Academic Journal
Molecular epidemiology and antimicrobial resistance determinants of Corynebacterium diphtheriae causing infections in Karachi, Pakistan, 2023-2024.
| Τίτλος: | Molecular epidemiology and antimicrobial resistance determinants of Corynebacterium diphtheriae causing infections in Karachi, Pakistan, 2023-2024. |
|---|---|
| Συγγραφείς: | Khan SMA; Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan., Irfan S; Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan., Ashraf J; Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan., Ghayas H; Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan., Ghanchi N; Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan., Farooqi J; Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan., Jabeen K; Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan., Saeed N; Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan., Naeem M; Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan., Zaka S; Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan., Ozer EA; Northwestern University Feinberg School of Medicine, Chicago, IL, USA., Hasan R; Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan; Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, UK. Electronic address: rumina.hasan@aka.edu. |
| Πηγή: | International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases [Int J Infect Dis] 2026 Oct; Vol. 171, pp. 109058. Date of Electronic Publication: 2026 Aug 20. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Elsevier Country of Publication: Canada NLM ID: 9610933 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1878-3511 (Electronic) Linking ISSN: 12019712 NLM ISO Abbreviation: Int J Infect Dis Subsets: MEDLINE |
| Imprint Name(s): | Publication: Hamilton, ON : Elsevier Original Publication: Hamilton, ON : Decker, c1996- |
| Ιατρικοί όροι (MeSH): | Corynebacterium diphtheriae*/genetics , Corynebacterium diphtheriae*/drug effects , Corynebacterium diphtheriae*/isolation & purification , Corynebacterium diphtheriae*/pathogenicity , Diphtheria*/epidemiology , Diphtheria*/microbiology , Diphtheria*/drug therapy , Drug Resistance, Bacterial*/genetics, Pakistan/epidemiology ; Anti-Bacterial Agents/pharmacology ; Anti-Bacterial Agents/therapeutic use ; Drug Resistance, Multiple, Bacterial/genetics ; Humans ; Male ; Female ; Child ; Microbial Sensitivity Tests ; Molecular Epidemiology ; Adolescent ; Phylogeny ; Child, Preschool ; Whole Genome Sequencing ; Infant ; Disease Outbreaks |
| Περίληψη: | Objectives: Diphtheria remains endemic in Pakistan, with cases increasing following the COVID-19 pandemic despite ongoing vaccination programs. This study analyzes the genomic diversity, virulence, and antimicrobial resistance patterns of pharyngeal diphtheria strains collected during the Karachi outbreak. Methods: Corynebacterium diphtheriae isolates from a tertiary care hospital laboratory in Karachi (August 2023-October 2024) were included. Antimicrobial susceptibility testing and whole-genome sequencing of phenotypically confirmed isolates were performed. Phylogenetic and bioinformatics analyses were performed using diphtOscan and AMRFinderPlus tools. Results: A total of 47 pharyngeal C. diphtheriae isolates were included. The median age of patients was 7 years, and the male-to-female ratio was 1.6:1. The tox gene was present in 89.4% of isolates, while only 29% (n = 13/45) demonstrated toxin production. Genomic analysis identified 10 sequence types; ST384 and ST698 were most prevalent. Phenotypically, 34% (n = 16) were resistant to both erythromycin and penicillin, and 49% (n = 23) were multidrug-resistant. The most prevalent resistance genes were sul1 (100%), erm(X) (76.6%), and pbp2m (51.1%). Conclusion: Circulation of diverse C. diphtheriae strains with alarming antimicrobial resistance underscores the need for genomic surveillance to evaluate transmission trends. We further highlight the limitations of the Elek test in detecting toxin production and the need for improved diagnostics in low- and middle-income countries. (Copyright © 2026 The Authors. Published by Elsevier Ltd.. All rights reserved.) |
| Competing Interests: | Declaration of competing interest The authors have no competing interests to declare. |
| Contributed Indexing: | Keywords: Antimicrobial resistance; Corynebacterium diphtheriae; Diphtheria; Outbreak; Pakistan; Whole-genome sequencing |
| Substance Nomenclature: | 0 (Anti-Bacterial Agents) |
| Entry Date(s): | Date Created: 20260820 Date Completed: 20260929 Latest Revision: 20260929 |
| Update Code: | 20260929 |
| DOI: | 10.1016/j.ijid.2026.109058 |
| PMID: | 42624284 |
| Βάση Δεδομένων: | MEDLINE |
καταχωρήστε σχόλιο πρώτοι!