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Introduction: Toxigenic Corynebacterium diphtheriae causes classical diphtheria. Skin infections by toxigenic or non-toxigenic Corynebacterium diphtheriae are prevalent in the tropics but are rarely reported. Case presentation: We report the identification of a non-toxigenic Corynebacterium diphtheriae (biovar Gravis) isolate in a 52-year-old Cambodian male. The patient presented purulent and non-healing ulcerations on the right hallux. The wound has healed after 7 days of antibiotic therapy with a favourable outcome. Conclusions: This case represents, to our knowledge, the first report of Corynebacterium diphtheriae in Cambodia in the last 10 years, and highlights the lack of diagnosis and notifications of diphtheria. It is important to raise awareness among clinicians and to set up diphtheria surveillance in Cambodia.

A group of six clinical isolates previously identified asCorynebacterium diphtheriaebiovar Belfanti, isolated from human cutaneous or peritoneum infections and from one dog, were characterized by genomic sequencing, biochemical analysis and mass spectrometry (MALDI-TOF MS). The six isolates were negative for the diphtheria toxin gene. Phylogenetic analyses showed that the six isolates (including FRC0190T) are clearly demarcated fromC. diphtheriae, C. belfantii, C. ulceransandC. pseudotuberculosis. The average nucleotide identity of FRC0190TwithC. diphtheriaeNCTC 11397Twas 92.6%, and was 91.8% withC. belfantiiFRC0043T.C. diphtheriaesubsp.lausannensestrain CHUV2995Tappeared to be a later heterotypic synonym ofC. belfantii(ANI, 99.3%). Phenotyping data revealed an atypical negative or heterogeneous intermediate maltose fermentation reaction for the six isolates. MALDI-TOF MS differentiated the new group from the otherCorynebacteriumtaxa by the presence of specific spectral peaks.rpoBsequences showed identity to atypical, maltose-negativeC. diphtheriaebiovar Belfanti isolates previously described from two cats in the USA. We propose the nameCorynebacterium rouxiisp. nov. for the novel group, with FRC0190T(= CIP 111752T= DSM 110354T) as type strain.

International audience; Introduction. Diphtheria is caused by toxigenic strains of Corynebacterium diphtheriae, Corynebacterium ulcerans and Corynebacterium pseudotuberculosis. For diagnostic purposes, species identification and detection of toxigenic strains (diphtheria toxin (tox)-positive strains) is typically performed using end-point PCR. A faster quadruplex real-time PCR (qPCR) was recently developed (De Zoysa et al. J.Med.Microbiol. 2016;65(12):1521-1527).Aims. We aimed to improve the quadruplex method by adding a 16S rRNA gene target as an internal processing control, providing confirmation of the presence of bacterial DNA in the assays, thus avoiding the possibility of false-negative reporting.Methodology. Universal 16S rRNA gene primers and a probe were defined. The novel method was tested using 36 bacterial isolates and 17 clinical samples. Experimental robustness to temperature and reagent concentration variations was assessed.Results. The method allows detection of the tox gene and distinguishing C. diphtheriae (including the newly described species Corynebacterium belfantii) from C. ulcerans and C. pseudotuberculosis. Complete diagnostic specificity, sensitivity and experimental robustness were demonstrated. The lower limit of detection for C. diphtheriae, C. ulcerans and tox targets was 1.86 genome copies per 5 µl reaction volume. The method was successfully used on two distinct qPCR technologies (LightCycler 480, Roche Diagnostics and Rotor-Gene Q, Qiagen) and in two laboratories (Institut Pasteur, Paris, France and Public Health England - National Infection Service, London, UK).Conclusion. This work describes validation of the improved qPCR quadruplex method and supports its implementation for the biological diagnosis of diphtheria.

International audience; Cystic fibrosis (CF) patients are commonly colonized by bacterial pathogens, which can induce persistent lung inflammation and may contribute to clinical deterioration. Colonization of CF patients and cross-transmission by Corynebacterium diphtheriae have not been reported so far. The aim of this article was to investigate the possibility of a cross-transmission of C. diphtheriae biovar Belfanti between four patients of a CF center. C. diphtheriae biovar Belfanti (now formally called C. belfantii) isolates were collected from four patients in a single CF care center over a period of 6 years and analyzed by microbiological methods and whole-genome sequencing. Epidemiological links among patients were investigated. Ten isolates were collected from 4 patients. Whole-genome sequencing of one isolate from each patient showed that a single strain was shared among them. In addition, one patient was found to have the same strain in two consecutive samplings performed 9 months apart. The strain was nontoxigenic and was susceptible to most antimicrobial agents. Ciprofloxacin resistance was observed in one patient. The idea of transmission of the strain among patients was supported by the occurrence of same-day visits to the CF center. This study demonstrated colonization of CF patients by C. diphtheriae biovar Belfanti (C. belfantii), and the data suggest persistence and transmission of a unique strain during at least 6 years in a single CF patient care center.

