du Plessis Mignon, Mikhari Rito, de Gouveia Linda, Duma Noluthando, Lovelock Tamsin, Lawrence Charlene, Mahabeer Prasha, Mahabeer Yesholata, Govender Nevashan, Nzenze Susan, Featherston Jonathan, Moodley Mishalan, Moyes Jocelyn, Walaza Sibongile, Cohen Cheryl, von Gottberg Anne
Emerg Infect Dis. 2025 Mar;31(3):417-426. doi: 10.3201/eid3103.241211.
We reviewed Corynebacterium spp. infection cases reported in South Africa during 2015-2023. We analyzed 84 isolates from 83 patients with C. diphtheriae, as well as 1 C. belfantii and 3 C. ulcerans isolates. Among C. diphtheriae cases, we observed respiratory diphtheria (26/83 patients [31%]), endocarditis (14/83 [17%]), cutaneous diphtheria (22/83 [27%]), nonspecific respiratory illnesses (5/83 [6%]), and asymptomatic carriage (16/83 [19%]). The median patient age was 19 (range 0-88) years. Diphtheria-tetanus-pertussis vaccination was incomplete for 26% (5/19) or unknown for 68% (13/19) of children 0-9 years of age. C. diphtheriae was intermediately resistant to penicillin (82/84 [98%] isolates; MIC 0.5 μg/mL) but susceptible to erythromycin (83/84 [99%] isolates; MIC 0.25 μg/mL). Eighteen unique sequence types were identified, corroborating C. diphtheriae heterogeneity. Toxin-producing strains were detected among cutaneous and respiratory diphtheria cases, indicating all forms of disease require monitoring and prompt public health action to curb transmission.
我们回顾了2015年至2023年期间在南非报告的棒状杆菌属感染病例。我们分析了来自83例白喉棒状杆菌患者的84株分离株，以及1株贝尔凡蒂棒状杆菌和3株溃疡棒状杆菌分离株。在白喉棒状杆菌病例中，我们观察到呼吸道白喉（26/83例患者[31%]）、心内膜炎（14/83[17%]）、皮肤白喉（22/83[27%]）、非特异性呼吸道疾病（5/83[6%]）和无症状携带（16/83[19%]）。患者年龄中位数为19岁（范围0至88岁）。0至9岁儿童中，26%（5/19）的白喉-破伤风-百日咳疫苗接种不完整，68%（13/19）的接种情况未知。白喉棒状杆菌对青霉素呈中度耐药（82/84[98%]株分离株；MIC 0.5μg/mL），但对红霉素敏感（83/84[99%]株分离株；MIC 0.25μg/mL）。鉴定出18种独特的序列类型，证实了白喉棒状杆菌的异质性。在皮肤和呼吸道白喉病例中检测到产毒素菌株，表明所有形式的疾病都需要监测并迅速采取公共卫生行动以遏制传播。
