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Screening for Corynebacterium diphtheriae.

A P Wilson1, S Matthews, M Bahl

  • 1Department of Clinical Microbiology, University College, London.

Journal of Clinical Pathology
|November 1, 1992
PubMed
Summary
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A non-toxigenic Corynebacterium diphtheriae strain was found in a child with pharyngitis. However, a toxin-producing strain was later identified in an asymptomatic sibling, highlighting the importance of complete bacterial identification.

Area of Science:

  • Microbiology
  • Bacterial Pathogenesis
  • Public Health

Background:

  • Diphtheria is a serious bacterial infection caused by Corynebacterium diphtheriae.
  • Non-toxigenic strains of C. diphtheriae can be mistaken for pathogenic strains.
  • Accurate identification of bacterial isolates is crucial for disease prevention and control.

Observation:

  • A 9-year-old girl presented with pharyngitis and yielded a non-toxigenic Corynebacterium diphtheriae var. mitis and Streptococcus group G from a throat swab.
  • Corynebacterium pseudodiphtheriticum was isolated from two of her four brothers.
  • One brother's sample contained a mixed culture, with the other isolate being a toxin-producing C. diphtheriae var. gravis.

Findings:

  • The presence of a toxin-producing C. diphtheriae var. gravis in an asymptomatic sibling indicates potential for silent carriage and transmission.

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  • The initial identification of a non-toxigenic strain in the symptomatic child did not rule out the presence of pathogenic strains within the household.
  • Complete identification of all colonial types on diagnostic plates, such as the Hoyles plate, is essential.

    • Implications:

    • This case underscores the necessity of thorough laboratory identification of all bacterial isolates, even in asymptomatic individuals.
    • Failure to identify all colonial types could lead to underestimation of pathogenic bacteria prevalence and delayed public health interventions.
    • Enhanced diagnostic protocols are needed to ensure the detection of all relevant bacterial strains, including toxigenic diphtheria.