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Journal of Clinical Microbiology, November 1998, p. 3173-3177, Vol. 36, No. 11
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.

Comparison of Phenotypic and Genotypic Methods for Detection of Diphtheria Toxin among Isolates of Pathogenic Corynebacteria

Androulla Efstratiou,1,* Kathryn H. Engler,1 Charlotte S. Dawes,2 and Dorothea Sesardic2

Respiratory and Systemic Infection Laboratory, Central Public Health Laboratory, London NW9 5HT,1 and Division of Bacteriology, National Institute for Biological Standards and Control, South Mimms, Hertfordshire EN6 3QG,2 United Kingdom

Received 1 May 1998/Returned for modification 1 July 1998/Accepted 2 August 1998

We have compared molecular, immunochemical, and cytotoxic assays for the detection of diphtheria toxin from 55 isolates of Corynebacterium diphtheriae and Corynebacterium ulcerans originally isolated in five different countries. The suitabilities and accuracies of these assays for the laboratory diagnosis of diphtheria were compared and evaluated against the "gold standard" in vivo methods. The in vivo and Vero cell cytotoxicity assays were accurate in their abilities to detect diphtheria toxin but were time-consuming; however, the cytotoxicity assay is a suitable in vitro alternative to the in vivo virulence test. There was complete concordance between all the phenotypic methods. Genotypic tests based upon PCR were rapid; however, PCR must be used with caution because some isolates of C. diphtheriae possessed toxin genes but failed to express a biologically active toxin. Therefore, phenotypic confirmation of toxigenicity for the microbiological diagnosis of diphtheria is recommended.

* Corresponding author. Mailing address: PHLS/WHO Streptococcus and Diphtheria Reference Unit, Respiratory and Systemic Infection Laboratory, Central Public Health Laboratory, 61 Colindale Ave., London NW9 5HT, United Kingdom. Phone: 44 181 200 4400. Fax: 44 181 205 6528. E-mail: aefstratiou{at}phls.co.uk.

Journal of Clinical Microbiology, November 1998, p. 3173-3177, Vol. 36, No. 11
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.


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