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Journal of Infection in Developing... Jun 2022Toxigenic Corynebacterium diphtheriae causes classical diphtheria. Skin infections by toxigenic or non-toxigenic Corynebacterium diphtheriae are prevalent in the tropics...
INTRODUCTION
Toxigenic Corynebacterium diphtheriae causes classical diphtheria. Skin infections by toxigenic or non-toxigenic Corynebacterium diphtheriae are prevalent in the tropics but are rarely reported.
CASE PRESENTATION
We report the identification of a non-toxigenic Corynebacterium diphtheriae (biovar Gravis) isolate in a 52-year-old Cambodian male. The patient presented purulent and non-healing ulcerations on the right hallux. The wound has healed after 7 days of antibiotic therapy with a favourable outcome.
CONCLUSIONS
This case represents, to our knowledge, the first report of Corynebacterium diphtheriae in Cambodia in the last 10 years, and highlights the lack of diagnosis and notifications of diphtheria. It is important to raise awareness among clinicians and to set up diphtheria surveillance in Cambodia.
Topics: Corynebacterium; Corynebacterium Infections; Corynebacterium diphtheriae; Diphtheria; Hallux; Humans; Male; Middle Aged
PubMed: 35797309
DOI: 10.3855/jidc.16153 -
Japanese Journal of Infectious Diseases Sep 2021Tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine is generally used for booster vaccination of infants in Europe and the United States to... (Observational Study)
Observational Study
Tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine is generally used for booster vaccination of infants in Europe and the United States to avoid increased reactogenicity after diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccination. However, Japan has extended the use of additional DTaP vaccination without reducing the antigen dose for diphtheria and pertussis in adolescents and adults, despite limited reports on its safety in adults. This prospective, observational, questionnaire-based study investigated the occurrence of adverse events (AEs) following DTaP vaccination between June 2018 and June 2019 in participants aged 10 years or older. Of the 250 eligible participants, 235 (94%) responded regarding AEs. Among them, 133 (56.6%) reported AEs, of which 39 reported systemic AEs (16.6%) and 120 reported local AEs (51.1%) attributed to DTaP vaccination. The incidence of local AEs was markedly higher with DTaP vaccination than with non-DTaP vaccination (51.1% vs. 10.5%), and AEs appeared later (P < 0.01) and lasted longer (P < 0.01) with DTaP vaccination. However, more than 75% of these AEs resolved within 7 days. DTaP vaccination was not associated with any serious AEs. These results indicate that the DTaP vaccine can be widely used as a booster in adults as an alternative to the Tdap vaccine.
Topics: Adolescent; Adult; Antibodies, Bacterial; Diphtheria; Diphtheria-Tetanus-Pertussis Vaccine; Diphtheria-Tetanus-acellular Pertussis Vaccines; Humans; Immunization, Secondary; Incidence; Infant; Japan; Male; Prospective Studies; Tetanus; Toxoids; Whooping Cough
PubMed: 33518629
DOI: 10.7883/yoken.JJID.2020.947 -
The Journal of Maternal-fetal &... Dec 2022Maternal immunization has the potential to reduce neonatal deaths caused by vaccine-preventable infectious diseases. Elimination of maternal and neonatal tetanus from... (Review)
Review
Maternal immunization has the potential to reduce neonatal deaths caused by vaccine-preventable infectious diseases. Elimination of maternal and neonatal tetanus from many countries illustrates the potential benefits of maternal immunization as a strategy to decrease neonatal mortality caused by vaccine-preventable infections. Many countries in South and Southeast Asia have high cases of neonatal deaths, which were historically attributed to vaccine-preventable infections. Still, these countries vary in recommendations regarding immunization of pregnant women. We reviewed the current recommendations for the use of tetanus toxoid, tetanus-diphtheria, or tetanus-diphtheria-acellular pertussis (Tdap) vaccines for immunization of pregnant women. In addition to protection against tetanus and diphtheria, administration of the Tdap vaccine to pregnant women could help protect neonates against pertussis until they can receive the first two vaccine doses of their primary course. Vaccination against seasonal influenza is also recommended in many countries worldwide for pregnant women as influenza can pose health risks for the mother-fetus unit and the infant. Despite the recognized benefit of influenza vaccination for pregnant women, only some South and Southeast Asian countries have implemented its recommendation. The success of maternal tetanus vaccination has kindled the interest in vaccines that can be safely administered during pregnancy. Future availability of vaccines against respiratory syncytial virus and group B streptococcus, for use in pregnant women, could help prevent neonatal infections, especially in regions where diseases are less controlled. Communicating the body of evidence that supports maternal immunization to obstetricians is key for achieving optimal vaccination coverage to ensure protection of neonates. The current review aims to create awareness about the existing and potential benefits of maternal immunization in South and Southeast Asia.
