Investigation of a Large Diphtheria Outbreak and Cocirculation of Corynebacterium pseudodiphtheriticum Among Forcibly Displaced Myanmar Nationals, 2017-2019

被引：7

作者：

Weil, Lauren M. ^{[1
,6
]}

Williams, Margaret M. ^{[2
]}

Shirin, Tahmina ^{[3
]}

Lawrence, Marlon ^{[4
,10
]}

Habib, Zakir H. ^{[3
]}

Aneke, Janessa S. ^{[5
]}

Tondella, Maria L. ^{[2
]}

Zaki, Quazi ^{[3
]}

Cassiday, Pamela K. ^{[2
]}

Lonsway, David ^{[6
]}

Farrque, Mirza ^{[7
,11
]}

Hossen, Tanvir ^{[7
]}

Feldstein, Leora R. ^{[1
,12
]}

Cook, Nicholas ^{[5
,13
]}

Maldonado-Quiles, Gladys ^{[5
,14
]}

Alam, Ahmed N. ^{[3
]}

Muraduzzaman, A. K. M. ^{[3
]}

Akram, Arifa ^{[3
]}

Conklin, Laura ^{[8
]}

Doan, Stephanie ^{[9
,15
]}

Friedman, Michael ^{[9
]}

Acosta, Anna M. ^{[2
]}

Hariri, Susan ^{[2
]}

Fox, LeAnne M. ^{[2
]}

Tiwari, Tejpratap S. P. ^{[2
,16
]}

Flora, Meerjady S. ^{[3
,17
]}

机构：

[1] Ctr Dis Control & Prevent, Epidem Intelligence Serv, Div Sci Educ & Profess Dev, Ctr Surveillance Epidemiol & Lab Serv, Atlanta, GA 30329 USA

[2] Ctr Dis Control & Prevent, Div Bacterial Dis, Natl Ctr Immunizat & Resp Dis, Atlanta, GA 30329 USA

[3] Inst Epidemiol Dis Control & Res, Dhaka, Bangladesh

[4] Ctr Dis Control & Prevent, Lab Leadership Serv, Div Sci Educ & Profess Dev, Ctr Surveillance Epidemiol & Lab Serv, Atlanta, GA 30329 USA

[5] IHRC Inc, US Ctr Dis Control & Prevent, Div Bacterial Dis, Atlanta, GA USA

[6] Ctr Dis Control & Prevent, Div Healthcare Qual Promot, Natl Ctr Emerging & Zoonot Infect Dis, Atlanta, GA 30329 USA

[7] Inst Epidemiol Dis Control & Res, Bangladesh Field Epidemiol Training Program, Dhaka, Bangladesh

[8] Ctr Dis Control & Prevent, Global Immunizat Div, Ctr Global Hlth, Atlanta, GA USA

[9] Ctr Dis Control & Prevent, Div Global Hlth Protect, Ctr Global Hlth, Atlanta, GA 30329 USA

[10] Publ Hlth Lab, Virgin Isl Dept Hlth, Charlotte Amalie, VI USA

[11] Emory Univ, Rollins Sch Publ Hlth, Atlanta, GA 30322 USA

[12] Ctr Dis Control & Prevent, Div Influenza, Natl Ctr Immunizat & Resp Dis, Atlanta, GA 30329 USA

[13] Clark Atlanta Univ, Atlanta, GA 30314 USA

[14] Childrens Healthcare Atlanta, Atlanta, GA USA

[15] Harvard TH Chan Sch Publ Hlth, Boston, MA USA

[16] Ctr Dis Control & Prevent, Off Director, Natl Ctr Immunizat & Resp Dis, Atlanta, GA 30329 USA

[17] Minist Hlth & Family Welf, Directorate Gen Hlth Serv, Dhaka, Bangladesh

来源：

JOURNAL OF INFECTIOUS DISEASES | 2021年 / 224卷 / 02期

关键词：

diphtheria outbreak; Corynebacterium pseudodiphtheriticum; Corynebacterium diphtheriae; RAPID DETECTION; PCR ASSAY;

D O I：

10.1093/infdis/jiaa729

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Background. Diphtheria, a life-threatening respiratory disease, is caused mainly by toxin-producing strains of Corynebacterium diphtheriae, while nontoxigenic corynebacteria (eg, Corynebacterium pseudodiphtheriticum) rarely causes diphtheria-like illness. Recently, global diphtheria outbreaks have resulted from breakdown of health care infrastructures, particularly in countries experiencing political conflict. This report summarizes a laboratory and epidemiological investigation of a diphtheria outbreak among forcibly displaced Myanmar nationals in Bangladesh. Methods. Specimens and clinical information were collected from patients presenting at diphtheria treatment centers. Swabs were tested for toxin gene (tox)-bearing C. diphtheriae by real-time polymerase chain reaction (RT-PCR) and culture. The isolation of another Corynebacterium species prompted further laboratory investigation. Results. Among 382 patients, 153 (40%) tested tox positive for C. diphtheriae by RT-PCR; 31 (20%) PCR-positive swabs were culture confirmed. RT-PCR revealed 78% (298/382) of patients tested positive for C. pseudodiphtheriticum. Of patients positive for only C. diphtheriae, 63% (17/27) had severe disease compared to 55% (69/126) positive for both Corynebacterium species, and 38% (66/172) for only C. pseudodiphtheriticum. Conclusions. We report confirmation of a diphtheria outbreak and identification of a cocirculating Corynebacterium species. The high proportion of C. pseudodiphtheriticum codetection may explain why many suspected patients testing negative for C. diphtheriae presented with diphtheria-like symptoms.

引用

页码：318 / 325

页数：8

共 34 条

[1] CORYNEBACTERIUM-PSEUDODIPHTHERITICUM - A RESPIRATORY-TRACT PATHOGEN [J].