Zoonotic Transmission of Toxigenic Corynebacterium ulcerans Strain, Germany, 2012 - Volume 21, Number 2—February 2015 - Emerging Infectious Disease journal - CDC

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Zoonotic Transmission of Toxigenic Corynebacterium ulcerans Strain, Germany, 2012 - Volume 21, Number 2—February 2015 - Emerging Infectious Disease journal - CDC

Volume 21, Number 2—February 2015

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Zoonotic Transmission of Toxigenic Corynebacterium ulcerans Strain, Germany, 2012

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Dominik M. Meinel, Regina Konrad, Anja Berger, Christina König, Torsten Schmidt-Wieland, Michael Hogardt, Heribert Bischoff, Nikolaus Ackermann, Stefan Hörmansdorfer, Stefan Krebs, Helmut Blum, Gabriele Margos, and Andreas Sing 

Author affiliations: Bavarian Health and Food Safety Authority, Oberschleißheim, Germany (D.M. Meinel, R. Konrad, A. Berger, C. König, M. Hogardt, H. Bischoff, N. Ackermann, S. Hörmansdorfer, G. Margos, A. Sing);National Consiliary Laboratory for Diphtheria, Oberschleißheim (R. Konrad, A. Berger, C. König, A. Sing); Labor Dr. Gaertner, Ravensburg, Germany (T. Schmidt-Wieland); Institut für Medizinische Mikrobiologie und Krankenhaushygiene, Klinikum der Goethe-Universität, Frankfurt/Main, Germany (M. Hogardt); Genecenter, Ludwig-Maximilians-University Munich, Munich, Germany (S. Krebs, H. Blum)

Suggested citation for this article

Abstract

Severe necrotizing fasciitis was diagnosed in a 53-year-old man in Germany in 2012. ToxigenicCorynebacterium 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.

Toxigenic Corynebacterium spp. C. diphtheriae, C. ulcerans, and rarely, C. pseudotuberculosis produce diphtheria toxin (DT) and thus cause respiratory and cutaneous diphtheria. DT is encoded by the phage-located tox gene. During the past decade, diphtheria-like infections with toxigenic C. ulcerans have outnumbered those caused by toxigenic C. diphtheriae in many industrialized countries (1). C. ulcerans has increasingly been isolated from domestic animals such as pet dogs and cats (1–5). Isolation of an undistinguishable toxigenic C. ulcerans strain from an animal and its owner has been documented for 2 dogs (2,3), 2 cats (4,5), and 1 pig (6) and their respective owners. Strain comparison was achieved in these cases by ribotyping alone (2,3), ribotyping in combination with multilocus sequence typing (4,6), or pulsed-field gel electrophoresis analysis (5). We report the first use of next generation sequencing (NGS) for proving zoonotic transmission of a toxigenic C. ulcerans strain between a pet dog and his human owner.

Dr. Meinel is a postdoctoral researcher at the Bavarian Health and Food Authority, Oberschleißheim, Germany. His major research interests are genomics, genome biology, and infectious diseases.

Acknowledgments

We thank Wolfgang Schmidt, Sabine Wolf, Jasmin Fräßdorf, and Christine Hartberger for excellent technical assistance and Georg Decker for continuous support. We dedicate this paper to Jürgen Heesemann, the first head of the German Consiliary Laboratory for Diphtheria, on the occasion of his retirement.

The study was partly supported by the Bavarian State Ministry of Health and Care and by the German Federal Ministry of Health through the Robert Koch-Institute and its National Reference Laboratories Network (09-47, FKZ 1369-359 and FKZ 415).