Topics: Infant; Infant, Newborn; Female; Pregnancy; Humans; Whooping Cough; Tetanus; Diphtheria; Influenza, Human; Perinatal Death; Diphtheria-Tetanus-acellular Pertussis Vaccines; Vaccination; Immunization
PubMed: 34517746
DOI: 10.1080/14767058.2021.1974389 -
Microbiology Spectrum Jul 2019Diphtheria is one of the most well studied of all the bacterial infectious diseases. These milestone studies of toxigenic along with its primary virulence determinant,... (Review)
Review
Diphtheria is one of the most well studied of all the bacterial infectious diseases. These milestone studies of toxigenic along with its primary virulence determinant, diphtheria toxin, have established the paradigm for the study of other related bacterial protein toxins. This review highlights those studies that have contributed to our current understanding of the structure-function relationships of diphtheria toxin, the molecular mechanism of its entry into the eukaryotic cell cytosol, the regulation of diphtheria expression by holo-DtxR, and the molecular basis of transition metal ion activation of apo-DtxR itself. These seminal studies have laid the foundation for the protein engineering of diphtheria toxin and the development of highly potent eukaryotic cell-surface receptor-targeted fusion protein toxins for the treatment of human diseases that range from T cell malignancies to steroid-resistant graft-versus-host disease to metastatic melanoma. This deeper scientific understanding of diphtheria toxin and the regulation of its expression have metamorphosed the third-most-potent bacterial toxin known into a life-saving targeted protein therapeutic, thereby at least partially fulfilling Paul Erlich's concept of a magic bullet-"a chemical that binds to and specifically kills microbes or tumor cells."
Topics: Animals; Bacterial Proteins; Corynebacterium diphtheriae; DNA-Binding Proteins; Diphtheria; Diphtheria Toxin; Gene Expression Regulation, Bacterial; Humans; Iron; Operon
PubMed: 31267892
DOI: 10.1128/microbiolspec.GPP3-0063-2019 -
MMW Fortschritte Der Medizin Jun 2018
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International Journal of Molecular... Mar 2022, the etiological agent of diphtheria, is a re-emerging pathogen, responsible for several thousand deaths per year. In addition to diphtheria, systemic infections, often... (Review)
Review
, the etiological agent of diphtheria, is a re-emerging pathogen, responsible for several thousand deaths per year. In addition to diphtheria, systemic infections, often by non-toxigenic strains, are increasingly observed. This indicates that besides the well-studied and highly potent diphtheria toxin, various other virulence factors may influence the progression of the infection. This review focuses on the known components of responsible for adhesion, invasion, inflammation, and cell death, as well as on the cellular signaling pathways activated upon infection.
Topics: Corynebacterium; Corynebacterium diphtheriae; Diphtheria; Diphtheria Toxin; Humans; Virulence Factors
PubMed: 35328715
DOI: 10.3390/ijms23063298 -
Pediatrics Mar 2016Because the effectiveness of diphtheria-tetanus-acellular pertussis (DTaP) vaccine wanes substantially after the fifth dose at ages 4 to 6 years, there is a growing...
BACKGROUND AND OBJECTIVE
Because the effectiveness of diphtheria-tetanus-acellular pertussis (DTaP) vaccine wanes substantially after the fifth dose at ages 4 to 6 years, there is a growing cohort of adolescents who rely on tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) for protection against pertussis. Yet despite high Tdap vaccine coverage among adolescents, California experienced large pertussis outbreaks in 2010 and 2014. We investigated Tdap vaccine effectiveness (VE) and waning within Kaiser Permanente Northern California among adolescents exclusively vaccinated with DTaP vaccines.
METHODS
We modeled pertussis risk in relation to Tdap vaccination status among adolescents beginning on their 10th birthday. We estimated the hazard ratio (HR) for each subsequent year after Tdap compared with unvaccinated adolescents by using Cox regression, adjusting for calendar time, age, gender, race, and facility. We calculated VE as 1 - HR. We also treated time since Tdap vaccination as a continuous variable and estimated the change in the HR per 1-year increase since vaccination.
RESULTS
On the basis of 1207 pertussis cases, Tdap VE during the first year after vaccination was 68.8% (95% confidence interval [CI] 59.7% to 75.9%), decreasing to 8.9% (95% CI -30.6% to 36.4%) by ≥4 years after vaccination. Adolescents who were more remote from Tdap were significantly more likely to test positive for pertussis than were those vaccinated more recently (HR per year 1.35, 95% CI 1.22 to 1.50).
