Demikhovskaia E V
Kyiv Scientific-Research Institute of Epidemiology and Infectious Diseases, Ministry of Public Health of Ukraine.
Mikrobiol Z. 1999 Jul-Aug;61(4):81-9.
The review raises a problem of cooperation between a laboratory and clinics for diphtheria diagnosis. According to scientific literature nontoxigenic diphtheroids cause different nosocomial infections of immunocompromised patients. Nontoxigenic Corynebacterium diphtheriae may cause such systemic infections as septic arthritis and endocarditis in people belonging to unsecured strata of the society. A toxin which can be produced not only by C. diphtheriae but also by diphtheroids is the sole reason of diphtheric inflammation. The role of the C. diphtheriae nontoxigenic strains should be elucidated by the improving of standard methods and introduction of the methods of molecular biology for the toxigenicity assay of diphtheria strains (e.g. polymerase chain reaction). But a complexity of gene expression and difficulties in distinguishing between the infection and the microorganism colonization of a vaccinated person reserve the last word in the diagnosis of diphtheria for a clinical physician.
该综述提出了实验室与临床在白喉诊断方面的合作问题。根据科学文献，非产毒类白喉杆菌可导致免疫功能低下患者发生不同的医院感染。非产毒白喉棒状杆菌可能在社会弱势群体中引起诸如化脓性关节炎和心内膜炎等全身性感染。一种不仅可由白喉杆菌产生，也可由类白喉杆菌产生的毒素是白喉性炎症的唯一原因。应通过改进标准方法并引入分子生物学方法对白喉菌株进行产毒性测定（如聚合酶链反应）来阐明非产毒白喉杆菌菌株的作用。但是基因表达的复杂性以及区分接种疫苗者的感染与微生物定植的困难，使得临床医生在白喉诊断中仍起决定性作用。