References

1. Zakikhany K, Efstratiou A. Diphtheria in Europe: current problems and new challenges. Future Microbiol. 2012;7:595–607 . DOIPubMed
2. Lartigue MF, Monnet X, Le Flèche A, Grimont PA, Benet JJ, Durrbach A, Corynebacterium ulcerans in an immunocompromised patient with diphtheria and her dog. J Clin Microbiol. 2005;43:999–1001. DOIPubMed
3. Hogg RA, Wessels J, Hart J, Efstratiou A, De Zoysa A, Mann G, Possible zoonotic transmission of toxigenic Corynebacterium ulcerans from companion animals in a human case of fatal diphtheria. Vet Rec. 2009;165:691–2 .PubMed
4. Berger A, Huber I, Merbecks SS, Ehrhard I, Konrad R, Hörmansdorfer S, Toxigenic Corynebacterium ulcerans in woman and cat. Emerg Infect Dis.2011;17:1767–9. DOIPubMed
5. Yoshimura Y, Tachikawa N, Komiya T, Yamamoto A. A case report and epidemiological investigation of axillary lymph node abscess caused byCorynebacterium ulcerans in an HIV-1-positive patient. Epidemiol Infect. 2014;142:1541–4. DOIPubMed
6. Schuhegger R, Schoerner C, Dlugaiczyk J, Lichtenfeld I, Trouillier A, Zeller-Peronnet V, Pigs as source for toxigenic Corynebacterium ulcerans. Emerg Infect Dis. 2009;15:1314–5. DOIPubMed
7. Schuhegger R, Lindermayer M, Kugler R, Heesemann J, Busch U, Sing A. Detection of toxigenic Corynebacterium diphtheriae and Corynebacterium ulcerans strains by a novel real-time PCR. J Clin Microbiol. 2008;46:2822–3. DOIPubMed
8. Sing A, Hogardt M, Bierschenk S, Heesemann J. Detection of differences in the nucleotide and amino acid sequences of diphtheria toxin fromCorynebacterium diphtheriae and Corynebacterium ulcerans causing extrapharyngeal infections. J Clin Microbiol. 2003;41:4848–51.DOIPubMed
9. Clinical Laboratory Standards Institute. Methods for antimicrobial dilution and disk susceptibility testing of infrequently isolated or fastidious bacteria; approved guideline. 2nd ed. Wayne (PA); The Institute; 2006. p. M45–A2.
10. Trost E, Al-Dilaimi A, Papavasiliou P, Schneider J, Viehoever P, Burkovski A, Comparative analysis of two complete Corynebacterium ulceransgenomes and detection of candidate virulence factors. BMC Genomics. 2011;12:383. DOIPubMed
11. Reeves PR, Liu B, Zhou Z, Li D, Guo D, Ren Y, Rates of mutation and host transmission for an Escherichia coli clone over 3 years. PLoS ONE.2011;6:e26907. DOIPubMed
12. Sekizuka T, Yamamoto A, Komiya T, Kenri T, Takeuchi F, Shibayama K, Corynebacterium ulcerans 0102 carries the gene encoding diphtheria toxin on a prophage different from the C. diphtheriae NCTC 13129 prophage. BMC Microbiol. 2012;12:72. DOIPubMed
13. Berger A, Schmidt-Wieland T, Huber I, Sing A. Human diphtheria infection from a cat bite. Ann Intern Med. 2011;155:646–8. DOIPubMed
14. Harrison EM, Paterson GK, Holden MT, Larsen J, Stegger M, Larsen AR, Whole genome sequencing identifies zoonotic transmission of MRSA isolates with the novel mecA homologue mecC. EMBO Mol Med. 2013;5:509–15. DOIPubMed
15. Komiya T, Seto Y, De Zoysa A, Iwaki M, Hatanaka A, Tsunoda A, Two Japanese Corynebacterium ulcerans isolates from the same hospital: ribotype, toxigenicity and serum antitoxin titre. J Med Microbiol. 2010;59:1497–504. DOIPubMed

Suggested citation for this article: Meinel DM, Konrad R, Berger A, König C, Schmidt-Wieland T, Hogardt M, et al. Zoonotic transmission of toxigenicCorynebacterium ulcerans strain, Germany, 2012. Emerg Infect Dis. 2015 Feb [date cited]. http://dx.doi.org/10.3201/eid2102.141160

DOI: 10.3201/eid2102.141160