their clinical presentation, diagnosis, treatment and outcome were analysed and discussed. Clinical awareness regarding the diagnosis of diphtheria is emphasised.

Matched MeSH terms: Corynebacterium diphtheriae

Fulltext Respiratory diphtheria in three paediatric patients

Lee JK, Huda S, Francis A, Aisai, Jusoh M

Med J Malaysia, 1999 Sep;54(3):377-82.

PMID: 11045069

From August till November 1998, the Paediatric and Anaesthetic Units of Hospital Kuala Terengganu managed three patients from Kuala Terengganu District who were ventilated for respiratory diphtheria. Their ages were 5, 4 and 7 years old and their immunisation for diphtheria were not complete. All three patients presented with respiratory distress and were ventilated for upper airway obstruction. Their treatment included intravenous penicillin and diphtheria antitoxin. One patient died of cardiogenic shock with secondary pneumonia. Pharyngeal and tonsillar swabs of all three patients grew toxigenic Corynebacterium diphtheriae biotype mitis. There were 765 throat cultures taken from contacts. The confirmed positive cultures grew 2 toxigenic and 3 non-toxigenic Corynebacterium diphtheriae biotype mitis and surprisingly, 10 non-toxigenic biotype gravis. A prevalence study is needed to document the endemicity of diphtheria in Kuala Terengganu and to determine the carrier rate of both biotypes. Steps have been taken to increase the immunisation coverage in children. The giving of regular booster doses of diphtheria toxoid to the adult population should be considered.

Matched MeSH terms: Corynebacterium diphtheriae/isolation & purification

Adult diphtheria in Malaysia: A case report

Loganathan T, Mohamed PY

Med J Malaysia, 2018 10;73(5):340-341.

PMID: 30350821 MyJurnal

In November 2016, a 28-year-old Malay man presented to the emergency department in respiratory distress, with a history of fever and sore throat. A clinical diagnosis of acute diphtheria was made and the patient was isolated and ventilated in the intensive care unit, and received diphtheria antitoxin and intravenous antibiotics. Initial laboratory findings failed to confirm diphtheria, leading to discontinuation of antibiotics and quarantine. Public health measures were reinstated after a reference laboratory cultured Corynebacterium diphtheriae. Although there was no contact with ill persons, investigation revealed incomplete immunisation history, and injection of high dose steroids prior to onset of symptoms.

Matched MeSH terms: Corynebacterium diphtheriae

Adult-onset nasopharyngeal diphtheria: an uncommon but rapidly progressive and potentially fatal infection

Ding CH, Wahab AA, Marina Z, Leong CL, Umur N, Wong PF

Trop Biomed, 2021 Jun 01;38(2):119-121.

PMID: 34172699 DOI: 10.47665/tb.38.2.045

Nasopharyngeal diphtheria is an acute infectious upper respiratory tract disease caused by toxigenic strains of Corynebacterium diphtheriae. We report a case of a young adult who presented to us with a short history of fever, sore throat, hoarseness of voice and neck swelling. He claimed to have received all his childhood vaccinations and had no known medical illnesses. During laryngoscopy, a white slough (or membrane) was seen at the base of his tongue. The epiglottis was also bulky and the arytenoids were swollen bilaterally. The membrane was sent to the microbiology laboratory for culture. A diagnosis of nasopharyngeal diphtheria was made clinically and the patient was treated with an antitoxin together with erythromycin, while awaiting the culture result. Nevertheless, the patient's condition deteriorated swiftly and although the laboratory eventually confirmed an infection by toxin-producing C. diphtheriae, the patient had already succumbed to the infection.

Matched MeSH terms: Corynebacterium diphtheriae

Fulltext Seroprevalence of diphtheria toxoid IgG antibodies in the Malaysian population

Yusoff AF, Mohd Sharani ZZ, Kee CC, Md Iderus NH, Md Zamri ASS, Nagalingam T, et al.

BMC Infect Dis, 2021 Jun 16;21(1):581.

PMID: 34134646 DOI: 10.1186/s12879-021-06285-3

BACKGROUND: Despite high childhood immunization coverage, sporadic cases of diphtheria have been reported in Malaysia in recent years. This study aims to evaluate the seroprevalence of diphtheria among the Malaysian population.

METHODS: A total of 3317 respondents age 2 years old to 60 years old were recruited in this study from August to November 2017. Enzyme-linked immunosorbent assay (ELISA) was used to measure the level of IgG antibody against the toxoid of C. diphtheriae in the blood samples of respondents. We classified respondent antibody levels based on WHO definition, as protective (≥0.1 IU/mL) and susceptible (

Matched MeSH terms: Corynebacterium diphtheriae/metabolism

Fulltext Screening for Corynebacterium diphtheriae

Wilson AP, Matthews S, Bahl M, Efstratiou A, Cookson BD

J Clin Pathol, 1992 Nov;45(11):1036-7.

PMID: 1452782 DOI: 10.1136/jcp.45.11.1036

A throat swab from a 9 year old girl with pharyngitis yielded a non-toxigenic strain of Corynebacterium diphtheriae var mitis and Streptococcus group G. C pseudodiphtheriticum was isolated from the throats of two of her four brothers. In each case the isolate was sent to the reference laboratory before full identification. The growth was found to be mixed for one brother; the other isolate being a toxin producing C diphtheriae var gravis. The child was asymptomatic and the case proves that all colonial types on the Hoyles plate should be identified.

Matched MeSH terms: Corynebacterium diphtheriae/isolation & purification*

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