ST534: the new sequence type of Corynebacterium diphtheriae causing diphtheria in Jakarta and surrounding areas, Indonesia

ST534: the new sequence type of Corynebacterium diphtheriae causing diphtheria in Jakarta and surrounding areas, Indonesia

Background/aim: The aim of this study was to find out characteristics and patterns of the spread of Corynebacterium diphtheriaeisolated from Jakarta and the surrounding areas, using the whole genome sequencing (WGS) technique and multilocus sequence typing(MLST) approach.Materials and methods: The study samples consisted of 86 C. diphtheriae isolates, which were isolated from diphtheria patients andclose contacts of patients. The DNA sequencing was carried out using the WGS technique. Data conversion applied the U-gene software.Molecular typing was conducted through the MLST approach, then followed by online data analysis.Results: The results showed that as many as 43 (50%) of all samples examined were new types with the same allele profile, namely 9-1-13-4-3-3-4. New sequence type C. diphtheriae is registered in the MLST global database as ST534 based on the allele profile. The tox geneanalysis in 43 isolates with ST534 indicated that there were three mutation positions, all of which were silent mutations.Conclusion: The main cause of diphtheria in Jakarta and the surrounding areas is a new sequence type of C. diphtheriae registered asST534.

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  • 1. Meera M, Rajarao M. Diphtheria in Andhra Pradesh-a clinicalepidemiological study. International Journal of Infectious Disease. 2014; 19: 74-78. doi: 10.1016/j.ijid.2013.10.017
  • 2. Jain A, Samdani S, Meena V, Sharma MP. Diphtheria: It is still prevalent!!! International Journal of Pediatric Otorhinolaryngology 2016; 86: 68-71. doi: 10.1016/j.ijporl.2016.04.024
  • 3. Blumberg LH, Prieto MA, Diaz JV, Blanco MJ, Valle B et al. The preventable tragedy of diphtheria in the 21st century. International Journal of Infectious Disease 2018; 71: 122-123. doi: 10.1016/j. ijid.2018.05.002
  • 4. Clarke KEN. Review of the Epidemiology of Diphtheria 2000- 2016. Geneva, Switzerland: World Health Organization; 2017.
  • 5. World Health Organization. Diphtheria Reported Cases. Geneva, Switzerland: WHO; 2019.
  • 6. Ditjen PP, Kemenkes RI. Diphtheria Surveillance Data -- Monthly Integrated VPD Report. Jakarta, Indonesia: WHO; 2014.
  • 7. Ditjen PP, Kemenkes RI. Laporan Kejadian difteri di Indonesia. Jakarta, Indonesia: Ministry of Health; 2018 (in Indonesian).
  • 8. Harapan H, Anwar S, Dimiati H, Hayati Z, Mudatsir M. Diphtheria outbreak in Indonesia, 2017: An outbreak of an ancient and vaccine-preventable disease in the third millennium. Clinical Epidemiology and Global Health 2019; 7: 261-262.
  • 9. Schroeder M, Brooks BD, Brooks AE. The complex relationship between virulence and antibiotic resistance. Genes 2017; 8 (1): 39. doi: 10.3390/genes8010039
  • 10. Henriques-Normark B, Normark S. Bacterial vaccine and antibiotic resistance. Uppsala Journal of Medical Sciences 2014; 119 (2): 205-208. doi: 10.3109/03009734.2014.903324
  • 11. Scheibner V. Speeding new antibiotic to market: a fake fix? British Medical Journal 2015; 350: h1453. doi: 10.1136/bmj.h1453
  • 12. Bodilis H, Guiso N. Virulence of pertactin-negative Bordetella pertussis isolates from infants, France. Emerging Infectious Disease 2013; 19 (3): 471-474. doi: 10.3201/1903.121475
  • 13. Hallin M, Strueens MJ. Molecular typing of bacterial pathogens: a tool for the epidemiological study and control of infectious diseases. In: Morand S (editor). New Frontiers of Molecular Epidemiology of Infectious Diseases. Berlin, Germany: Springer Sciences+Business; 2012. pp. 9-25.
  • 14. Tse CWS, Curreem SOT, Cheung I, Tang BSF, Leung KW et al. A novel MLST sequence type discovered in the first fatal case of Laribacter hongkongensis bacteremia clusters with the sequence types of other human isolates. Emerging Microbes and Infections 2014; 3 (6): e41. doi: 10.1038/emi.2014.39
  • 15. Wagner KS, White JM, Lucenko I, Mercer D, Crowcroft NS et al. Diphtheria in the postepidemic period, Europe, 2000-2009. Emerging Infectious Diseases 2012; 18 (2): 217-225. doi: 10.3201/ eid1802.110987
  • 16. De Zoysa A, Hawkey P, Charlett A, Efstratiou A. Comparison of four molecular typing methods for characterization of Corynebacterium diphtheriae and determination of transcontinental spread of C. diphtheriae based on BstEII rRNA gene profiles. Journal of Clinical Microbiology 2008; 46 (11): 3626-3635. doi: 10.1128/JCM.00300-08
  • 17. Bolt F, Cassiday PK, Tondella ML, Dezoysa A, Efstratiou A et al. Multilocus sequence typing identifies evidence for recombination and two distinct lineages of Corynebacterium diphtheriae. Journal of Clinical Microbiology 2010; 48 (11): 4177-4185. doi: 10.1128/ JCM.00274-10
  • 18. Sane J, Sorvari T, Widestrom M, Kauma H, Kaukoniemi U et al. Respiratory diphtheria in an asylum seeker from Afghanistan arriving to Finland via Sweden, December 2015. Euro Surveillance 2010; 21 (2): 30105. doi: 10.2807/1560-7917. ES.2016.21.2.30105
  • 19. König C, Meinel DM, Margos G, Konrad R, Sing A. Multilocus sequence typing of Corynebacterium ulcerans provides evidence for zoonotic transmission and increased prevalence of certain sequence types among toxigenic strains. Journal of Clinical Microbiology 2014; 52 (12): 4318-4324. doi: 10.1128/JCM.02291- 14
  • 20. Wagner KS, White JM, Crowcroft NS, De Martin S, Mann G et al. Diphtheria in the United Kingdom, 1986-2008: the increasing role of Corynebacterium ulcerans. Epidemiology & Infection 2010; 138 (11): 1519-1530. doi:10.1017/S0950268810001895
  • 21. Zakikhany K, Efstratiou A. Diphtheria in Europe: current problems and new challenges. Future Microbiology 2012; 7 (5): 595-607. doi: 10.2217/fmb.12.24
  • 22. Sing A, Hogardt M, Bierschenk S, Heesemann J. Detection of differences in the nucleotide and amino acid sequences of diphtheria toxin from Corynebacterium diphtheriae and Corynebacterium ulcerans causing extrapharingeal infections. Journal of Clinical Microbiology 2003; 41 (10): 4848-4851. doi: 10.1128/jcm.41.10.4848-4851.2003
  • 23. Sekizuka T, Yamamoto A, Komiya T, Kenri T, Takeuchi F et al. Corynebacterium ulcerans 0102 carries the gene encoding diphtheria toxin on a prophage different from the C. diphtheriae NCTC 13129 prophage. BMC Microbiology 2012; 12: 72. doi: 10.1186/1471-2180-12-72