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Corynebacterium species nasopharyngeal carriage in asymptomatic individuals aged ≥ 65 years in Germany

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Abstract

Purpose

The prevalence of protective anti-diphtheria toxin antibodies decreases with age. Therefore, the elderly might serve as reservoir for potentially toxigenic Corynebacterium (C.) species (C. diphtheriae, C. ulcerans, and C. pseudotuberculosis). This study aimed to examine the colonization rate of the nasopharynx with corynebacteria of individuals aged 65 years and older.

Methods

In the period from October 2012 to June 2013, nasal and throat swabs were taken from 714 asymptomatic subjects aged 65–106 years (average age 77.2) at three regions in Germany and investigated for Corynebacterium species.

Results

A total of 402 strains of Corynebacterium species were isolated from 388 out of 714 asymptomatic subjects (carriage rate 54.3%). The carriage rate was significantly higher in study participants living in retirement homes (68.4%) compared to those living autonomously at home (51.1%). Strains were isolated mostly from the nose (99%). Corynebacterium accolens was the most often isolated species (39.8%), followed by C. propinquum (24.1%), C. pseudodiphtheriticum (19.4%), and C. tuberculostearicum (10.2%). No C. diphtheriae, C. ulcerans, and C. pseudotuberculosis strains were isolated. A subsample of 74 subjects was tested serologically for anti-diphtheria antibodies. Protective anti-diphtheria toxin antibodies were found in 29.7% of the subjects; 70.3% showed no protective immunity.

Conclusions

These results suggest that carriage of potentially toxigenic corynebacteria is very rare among people aged 65 and older in Germany. However, the low prevalence of protective anti-diphtheria toxin antibodies might pose a risk for acquiring diphtheria especially for the elderly.

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Acknowledgements

We would like to thank the elderly people who volunteered to participate in this study and the institutions of the elderly for their support. We thank Wolfgang Schmidt, Turgut-Cengiz Dedeoglu, Annegret Mahl and Jasmin Fräßdorf for excellent technical and Dr. Angelika Torka for expert medical support. The study was supported by the German Federal Ministry of Health via the Robert Koch Institute and its National Reference Laboratories Network (FKZ 415).

Author information

Author notes

  1. Barbara Teutsch and Anja Berger equally contributed to this study.

Authors and Affiliations

  1. Bavarian Health and Food Safety Authority, Veterinärstraße 2, 85764, Oberschleißheim, Germany

    Barbara Teutsch, Anja Berger, Durdica Marosevic, Katharina Schönberger, Nikolaus Ackermann & Andreas Sing

  2. National Consiliary Laboratory for Diphtheria, Oberschleißheim, Germany

    Anja Berger & Andreas Sing

  3. European Programme for Public Health Microbiology Training, European Centre of Disease Prevention and Control (ECDC), Stockholm, Sweden

    Durdica Marosevic

  4. National Reference Center for Meningococci and Haemophilus Influenzae, Institute for Hygiene and Microbiology, University of Würzburg, Würzburg, Germany

    Thiên-Trí Lâm, Kerstin Hubert, Heike Claus, Maria Drayß, Kathrin Thiel & Ulrich Vogel

  5. Sanitätsdienst der Bundeswehr, Koblenz, Germany

    Steffi Beer

  6. Medical Office, Schönau am Königssee, Germany

    Peter Wienert

  7. National Reference Center for Streptococci, Institut für Medizinische Mikrobiologie des UKA, RWTH Aachen, Aachen, Germany

    Mark van der Linden

Authors
  1. Barbara Teutsch
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  2. Anja Berger
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  3. Durdica Marosevic
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  4. Katharina Schönberger
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  5. Thiên-Trí Lâm
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  6. Kerstin Hubert
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  7. Steffi Beer
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  8. Peter Wienert
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  9. Nikolaus Ackermann
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  10. Heike Claus
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  11. Maria Drayß
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  12. Kathrin Thiel
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  13. Mark van der Linden
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  14. Ulrich Vogel
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  15. Andreas Sing
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Corresponding author

Correspondence to Andreas Sing.

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Ethical standards

The study has been approved by the responsible human subjects’ research ethical review board at the University of Würzburg (no. 150/11). All participants gave their informed consent prior to their inclusion in this study.

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

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Teutsch, B., Berger, A., Marosevic, D. et al. Corynebacterium species nasopharyngeal carriage in asymptomatic individuals aged ≥ 65 years in Germany. Infection 45, 607–611 (2017). https://doi.org/10.1007/s15010-017-1017-0

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  • DOI: https://doi.org/10.1007/s15010-017-1017-0

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