Tellurite resistance: a putative pitfall in Corynebacterium diphtheriae diagnosis?
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Corynebacterium diphtheriae strains continue to circulate worldwide causing diphtheria and invasive diseases, such as endocarditis, osteomyelitis, pneumonia and catheter-related infections. Presumptive C. diphtheriae infections diagnosis in a clinical microbiology laboratory requires a primary isolation consisting of a bacterial culture on blood agar and agar containing tellurite (TeO 3 2− ). In this study, nine genome sequenced and four unsequenced strains of C. diphtheriae from different sources, including three samples from a recent outbreak in Brazil, were characterized with respect to their growth properties on tellurite-containing agar. Levels of tellurite-resistance (TeR) were evaluated by determining the minimum inhibitory concentrations of potassium tellurite (K2TeO3) and by a viability reduction test in solid culture medium with K2TeO3. Significant differences in TeR levels of C. diphtheriae strains were observed independent of origin, biovar or presence of the tox gene. Data indicated that the standard initial screening with TeO 3 2− -selective medium for diphtheria bacilli identification may lead to false-negative results in C. diphtheriae diagnosis laboratories.
KeywordsCorynebacterium diphtheriae Diphtheria Invasive infections Telurite-resistance Laboratory diagnosis
This is work was supported by Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Sub-Reitoria de Pós-Graduação e Pesquisa da Universidade do Estado do Rio de Janeiro (SR-2/UERJ).
Compliance with ethical standards
The authors disclose any financial and personal relationships with other people or organizations that could inappropriately influence their work. All authors declare that they have no competing interests.
- CLSI. Performance for standards for antimicrobial susceptibility testing. http://reflab.yums.ac.ir/uploads/clsi_m100-s23-2013.pdf. Accessed 2 Feb 2015
- Dias AASO, Silva FC, Santos LS, Ribeiro-Carvalho MM, Sabbadini PS, Santos CS, Filardy AA, Myioshi A, Azevedo VA, Hirata R, Villas-Bôas MHS, Mattos-Guaraldi AL (2011a) Strain-dependent arthritogenic potential of the zoonotic pathogen Corynebacterium ulcerans. Vet Microbiol 153:323–331CrossRefPubMedGoogle Scholar
- Gomes DL, Martins CA, Faria LM, Santos LS, Santos CS, Sabbadini PS, Souza MC, Alves GB, Rosa AC, Nagao PE, Pereira GA, Hirata R Jr, Mattos-Guaraldi AL (2009) Corynebacterium diphtheriae as an emerging pathogen in nephrostomy catheter-related infection: evaluation of traits associated with bacterial virulence. J Med Microbiol 58:1419–1427CrossRefPubMedGoogle Scholar
- National Center for Biotechnology Information (NCBI). http://www.ncbi.nlm.nih.gov/. Accessed 2 Feb 2015
- Public Health England, UK. Standards for Microbiology Investigations: Identification of Corynebacterium species. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/371490/ID_2i4.1.pdf. Accessed 2 Feb 2015
- Santos LS, Sant’anna LO, Ramos JN, Ladeira EM, Stavracakis-Peixoto R, Borges LLG, Santos CS, Napoleão F, Camello TCF, Pereira GA, Hirata R, Vieira VV, Cosme LMSS, Sabbadini PS, Mattos-Guaraldi AL (2014) Diphtheria outbreak in Maranhão, Brazil: microbiological, clinical and epidemiological aspects. Epidemiol Infect 1:1–8Google Scholar
- Santos LS, Antunes CA, Santos CS, Pereira JAA, Sabbadini PS, Luna MG, Azevedo V, Hirata R Jr, Burkovski A, Asad LMBO, Mattos-Guaraldi AL (2015) Corynebacterium diphtheriae putative tellurite-resistance protein (CDCE8392_0813): effects on intracellular survival in human epithelial cell and lethality of Caenorhabditis elegans. Mem Inst Oswaldo Cruz 110:1–7CrossRefGoogle Scholar
- Viguetti SZ, Pacheco LG, Santos LS, Soares SC, Bolt F, Baldwin A, Dowson CG, Rosso ML, Guiso N, Miyoshi A, Hirata R Jr, Mattos-Guaraldi AL, Azevedo V (2012) Multilocus sequence types of invasive Corynebacterium diphtheriae isolated in the Rio de Janeiro urban area, Brazil. Epidemiol Infect 140:617–620CrossRefPubMedGoogle Scholar
- World Health Organization (WHO). Diphtheria reported cases. http://apps.who.int/immunization_monitoring/globalsummary/timeseries/tsincidencediphtheria.html. Accessed 2 Feb 2015
- Zasada AA (2013) Nontoxigenic highly pathogenic clone of Corynebacterium diphtheriae, Poland, 2004–2012. Emerg Infect Dis 11:1870–1872Google Scholar