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Journal of Clinical Microbiology, May 2006, p. 1625-1629, Vol. 44, No. 5
0095-1137/06/$08.00+0     doi:10.1128/JCM.44.5.1625-1629.2006
Copyright © 2006, American Society for Microbiology. All Rights Reserved.

Emergence of an Invasive Clone of Nontoxigenic Corynebacterium diphtheriae in the Urban Poor Population of Vancouver, Canada

M. G. Romney,1,2* D. L. Roscoe,1,3 K. Bernard,4 S. Lai,5 A. Efstratiou,5 and A. M. Clarke1,2

Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada,1 St. Paul's Hospital, Providence Health Care, Vancouver, Canada,2 Vancouver Coastal Health, Vancouver, Canada,3 National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Canada,4 Health Protection Agency Centre for Infections, London, United Kingdom5

Received 29 December 2005/ Returned for modification 26 February 2006/ Accepted 5 March 2006

Invasive disease due to Corynebacterium diphtheriae is rare in North America. Here we describe the emergence of a predominant clone of a nontoxigenic strain of C. diphtheriae in the impoverished population of Vancouver's downtown core. This clone has caused significant morbidity and contributed to at least two deaths. Over a 5-year period, seven cases of bacteremia due to C. diphtheriae were detected in patients admitted to Vancouver hospitals. Injection drug use, diabetes mellitus, skin colonization/infection with C. diphtheriae, and homelessness all appeared to be related to the development of bacteremia with the organism. Ribotyping of isolates recovered from blood culture revealed a predominant ribotype pattern that has not previously been reported in North America.

* Corresponding author. Mailing address: Division of Medical Microbiology, St. Paul's Hospital, 1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada. Phone: (604) 806-8188. Fax: (604) 806-8661. E-mail: mromney{at}providencehealth.bc.ca.

Journal of Clinical Microbiology, May 2006, p. 1625-1629, Vol. 44, No. 5
0095-1137/06/$08.00+0     doi:10.1128/JCM.44.5.1625-1629.2006
Copyright © 2006, American Society for Microbiology. All Rights Reserved.





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