CONCLUSIONS
Routine Tdap did not prevent pertussis outbreaks. Among adolescents who have only received DTaP vaccines in childhood, Tdap provided moderate protection against pertussis during the first year and then waned rapidly so that litle protection remained 2-3 years after vaccination..
Topics: Adolescent; California; Child; Confidence Intervals; Diphtheria; Diphtheria-Tetanus-acellular Pertussis Vaccines; Disease Outbreaks; Female; Humans; Immunization Schedule; Male; Retrospective Studies; Tetanus; Vaccination; Whooping Cough
PubMed: 26908667
DOI: 10.1542/peds.2015-3326 -
Medecine Et Maladies Infectieuses Sep 2019Diphtheria is re-emerging in Europe. A total of 36 cases were reported in Europe in 2015 versus 53 cases between 2000 and 2009.
BACKGROUND
Diphtheria is re-emerging in Europe. A total of 36 cases were reported in Europe in 2015 versus 53 cases between 2000 and 2009.
PATIENTS
We report two cases of Corynebacterium diphtheriae infection in a French hospital in 2016: a cutaneous infection with negative toxin testing in a French traveller, and a respiratory diphtheria carriage with positive toxin testing in an Afghan refugee diagnosed with pulmonary tuberculosis. The vaccination history of the Afghan patient could not be retrieved.
Topics: Adult; Afghanistan; Communicable Diseases, Emerging; Corynebacterium diphtheriae; Diphtheria; Emigrants and Immigrants; France; Humans; Madagascar; Male; Refugees; Skin Ulcer; Travel-Related Illness; Young Adult
PubMed: 30583866
DOI: 10.1016/j.medmal.2018.12.001 -
Nederlands Tijdschrift Voor Geneeskunde Oct 2019Respiratory diphtheria is an acute respiratory tract infection. The high mortality rates (5-10%) are related to airway obstruction and local and systemic effects of the...
Respiratory diphtheria is an acute respiratory tract infection. The high mortality rates (5-10%) are related to airway obstruction and local and systemic effects of the diphtheria toxin. Vaccination against diphtheria has been available through the Dutch national vaccination programme since the 1950s. The disease has now become rare as a result of herd immunity by these vaccinations. As a consequence, the disease has largely been forgotten, which can result in it not being recognised and treated in time. In addition, diphtheria antitoxin is not always available. In this article, we are drawing attention to the need for immunisation. We also look back at how diphtheria prevention started in the Netherlands.
Topics: Diphtheria; Diphtheria Antitoxin; Diphtheria Toxoid; Humans; Immunization; Immunization Programs; Netherlands; Respiratory Tract Infections
PubMed: 31609562
DOI: No ID Found -
Paediatric Drugs Dec 2015Pertussis is a potentially severe respiratory disease, which affects all age groups from young infants to older adults and is responsible for an estimated 195,000 deaths... (Review)
Review
Pertussis is a potentially severe respiratory disease, which affects all age groups from young infants to older adults and is responsible for an estimated 195,000 deaths occurred globally in 2008. Active research is ongoing to better understand the pathogenesis, immunology, and diagnosis of pertussis. For diagnosis, molecular assays (e.g., polymerase chain reaction) for detection of Bordetella pertussis have become more widely available and support improved outbreak detection. In children, pertussis vaccines have been incorporated into routine immunization schedules and deployed for pertussis outbreak control. Lower levels of vaccine coverage are now being observed in communities where vaccine hesitancy is rising. Additionally, recognition that newborn babies are at risk of pertussis in the USA and UK has led to recommendations to immunize pregnant women. Among adolescents and older adults in the USA, Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular pertussis (Tdap) Vaccines are recommended, but substantial individual- and system-level barriers exist that will make achieving national Healthy People 2020 targets for immunization challenging. Current antimicrobial regimens for pertussis are focused on reducing the severity of disease, reducing rates of sequelae, and minimizing transmission of infection to susceptible individuals. Continued surveillance for pertussis will be important to identify opportunities for reducing young infants' exposure and reducing the impact of outbreaks among school-aged children. Laboratory-based surveillance for newly emerging strains of B. pertussis will be important to identify strains that may evade protection elicited by currently available vaccines. Efforts to develop new-generation pertussis vaccines should be considered now in anticipation of vaccine development programs, which may require ten or more years to deliver a licensed vaccine.
Topics: Diphtheria; Diphtheria Toxoid; Diphtheria-Tetanus-acellular Pertussis Vaccines; Female; Humans; Immunization Schedule; Immunization, Secondary; Infant, Newborn; Pertussis Vaccine; Pregnancy; Pregnant Women; Tetanus; Treatment Outcome; Vaccination; Whooping Cough
PubMed: 26542059
DOI: 10.1007/s40272-015-0149-x