Imported Toxigenic Corynebacterium Diphtheriae in Refugees with Polymicrobial Skin Infections, Germany, 2022

Area of Science:

• Infectious Diseases
• Microbiology
• Public Health

Background:

• Refugee populations can present unique public health challenges.
• Skin infections are common in diverse settings.
• Corynebacterium diphtheriae is a bacterium known for causing diphtheria.

Purpose of the Study:

• To investigate the presence and characteristics of toxigenic Corynebacterium diphtheriae in a refugee population.
• To determine the association of C. diphtheriae with skin infections and asymptomatic colonization.
• To assess the clinical presentation and implications of C. diphtheriae findings in this group.

Main Methods:

• Bacterial isolation and identification of Corynebacterium diphtheriae from clinical samples (skin, throat).
• Toxigenicity testing of isolated C. diphtheriae strains.
• Clinical data collection on patient symptoms, infection types, and comorbidities.
• Microbiological analysis of polymicrobial infections.

Main Results:

• Toxigenic Corynebacterium diphtheriae was isolated from 25 refugees with skin infections and 2 with asymptomatic throat colonization.
• The majority of skin infections (96%) were polymicrobial.
• No systemic toxin-mediated diphtheria was observed in any of the affected refugees.

Conclusions:

• Cutaneous diphtheria should be considered in refugees presenting with erosive/ulcerative skin wounds.
• Routine testing of skin lesions in this population is warranted to rule out C. diphtheriae.
• The findings highlight the importance of microbiological surveillance in refugee health settings.