Persistent Corynebacterium bovis Infectious Hyperkeratotic Dermatitis in Immunocompetent Epidermal-Mutant dep/dep Mice.

During a previously reported program-wide Corynebacterium bovis outbreak, both immunocompetent depilated (dep/dep) mutant mice and transgenic mice that express the papillomavirus E6 oncoprotein became persistently infected with C. bovis. An orthokeratotic, hyperkeratotic, acanthotic dermatitis developed in the C. bovis-infected dep/dep mice, which remained C. bovis PCR-positive for >45 days prior to euthanasia as part of the program-wide C. bovis eradication effort. Since both affected strains of mice have altered skin homeostasis, immune status or the presence of hair may not alone be sufficient to explain strain susceptibility to C. bovis-related cutaneous disease. In order to avoid invalidation of preclinical studies due to C. bovis infection, it may be necessary to isolate immunodeficient mouse strains, implement facililty-wide surveillance for C. bovis, and sterilize equipment with vaporized hydrogen peroxide.

Whole-Genome Sequencing Reveals a Prolonged and Persistent Intrahospital Transmission of Corynebacterium striatum, an Emerging Multidrug-Resistant Pathogen.

Corynebacterium striatum is an emerging multidrug-resistant (MDR) pathogen that occurs primarily among immunocompromised and chronically ill patients. However, little is known about the genomic diversity of C. striatum, which contributes to its long-term persistence and transmission in hospitals. In this study, a total of 192 C. striatum isolates obtained from 14 September 2017 to 29 March 2018 in a hospital in Beijing, China, were analyzed by antimicrobial susceptibility testing and pulsed-field gel electrophoresis (PFGE). Whole-genome sequencing was conducted on 91 isolates. Nearly all isolates (96.3%, 183/190) were MDR. The highest resistance rate was observed for ciprofloxacin (99.0%, 190/192), followed by cefotaxime (90.6%, 174/192) and erythromycin (89.1%, 171/192). PFGE separated the 192 isolates into 79 pulsotypes, and differences in core genome single-nucleotide polymorphisms (SNPs) partitioned the 91 isolates sequenced into four clades. Isolates of the same pulsotype were identical or nearly identical at the genome level, with some exceptions. Two dominant subclones, clade 3a, and clade 4a, were responsible for the hospital-wide dissemination. Genomic analysis further revealed nine resistance genes mobilized by eight unique cassettes. PFGE and whole-genome sequencing revealed that the C. striatum isolates studied were the result mainly of predominant clones spreading in the hospital. C. striatum isolates in the hospital progressively acquired resistance to antimicrobial agents, demonstrating that isolates of C. striatum may adapt rapidly through the acquisition and accumulation of resistance genes and thus evolve into dominant and persistent clones. These insights will be useful for the prevention of C. striatum infection in hospitals.

Transmission of toxigenic Corynebacterium diphtheriae by a fully immunised resident returning from a visit to West Africa, United Kingdom, 2017.

In early 2017, a United Kingdom (UK)-born person in their 20s presented with a skin ulcer on the foot 3 weeks after returning from Ghana. The patient had last received a diphtheria-containing vaccine in 2013, completing the recommended course. MALDI-TOF of a cutaneous swab identified Corynebacterium diphtheriae. Real-time PCR ascertained the species and presence of the diphtheria toxin gene. An Elek test confirmed toxigenicity. The isolate was macrolide sensitive and penicillin resistant. The local Public Health England (PHE) Health Protection Team obtained the patient's clinical history and traced contacts to inform appropriate public health action. One close contact (in their early 80s with uncertain immunisation status who had not recently travelled) had a positive throat swab for toxigenic C. diphtheriae and reported a history of mild coryzal symptoms. Multilocus sequence typing revealed that strains from the index case and contact had Sequence Type 463. Diphtheria is extremely rare in the UK due to high vaccine coverage and this is the first documented transmission in 30 years. Clinicians and laboratory staff should remain highly suspicious of lesions in overseas travellers, even when patients are fully vaccinated. Older individuals who might not have completed a full immunisation course may have higher diphtheria susceptibility.

Transmission dynamics of intramammary infections caused by Corynebacterium species.

