Corynebacterium Diphtheriae Epidemiology and Pathogenesis
Summary
Corynebacterium diphtheriae remains the principal cause of diphtheria, characterised by a fibrinous pseudomembrane in the respiratory tract, systemic toxin-mediated damage and potentially fatal complications. The bacterium colonises the nasopharyngeal mucosa or skin using pilus-like adhesins before secreting an A–B exotoxin that inactivates host elongation factor-2, halting protein synthesis and inducing cell death. Universal infant immunisation with diphtheria–tetanus–pertussis vaccines has driven a dramatic global decline in incidence, yet incomplete coverage, waning adult immunity and humanitarian crises have led to resurgence in pockets of vulnerability. Cutaneous infections and asymptomatic carriage now play an important role in sustaining transmission, while genomic analyses reveal considerable phylogenetic diversity, horizontal acquisition of toxin genes and emerging antimicrobial resistance. Maintaining high primary and booster vaccination rates, enhancing surveillance of respiratory and skin presentations, and rapid laboratory confirmation are central to preventing re-establishment of endemic diphtheria.
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Corynebacterium Diphtheriae Epidemiology and Pathogenesis publication trend
The graph below shows the total number of articles in corynebacterium diphtheriae epidemiology and pathogenesis across all publications each year (not limited to Nature Index journals).
Technical terms
Toxigenic strain: a bacterial isolate carrying and expressing the gene for diphtheria toxin, responsible for classic disease manifestations.
Nontoxigenic strain: a Corynebacterium diphtheriae variant lacking functional toxin expression but capable of carriage and invasive infection.
Carriage: the asymptomatic presence of a pathogen on mucosal or skin surfaces, which can serve as a reservoir for transmission.
Seroprevalence: the proportion of a population with detectable specific antibodies, indicating prior exposure or immunisation.
Cutaneous diphtheria: a form of infection in which C. diphtheriae causes chronic skin lesions, often without respiratory involvement.
References
- Notes from the Field: Increase in Nontoxigenic Corynebacterium diphtheriae — Washington, 2018–2023. MMWR Morbidity and Mortality Weekly Report (2024).
- Outbreak of Corynebacterium diphtheriae among asylum seekers in Belgium in 2022: operational challenges and lessons learnt. Eurosurveillance (2023).
- Seroepidemiology and Carriage of Diphtheria in Epidemic-Prone Area and Implications for Vaccination Policy, Vietnam - Volume 29, Number 1—January 2023 - Emerging Infectious Diseases journal - CDC. Emerging Infectious Diseases (2023).
- Global Epidemiology of Diphtheria, 2000–2017 - Volume 25, Number 10—October 2019 - Emerging Infectious Diseases journal - CDC. Emerging Infectious Diseases (2019).
- Population genomics and antimicrobial resistance in Corynebacterium diphtheriae. Genome Medicine (2020).
- Diphtheria outbreak in Yemen: the impact of conflict on a fragile health system. Conflict and Health (2019).
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