Whole genome sequencing suggests transmission of Corynebacterium diphtheriae-caused cutaneous diphtheria in two siblings, Germany, 2018

Euro Surveill. 2019 Jan;24(2):1800683. doi: 10.2807/1560-7917.ES.2019.24.2.1800683.

Abstract

In September 2018, a child who had returned from Somalia to Germany presented with cutaneous diphtheria by toxigenic Corynebacterium diphtheriae biovar mitis. The child's sibling had superinfected insect bites harbouring also toxigenic C. diphtheriae. Next generation sequencing (NGS) revealed the same strain in both patients suggesting very recent human-to-human transmission. Epidemiological and NGS data suggest that the two cutaneous diphtheria cases constitute the first outbreak by toxigenic C. diphtheriae in Germany since the 1980s.

Keywords: Corynebacterium diphtheriae; MLST; WGS; diphtheria; outbreak; toxigenic; typing.

Publication types

  • Case Reports

MeSH terms

  • Amoxicillin / therapeutic use
  • Anti-Bacterial Agents / therapeutic use
  • Child
  • Clavulanic Acid / therapeutic use
  • Corynebacterium diphtheriae / genetics*
  • Corynebacterium diphtheriae / isolation & purification*
  • DNA, Bacterial / isolation & purification
  • DNA, Bacterial / metabolism
  • Diphtheria / diagnosis*
  • Diphtheria / drug therapy
  • Diphtheria / transmission
  • Diphtheria Toxin / genetics*
  • Female
  • Germany
  • High-Throughput Nucleotide Sequencing / methods*
  • Humans
  • Real-Time Polymerase Chain Reaction
  • Siblings
  • Somalia
  • Travel
  • Treatment Outcome
  • Whole Genome Sequencing

Substances

  • Anti-Bacterial Agents
  • DNA, Bacterial
  • Diphtheria Toxin
  • Clavulanic Acid
  • Amoxicillin