The development of reliable models for transmission of intramammary infections (IMI) is the subject of extensive research. Such models are useful to enhance the identification and understanding of factors that affect pathogen-specific IMI dynamics. Longitudinal transmission models are valuable for predicting infection outbreak risks, quantifying the effectiveness of response tactics, and performing response planning. In this work, we focused on modeling Corynebacterium spp. by using a compartmental model. Previous investigations have considered modeling the transmission dynamics of several bacterial pathogens, but not Corynebacterium spp. We established a Corynebacterium spp. Susceptible-Infectious-Susceptible (SIS) model. We simulated the model numerically by using parameters that we estimated by a generalized linear model approach, using month of study as the time variable. The data, from which the parameters of the model were estimated, were obtained in a field trial conducted in 2 US dairy herds. Altogether, 786 cows were sampled at least once during the 13-mo study period. The total number of quarter milk cultures and cases of IMI caused by Corynebacterium spp. were 11,744 and 556, respectively, in farm A; the corresponding figures for farm B were 11,804 and 179. Our modeling study included only transmission from persistent IMI caused by Corynebacterium spp. within the lactation pens. The rate of new infections was significantly related to preexisting IMI in both farms, underscoring the importance of preexisting Corynebacterium spp. IMI for the transmission of Corynebacterium spp. within lactation pens. The estimated basic reproduction numbers (R0) in the 2 farms were 1.18 and 0.98, respectively. The nonsignificant disparity in R0 was associated with significant differences in cure rates between farms.

Capacidad de supervivencia de Corynebacterium pseudotuberculosis biovar ovis en distintos suelos de la provincia de Chubut, Patagonia argentina / Survival capacity of Corynebacterium pseudotuberculosis biovar ovis in different soil types from Chubut, Argentine Patagonia

Corynebacterium pseudotuberculosis se transmite entre ovinos de la Patagonia argentina y ocasiona pseudotuberculosis. Esta bacteria, que infecta ganglios superficiales y vísceras, ingresa al animal a través de heridas en la piel o membranas mucosas. Durante la esquila, se cortan abscesos superficiales que drenan el contenido purulento y contaminan las herramientas y el suelo. El objetivo de este trabajo fue evaluar la capacidad de C. pseudotuberculosis de sobrevivir a lo largo del tiempo en suelos de la Patagonia extraandina. Se recolectaron 5 muestras de suelos de distintas zonas de la provincia del Chubut (Patagonia extraandina) con características fisicoquímicas diferenciales en lo que respecta a contenido de materia orgánica, pH, conductividad eléctrica y textura. Diferentes alícuotas de estas muestras se inocularon con la cepa de C. pseudotuberculosis PAT10, aislada de un ovino patagónico, y se conservaron a temperatura ambiente. A distintos tiempos se determinó el número de bacterias supervivientes. El 60% de la población de C. pseudotuberculosis inoculada sobrevivió durante 80 y 210 días en suelos con moderadas y altas concentraciones de materia orgánica, respectivamente. Los suelos de características diversas de la Patagonia contaminados con poblaciones de C. pseudotuberculosis cumplirían un papel importante en el ciclo de infección en la naturaleza. La supervivencia de la bacteria por largos períodos se vio favorecida por el mayor contenido de materia orgánica sumado a la textura franco-limosa y no se observó la influencia de variables como el pH y la salinidad.

Corynebacterium pseudotuberculosis is transmitted among sheep in Argentine Patagonia causing pseudotuberculosis. The bacterium penetrates the skin or mucous membrane wounds, infecting the superficial lymph nodes and viscera. When surface abscesses are cut during shearing, they drain their purulent contents and contaminate tools and the soil. The objective of this work was to evaluate the survival capacity of C. pseudotuberculosis over time, in soils from the extra-Andean Patagonia region. Five types of superficial soils were collected from different areas in Chubut province (extra-Andean Patagonia), having distinctive physicochemical properties including organic matter content (very high to nonexistent), pH (neutral to strongly alkaline), electrical conductivity (saline to non-saline) and texture (sandy, clayey, silty loam). Different aliquots of each type of soil were inoculated with C. pseudotuberculosis PAT10 strain isolated from a Patagonian sheep, and were stored at room temperature. The number of surviving bacteria was determined at various times. Sixty percent (60%) of the inoculated C. pseudotuberculosis population survived for 80 to 210 days in soils with moderate to high organic matter content respectively. Silty soils favored bacterial survival, whereas the variables pH and salinity had no effect on survival.