Cystic fibrosis (CF) patients are commonly colonized by bacterial pathogens, which can induce persistent lung inflammation and may contribute to clinical deterioration. Colonization of CF patients and cross-transmission by Corynebacterium diphtheriae has not been reported so far. The aim of this article was to investigate the possibility of a cross transmission of C. diphtheriae biovar Belfanti between four patients of a CF center. C. diphtheriae biovar belfanti (now formally called C. belfantii) isolates were collected from four patients in a single CF care center over a 6 years period and analyzed by microbiological methods and whole genome sequencing. Epidemiological links among patients were investigated. Ten isolates were collected from 4 patients. Whole genome sequencing of one isolate from each patient showed that a single strain was shared among them. In addition, one patient had the same strain on two consecutive samplings nine months apart. The strain was non-toxigenic and was susceptible to most antimicrobial agents. Ciprofloxacin resistance was observed in one patient. Transmission of the strain among patients was supported by the occurrence of same-day visits to the CF center. This study demonstrates colonization of CF patients by C. diphtheriae biovar Belfanti (C. belfantii) and shows persistence and transmission of a unique strain during at least six years in a single CF patient care center.Previous meeting presentationsThe information in this work was not previously presented in any meeting.Accession numbersThe genomic sequence data generated in this work were submitted to the European Nucleotide Archive and are available from the International Nucleotide Sequence Database Collaboration (NCBI/ENA/DDBJ) databases under project accession number PRJEB28372 and run data accession numbers ERR2757916 to ERR2757921.

International audience; Clinical isolates belonging to Corynebacterium diphtheriae biovar Belfanti were characterized by genomic sequencing and biochemical and chemotaxonomic analyses. Phylogenetic analyses indicated that biovar Belfanti represents a branch that is clearly demarcated from C. diphtheriae strains of biovars Mitis and Gravis. The average nucleotide identity of isolates of biovar Belfanti with C. diphtheriae type strain NCTC 11397T (biovar Gravis) was 94.85 %. The inability to reduce nitrate differentiated biovar Belfanti from other strains of C. diphtheriae. On the basis of these results, we propose the name Corynebacterium belfantii sp. nov. for the group of strains previously considered as C. diphtheriaebiovar Belfanti. The type strain of C. belfantii is FRC0043T (=CIP 111412T=DSM 105776T). Strains of C. belfantii were isolated mostly from human respiratory samples.

Corynebacterium ulcerans is a bacterium able to infect humans by inducing a disease close to diphtheria. We describe the case of a 83-year-old patient hospitalized as a matter of urgency in intensive care for which C. ulcerans was isolated in pure culture in its bronchial samples. Even if the isolate was not secreting toxin in vitro, it possesses the tox gene which motivated the use of specific antitoxin serum. After two months of intensive care the patient went out of the service. It is about a remarkable case of clinicobiologic collaboration.

International audience; Epidemiology of diphtheria in the southwestern Indian Ocean is poorly documented. We analyzed 14 cases of infection with toxigenic Corynebacterium diphtheriae reported during 2007–2015 in Mayotte, a French department located in this region. Local control of diphtheria is needed to minimize the risk for importation of the bacterium into disease-free areas.

The species Corynebacterium renale, Corynebacterium pilosum, and Corynebacterium cystitidis were initially thought to be the same species C. renale, but with different immunological types. These bacteria are the causative agent of cystitis, urethritis and pyelonephritis and are found usually as constituents of the normal flora in the lower urogenital tract of cattle. Therefore, we present the draft genome sequences of two pathogenic Corynebacterium species: C. renale CIP 52.96 and C. pilosum CIP 103422. The genome sequences of these species have 2,322,762 bp with 2,218 protein encoding genes and 2,548,014 bp with 2,428 protein encoding genes, respectively. These genomes can help clarify the virulence mechanisms of these unknown bacteria and enable the development of more effective methods for control.

Cutaneous diphtheria is uncommon in Europe. In this study, we report a case of imported cutaneous infection due to a non-toxigenic but tox gene-bearing (NTTB) strain of Corynebacterium diphtheriae. The NTTB strains are recognized as emerging pathogens across Europe, and physicians and bacteriologists should be aware of the circulation of these strains.

UNLABELLED Selection of appropriate typing method depends on a number of factors, including the scale of the investigation, the rapidity required of the results and the financial and technical resources available. Several typing methods have been applied to Corynebacterium diphtheriae genotyping, but most are laborious and time-consuming or require expensive equipment. We report an evaluation of the utility of the PCR melting profile technique for simple and easy-to-perform genotyping of C. diphtheriae. We compared the method with ribotyping-the 'gold standard' for C. diphtheriae typing-and PFGE, MLST, AFLP, RAPD and spoligotyping. SIGNIFICANCE AND IMPACT OF THE STUDY Occurrence of Corynebacterium diphtheriae infections-in the form of diphtheria in endemic countries and in the form of invasive infections in countries with high antidiphtheria vaccination coverage-indicates the need for maintenance of ability to genotype this pathogen by laboratories. Application of an appropriate typing method is essential not only in outbreak investigations for understanding and predicting epidemics but also in monitoring of the evolution and spread of epidemic clones of C. diphtheriae. The PCR melting profile method presented in the study is a good alternative for C. diphtheriae typing.

