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Multicenter Study
. 2024 Aug;30(8):1545-1554.
doi: 10.3201/eid3008.231671.

Retrospective Study of Infections with Corynebacterium diphtheriae Species Complex, French Guiana, 2016-2021

Mélanie Gaillet, Mélanie Hennart, Vincent Sainte Rose, Edgar Badell, Céline Michaud, Romain Blaizot, Magalie Demar, Luisiane Carvalho, Jean François Carod, Audrey Andrieu, Félix Djossou, Julie Toubiana, Loic Epelboin, Sylvain Brisse
Multicenter Study

Retrospective Study of Infections with Corynebacterium diphtheriae Species Complex, French Guiana, 2016-2021

Mélanie Gaillet et al. Emerg Infect Dis. 2024 Aug.

Abstract

Human infections with Corynebacterium diphtheriae species complex (CdSC) bacteria were rare in French Guiana until 2016, when the number of cases diagnosed increased. We conducted an epidemiologic, multicenter, retrospective study of all human CdSC infections diagnosed in French Guiana during January 1, 2016-December 31, 2021. A total of 64 infectious episodes were observed in 60 patients; 61 infections were caused by C. diphtheriae and 3 by C. ulcerans. Estimated incidence increased from 0.7 cases/100,000 population in 2016 to 7.7 cases/100,000 population in 2021. The mean patient age was 30.4 (+23.7) years, and male-to-female ratio was 1.7:1 (38/22). Of the 61 C. diphtheriae isolates, 5 tested positive for the diphtheria toxin gene, and all results were negative by Elek test; 95% (61/64) of cases were cutaneous, including the C. ulcerans cases. The increase in reported human infections underscores the need to raise awareness among frontline healthcare practitioners to improve prevention.

Keywords: Amazonia; Corynebacterium diphtheriae; Corynebacterium diphtheriae species complex; French Guiana; antimicrobial resistance; bacteria; cutaneous diphtheria; diphtheria; zoonoses.

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Figures

Figure 1
Figure 1
Geographic distribution of 64 cases of Corynebacterium diphtheriae species complex infections, French Guiana, 2016–2021. Inset map shows location of French Guiana in South America. DCPC, Delocalized Centers for Prevention and Care.
Figure 2
Figure 2
Flowchart of cases included in retrospective study of infections with Corynebacterium diphtheriae species complex, French Guiana, 2016–2021.
Figure 3
Figure 3
Temporal distribution of isolates corresponding to 64 clinical episodes of infection with Corynebacterium diphtheriae species complex in French Guiana, 2016–2021. Each box indicates 1 case; patient number labels (e.g., P1) indicate multiple cases in the same patient. EAI, estimated annual incidence (cases/100,000 population); NTTB, nontoxigenic tox-gene–bearing; PSE, population size estimation; Q, quarter.
Figure 4
Figure 4
Diversity of Corynebacterium diphtheriae isolates in retrospective study of infections with C. diphtheriae species complex, French Guiana, 2016–2021. Star in column 7 indicates narH gene was not complete. MLST, multilocus sequence type; ST, sequence type.
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