[Survival capacity of Corynebacterium pseudotuberculosis biovar ovis in different soil types from Chubut, Argentine Patagonia]. / Capacidad de supervivencia de Corynebacterium pseudotuberculosis biovar ovis en distintos suelos de la provincia de Chubut, Patagonia argentina.

Corynebacterium pseudotuberculosis is transmitted among sheep in Argentine Patagonia causing pseudotuberculosis. The bacterium penetrates the skin or mucous membrane wounds, infecting the superficial lymph nodes and viscera. When surface abscesses are cut during shearing, they drain their purulent contents and contaminate tools and the soil. The objective of this work was to evaluate the survival capacity of C. pseudotuberculosis over time, in soils from the extra-Andean Patagonia region. Five types of superficial soils were collected from different areas in Chubut province (extra-Andean Patagonia), having distinctive physicochemical properties including organic matter content (very high to nonexistent), pH (neutral to strongly alkaline), electrical conductivity (saline to non-saline) and texture (sandy, clayey, silty loam). Different aliquots of each type of soil were inoculated with C. pseudotuberculosis PAT10 strain isolated from a Patagonian sheep, and were stored at room temperature. The number of surviving bacteria was determined at various times. Sixty percent (60%) of the inoculated C. pseudotuberculosis population survived for 80 to 210 days in soils with moderate to high organic matter content respectively. Silty soils favored bacterial survival, whereas the variables pH and salinity had no effect on survival.

Rapid transmission of multidrug-resistant Corynebacterium striatum among susceptible patients in a tertiary hospital in China.

INTRODUCTION: With increasing reports about Corynebacterium striatum, its potential pathogenicity and clinical significance are drawing more attention in recent years. METHODOLOGY: During a 14-month period, Corynebacterium striatum strains were routinely isolated in lower respiratory tract samples of the inpatients in a tertiary hospital in China, and the suspected isolates were identified with VITEK-2 ANC card and 16S rRNA sequencing technique, respectively. Pulsed-field gel electrophoresis (PFGE) was employed to discriminate different clones, and biofilm-producing abilities of different strains were compared. RESULTS: A total of 82 strains of Corynebacterium striatum were mainly isolated from neurosurgery patients (45.1%, 37/82). Three epidemic clones (type D, F, and I) were identified, accounting for 82.9% (68/82) of strains. All 82 C. striatum strains were all sensitive to vancomycin, and resistant to ceftriaxone, imipenem, and ciprofloxacin. One week before C. striatum isolation, 89.0% (73/82) patients showed lower levels of hemoglobin, 93.9% (77/82) of patients received treatment of several kinds of antibiotics, and 41.5% (34/82) patients with glucocorticoid, and 46.3% (38/82) of patients showed disturbed consciousness at different levels. CONCLUSIONS: Corynebacterium striatum strains isolated during this study were mainly multidrug resistant, and the predominant clones could rapidly transmit among susceptible inpatients. Corynebacterium striatum seems to be an important pathogen for patients with specific risk factors, especially for the ones with lower hemoglobin levels who are being treated with broad-spectrum antibiotics.

Colonisation with toxigenic Corynebacterium diphtheriae in a Scottish burns patient, June 2015.

On 12 June 2015, Corynebacterium diphtheriae was identified in a skin swab from a burns patient in Scotland. The isolate was confirmed to be genotypically and phenotypically toxigenic. Multilocus sequence typing of three patient isolates yielded sequence type ST 125. The patient was clinically well. We summarise findings of this case, and results of close contact identification and screening: 12 family and close contacts and 32 hospital staff have been found negative for C. diphtheriae.

Experimental transmission of Corynebacterium pseudotuberculosis biovar equi in horses by house flies.

