An Outbreak of Nontoxigenic Corynebacterium diphtheriae Infection: Single Bacterial Clone Causing Invasive Infection Among Swiss Drug Users

From 1990 to 1996, a total of 65 patients from whom Corynebacterium diphtheriae had been isolated were reported to the Swiss Federal Office of Public Health. A retrospective review of medical and microbiological records as well as results of ribotyping of available isolates was performed. Twenty-sev...

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Bibliographic Details
Published in:Clinical infectious diseases 1998-11, Vol.27 (5), p.1295-1298
Main Authors: Gubler, Jacques, Huber-Schneider, Christina, Gruner, Eva, Altwegg, Martin
Format: Article
Language:English
Subjects:
Bacteremia - microbiology
Bacterial diseases
Bacterial Typing Techniques
Biological and medical sciences
Blood
Clinical Articles
Corynebacterium diphtheriae
Corynebacterium diphtheriae - classification
Corynebacterium diphtheriae - isolation & purification
Diphtheria
Diphtheria - complications
Diphtheria - epidemiology
Diphtheria - microbiology
Diphtheria - pathology
Disease Outbreaks
DNA, Bacterial - analysis
Endocarditis
Endocarditis, Bacterial - microbiology
Ent and stomatologic bacterial diseases
Epidemiology
Human bacterial diseases
Humans
Infections
Infectious diseases
Intravenous drug abuse
Medical sciences
Restriction Mapping
Retrospective Studies
Ribotyping
Sepsis
Skin - microbiology
Substance Abuse, Intravenous - complications
Substance Abuse, Intravenous - microbiology
Switzerland - epidemiology
Travel
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Summary:From 1990 to 1996, a total of 65 patients from whom Corynebacterium diphtheriae had been isolated were reported to the Swiss Federal Office of Public Health. A retrospective review of medical and microbiological records as well as results of ribotyping of available isolates was performed. Twenty-seven patients had acquired their infection without evidence of use of illicit drugs, mostly as a skin infection imported from subtropical areas (20 patients); 38 isolations were associated with intravenous drug use (IVDU) (skin, 15; respiratory tract, 10; blood, 13). Endocarditis was documented in nine patients with bloodstream infection, four of whom died. There were two additional deaths due to overwhelming sepsis. The same ribotype of nontoxigenic C. diphtheriae was found in 31 of the 32 examined isolates associated with IVDU. All non-IVDU isolates had different ribotypes. Among Swiss drug users, a single clone of nontoxigenic C. diphtheriae was found over a period of several years with a high potential to cause severe invasive infection.
ISSN:1058-4838
1537-6591
DOI:10.1086/514997