A case of fatal respiratory diphtheria imported from Poland to Germany: possible link to an undetected imported diphtheria cluster in Poland?

IF 3.6 2区医学 Q1 INFECTIOUS DISEASES Infection Pub Date : 2025-12-01 Epub Date: 2025-04-02 DOI:10.1007/s15010-025-02522-y

Anja Berger, Aleksandra A Zasada, Alexandra Dangel, Katarzyna Piekarska, Iwona Paradowska-Stankiewicz, Katja Bengs, Christine Noll, Andreas Sing

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Abstract

Purpose: Diphtheria is a re-emerging vaccine-preventable disease, mainly caused by toxigenic Corynebacterium diphtheriae.

Methods: Here, we report a fatal respiratory diphtheria infection in a Polish woman travelling to Germany possibly linked to a cutaneous diphtheria infection in a homeless man living in the same geographic area. Laboratory diagnostics involving MALDI-TOF MS, tox-gene PCR, Lateral Flow Immuno Assay, a modified Elek test and Next Generation Sequencing (NGS) identified the causative strain as cotrimoxazole-resistant toxigenic Corynebacterium diphtheriae biotype mitis, sequence type ST574. Moreover, a review on the diphtheria situation in Poland is presented.

Results: NGS data suggest a common source of infection in Poland and a possible link to the Europe-wide outbreak of imported diphtheria with C. diphtheriae since 2022. This is the first diphtheria case in Poland since 2000.

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从波兰输入到德国的致命呼吸性白喉病例：可能与波兰未发现的输入性白喉群集有关？

目的：白喉是一种疫苗可预防的新发疾病，主要由产毒性白喉棒状杆菌引起。方法：在这里，我们报告了一名前往德国的波兰妇女的致命呼吸道白喉感染，可能与居住在同一地理区域的无家可归者的皮肤白喉感染有关。实验室诊断包括MALDI-TOF质谱、毒素基因PCR、侧流免疫测定、改进的Elek试验和下一代测序（NGS），确定致病菌株为cotrimoxazol耐药的产毒白喉棒状杆菌生物型mitis，序列型ST574。此外，还对波兰的白喉情况进行了审查。结果：NGS数据表明，波兰有一个共同的感染源，并可能与自2022年以来全欧洲范围内的白喉与白喉支原体的输入性白喉暴发有关。这是波兰自2000年以来的第一例白喉病例。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Infection 医学-传染病学

CiteScore

12.50

自引率

1.30%

发文量

224

审稿时长

6-12 weeks

期刊介绍： Infection is a journal dedicated to serving as a global forum for the presentation and discussion of clinically relevant information on infectious diseases. Its primary goal is to engage readers and contributors from various regions around the world in the exchange of knowledge about the etiology, pathogenesis, diagnosis, and treatment of infectious diseases, both in outpatient and inpatient settings. The journal covers a wide range of topics, including: Etiology: The study of the causes of infectious diseases. Pathogenesis: The process by which an infectious agent causes disease. Diagnosis: The methods and techniques used to identify infectious diseases. Treatment: The medical interventions and strategies employed to treat infectious diseases. Public Health: Issues of local, regional, or international significance related to infectious diseases, including prevention, control, and management strategies. Hospital Epidemiology: The study of the spread of infectious diseases within healthcare settings and the measures to prevent nosocomial infections. In addition to these, Infection also includes a specialized "Images" section, which focuses on high-quality visual content, such as images, photographs, and microscopic slides, accompanied by brief abstracts. This section is designed to highlight the clinical and diagnostic value of visual aids in the field of infectious diseases, as many conditions present with characteristic clinical signs that can be diagnosed through inspection, and imaging and microscopy are crucial for accurate diagnosis. The journal's comprehensive approach ensures that it remains a valuable resource for healthcare professionals and researchers in the field of infectious diseases.