BACKGROUND: The route of Corynebacterium pseudotuberculosis infection in horses remains undetermined, but transmission by insects is suspected. OBJECTIVES: To investigate house flies (Musca domestica L.) as vectors of C. pseudotuberculosis transmission in horses. ANIMALS: Eight healthy, adult ponies. METHODS: Randomized, controlled, blinded prospective study. Ten wounds were created in the pectoral region where cages for flies were attached. Three ponies were directly inoculated with C. pseudotuberculosis. Four ponies were exposed for 24 hours to 20 hours C. pseudotuberculosis-inoculated flies. One negative control pony was exposed to noninoculated flies. Ponies were examined daily for swelling, heat, pain, and drainage at the inoculation site. Blood was collected weekly for CBC and biochemical analysis, and twice weekly for synergistic hemolysis inhibition titers. RESULTS: Clinical signs of local infection and positive cultures were observed in 7/7 exposed ponies and were absent in the negative control. In exposed ponies, peak serologic titers (1:512 to 1:2,048) were obtained between days 17 and 21. Seroconversion was not observed in the negative control. Neutrophil counts were higher in the positive and fly-exposed groups than in the negative control (P = .002 and P = .005) on day 3 postinoculation. Serum amyloid A concentrations were higher in the positive control than in the negative control and fly-exposed ponies on days 3 (P < .0001) and 7 (P = .0004 and P = .0001). No differences were detected for other biochemical variables. CONCLUSIONS AND CLINICAL IMPORTANCE: House flies can serve as mechanical vectors of C. pseudotuberculosis and can transmit the bacterium to ponies.

Zoonotic transmission of toxigenic Corynebacterium ulcerans strain, Germany, 2012.

Severe necrotizing fasciitis was diagnosed in a 53-year-old man in Germany in 2012. Toxigenic Corynebacterium ulcerans was grown from a wound swab sample. One of the patient's 2 dogs was found to harbor a toxigenic C. ulcerans strain. Results of next generation sequencing of both isolates supported recent zoonotic transmission of this bacterial pathogen.

Multilocus sequence typing of Corynebacterium ulcerans provides evidence for zoonotic transmission and for increased prevalence of certain sequence types among toxigenic strains.

Human-to-human-transmitted Corynebacterium diphtheriae was historically the main pathogen causing diphtheria and has therefore been studied extensively in the past. More recently, diphtheria caused by toxigenic Corynebacterium ulcerans is an emerging disease in several industrial countries, including the United Kingdom, the United States, France, and Germany. However, toxigenic C. ulcerans has so far been almost neglected in the development of epidemiologic tools. One of the most important tools in modern epidemiology to understand transmission pathways is sequence typing of pathogens. Here, we provide a protocol for multilocus sequence typing (MLST) to type C. ulcerans strains rapidly and relatively cost-effectively. Applying MLST to C. ulcerans for the first time, we show that related sequence types (STs) might be associated with the presence of the diphtheria toxin gene, which encodes diphtheria toxin (DT), the most important diphtheria-causing virulence factor. Interestingly, we found only two very closely related STs in the isolates derived from six dogs. Additionally, our data show that all STs derived from animals which were at least twice present in our analysis were found in humans as well. This finding is congruent with zoonotic transmission of C. ulcerans.

Toxigenic Corynebacterium ulcerans in a fatal human case and her feline contacts, France, March 2014.

In March 2014, a person in their eighties who was diagnosed with extensive cellulitis due to toxigenic Corynebacterium ulcerans died from multiple organ failure. Environmental investigation also isolated C. ulcerans in biological samples from two stray cats in contact with the case. This finding provides further evidence that pets can carry toxigenic C. ulcerans and may be a source of the infection in humans.

Corynebacterium propinquum associated with acute, nongonococcal urethritis.

Corynebacterium propinquum is usually considered part of the normal human oropharyngeal flora and is rarely responsible for clinical infection. We report here what seems to be the first case of acute purulent urethral discharge in a young Iranian man with urethritis acquired after orogenital contact. Attention should be devoted to less common nondiphtheriae Corynebacterium species for differential diagnosis.

[Case of acute pharyngitis caused by Corynebacterium ulcerans in Ibaraki Prefecture].

