title: Emergence of an invasive clone of nontoxigenic Corynebacterium diphtheriae in the urban poor population of Vancouver, Canada.
abstract: 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.
authors: Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada. mromney@providencehealth.bc.ca
authors: M G
authors: MG
authors: Romney
authors: D L
authors: DL
authors: Roscoe
authors: K
authors: K
authors: Bernard
authors: S
authors: S
authors: Lai
authors: A
authors: A
authors: Efstratiou
authors: A M
authors: AM
authors: Clarke