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Journal of Clinical Microbiology, April 1999, p. 1092-1099, Vol. 37, No. 4
0095-1137/99/$04.00+0

Use of Molecular Subtyping To Document Long-Term Persistence of Corynebacterium diphtheriae in South Dakota

Tanja Popovic,1,* Chung Kim,1 Jonathan Reiss,1 Mike Reeves,1 Hiroshi Nakao,1 and Anne Golaz2

Meningitis and Special Pathogens Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases,1 and Epidemiology and Surveillance Division, National Immunization Program,2 Centers for Disease Control and Prevention, Public Health Service, U.S. Department of Health and Human Services, Atlanta, Georgia

Received 10 September 1998/Returned for modification 10 November 1998/Accepted 7 January 1999

Enhanced surveillance of patients with upper respiratory symptoms in a Northern Plains community revealed that approximately 4% of them were infected by toxigenic Corynebacterium diphtheriae of both mitis and gravis biotypes, showing that the organism is still circulating in the United States. Toxigenic C. diphtheriae was isolated from five members of four households. Four molecular subtyping methods---ribotyping, multilocus enzyme electrophoresis (MEE), random amplified polymorphic DNA (RAPD), and single-strand conformation polymorphism---were used to molecularly characterize these strains and compare them to 17 archival South Dakota strains dating back to 1973 through 1983 and to 5 isolates collected from residents of diverse regions of the United States. Ribotyping and RAPD clearly demonstrated the household transmission of isolates and provided precise information on the circulation of several distinct strains within three households. By MEE, most recent and archival South Dakota strains were identified as closely related and clustered within the newly identified ET (electrophoretic type) 215 complex. Furthermore, three recent South Dakota isolates and eight archival South Dakota isolates were indistinguishable by both ribotyping and RAPD. All of these molecular methods showed that recent South Dakota isolates and archival South Dakota isolates were more closely related to each other than to the C. diphtheriae strains isolated in other parts of the United States or worldwide. The data also supported the improbability of importation of C. diphtheriae into this area and rather strongly suggest the long-term persistence of the organism in this region.

* Corresponding author. Mailing address: Epidemiologic Investigations Laboratory, Meningitis and Special Pathogens Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, CDC, MS CO2, 1600 Clifton Rd., Atlanta, GA 30333. Phone: (404) 639-1730. Fax: (404) 639-3123. E-mail: TXP1{at}CDC.GOV.

Journal of Clinical Microbiology, April 1999, p. 1092-1099, Vol. 37, No. 4
0095-1137/99/$04.00+0


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