We report on the case of a 51-year-old woman who presented with refractory pharyngitis caused by toxigenic Corynebacteriumn ulcerans (C. ulcerans). Thick pseudomembrane formations and yellowish pus were observed in her nasopharynx. Based on her clinical course and history of breeding cats, we considered C. ulcerans infection as the possible diagnosis. She was treated with macrolide administration and her symptoms immediately improved. C. ulcerans was identified in pus from the patient's pharynx as well as in discharge material from her cat's eyes, and C. ulcerans was thought to have caused her pharyngitis. C. ulcerans is one of the infecting bacteria which can cause a zoonotic infection. In Japan, some cases with C. ulcerans infection from cats have been reported. It is important that we should consider C. ulcerans infection as a differential diagnosis of refractory pharyngitis.

Corynebacterium bovis: epizootiologic features and environmental contamination in an enzootically infected rodent room.

Corynebacterium bovis is a common pathogen in athymic nude mouse colonies. Control and eradication of the organism are challenging because depopulation and restricted colony access are often not options within vivaria. We evaluated potential sources and dissemination routes of C. bovis in an enzootically infected colony. Immunocompetent mice and personnel were evaluated for their potential to carry C. bovis, and husbandry and sanitation methods were evaluated for their efficacy in preventing cross-contamination. C. bovis was detected in furred immunocompetent mice previously exposed to infected athymic nude mice and in the nasopharynx of humans. Microisolation cages were not effective in maintaining athymic nude mice C. bovis-free when they were housed in a room known to contain immunodeficient mice with C. bovis infections. A tunnel washer that provided a ≥180 °F final rinse provided effective elimination of C. bovis from cage components. Passive and active air sampling techniques showed airborne dispersal of C. bovis despite the use of individually ventilated caging systems and stringent operational standards. Bacterial growth was not observed in settle plates placed inside autoclaved individually ventilated microisolation cages on various ventilated racks for 24-h periods. C. bovis aerosolization was shown to be a means of spread of the bacterium during cage-change procedures inside a class II type A2 biosafety cabinet. Our findings indicate that C. bovis can be a pervasive environmental contaminant in infected rodent holding rooms and successful eradication strategies must include environmental decontamination and attention to air quality.

Rare human skin infection with Corynebacterium ulcerans: transmission by a domestic cat.

Corynebacterium ulcerans is mainly known for its ability to cause animal infections. Some strains of C. ulcerans produce diphtheria toxin, which can cause life-threatening cardiopathies and neuropathies in humans. Human cutaneous C. ulcerans infection is a very rare disease that mimics classical cutaneous diphtheria. We present a very rare case of a C. ulcerans skin infection caused by a non-diphtheria toxin-producing strain of C. ulcerans that resolved after 3 weeks of therapy with amoxicillin-clavulanate. A pet cat was the probable source of infection. The presence of C. ulcerans in the mouth of the cat was confirmed by 16S rRNA gene analysis and the API Coryne system. In cases of human infection with potentially toxigenic corynebacteria, it is important to determine the species and examine the isolate for diphtheria toxin production. If toxigenicity is present, diphtheria antitoxin should be administered immediately. Carriers and potential infectious sources of C. ulcerans include not only domestic livestock but also pet animals. For the primary prevention of disease caused by diphtheria toxin-producing corynebacteria, vaccination with diphtheria toxoid is recommended.

Evaluation of the risk factors influencing the spread of caseous lymphadenitis in goat herds.

Epidemiological studies on caseous lymphadenitis were carried out in Poland in 1996 and 2002 among goat herds covered by a milk recording program. Between-herd seroprevalence was 13.2% in 1996 and increased to 62.5% in 2002. The average size of seropositive herds was statistically significantly higher than that of seronegative ones, however there was no statistically significant difference in the age between the herds. A statistically significant prevalence ratio (PR) was identified and relevant attributable risk for exposed animals (AR(exp)) was calculated for the following risk factors: presence of seropositive males in a herd (PR = 8.350; AR(exp) = 0.651), presence of superficial abscesses in animals (PR = 6.142; AR(exp) = 0.620), presence of respiratory signs (PR = 2.900; AR(exp) = 0.393), presence of animals in poor condition in a herd (PR = 2.774; AR(exp) = 0.390) and occurrence of reproductive failures in a herd (PR = 1.798; AR(exp) = 0.230). Purchase of animals from abroad, mastitis and husbandry conditions (housing system, grazing system, hygienic conditions) were not shown to be statistically significant risk factors.