Corynebacterium diphtheriae is the etiological agent of diphtheria, a potential fatal disease caused by a corynephage toxin. The expression of this diphtheria toxin is controlled via an iron-dependent repressor with various functions (DtxR). Some mutations in the dtxR gene are associated with diminished activity or even with total loss of DtxR function. We conducted a molecular study to characterize the dtxR alleles harbored by 34 isolates of C. diphtheriae recovered from Romanian patients between 1961 and 2007. Three of the seven alleles identified in this study have not previously been described. Two new DtxR types were identified, one of which has an unusual polypeptide length. All the new DtxR types were found in toxigenic isolates, suggesting that they effectively regulate the expression of diphtheria toxin. Furthermore, one of the new DtxR identified was also found in a non-toxigenic isolate, making it a potential source of toxigenic isolates after lysogenic conversion.

Autochtonous toxigenic Corynebacterium diphtheriae have disappeared in mainland France, but non-toxigenic C. diphtheriae are still circulating. Using phenotypic and molecular tools, we retrospectively characterized 103 non-toxigenic C. diphtheriae collected in mainland France and highlight several changes. The proportion of C. diphtheriae belfanti increased between 1977 and 2011 and it is the most frequent biotype recovered in recent years. Resistance to ciprofloxacin has increased and most isolates with decreased sensitivity belong to the belfanti biotype. Using multilocus sequence typing, we demonstrate that French isolates are distributed in a large number of sequence types and identify three distinct lineages. C. diphtheriae mitis and gravis form lineage I while C. diphtheriae belfanti forms lineages II and III. Almost all isolates of lineage II are part of a unique clonal complex or are very close to it. Most French isolates have a dtxR sequence homologous to that of toxigenic isolates, suggesting that if lyzogenised by a corynephage, they can express diphtheria toxin.

Corynebacterium ulcerans is an emergent pathogen infecting wild and domesticated animals worldwide that may serve as reservoirs for zoonotic infections. In this study, we present the draft genome of C. ulcerans strain 03-8664. The draft genome has 2,428,683 bp, 2,262 coding sequences, and 12 rRNA genes.

Matrix-associated laser desorption ionization–time of flight mass spectrometry (MALDI-TOF MS) is a rapid and simple microbial identification method. Previous reports using the Biotyper system suggested that this technique requires a preliminary extraction step to identify Gram-positive rods (GPRs), a technical issue that may limit the routine use of this technique to identify pathogenic GPRs in the clinical setting. We tested the accuracy of the MALDI-TOF MS Andromas strategy to identify a set of 659 GPR isolates representing 16 bacterial genera and 72 species by the direct colony method. This bacterial collection included 40 C. diphtheriae , 13 C. pseudotuberculosis , 19 C. ulcerans , and 270 other Corynebacterium isolates, 32 L. monocytogenes and 24 other Listeria isolates, 46 Nocardia , 75 Actinomyces , 18 Actinobaculum , 11 Propionibacterium acnes , 18 Propionibacterium avidum , 30 Lactobacillus , 21 Bacillus , 2 Rhodococcus equi , 2 Erysipelothrix rhusiopathiae , and 38 other GPR isolates, all identified by reference techniques. Totals of 98.5% and 1.2% of non- Listeria GPR isolates were identified to the species or genus level, respectively. Except for L. grayi isolates that were identified to the species level, all other Listeria isolates were identified to the genus level because of highly similar spectra. These data demonstrate that rapid identification of pathogenic GPRs can be obtained without an extraction step by MALDI-TOF mass spectrometry.

International audience; Neutrophils are increasingly thought to modulate dendritic cell (DC) functions. We investigated the role of the neutrophil-DC partnership in the response to Mycobacterium bovis BCG-the vaccine used against tuberculosis. We compared neutrophil-DC crosstalk in humans and mice, searching for functional differences. In both species, neutrophils captured fluorescent BCG-enhanced green fluorescent protein (EGFP) and were more phagocytic than DC. Non-apoptotic BCG-infected neutrophils clustered with immature DC, establishing intimate contacts with dendrites, at which fluorescent intact bacilli were observed. Physical interactions between neutrophils and DC were required for DC activation. Human BCG-infected DC produced interleukin (IL)-10, an inhibitory cytokine, whereas DC exposed to BCG-infected neutrophils produced low to undetectable amounts of the cytokine. Mouse BCG-infected neutrophils induced sustained IL-2 production by DC. Human DC exposed to BCG-infected neutrophils stimulated recall T cell reactivity from vaccinated donors. Mouse DC infected with recombinant ovalburnin (OVA)-producing BCG (rBCG(ova)) elicited proliferation of TCR-OVA-transgenic CD4 and CD8 T cells. Moreover, exposing DC to rBCG(ova)-infected neutrophils enhanced OVA presentation. Thus, in mice and humans, neutrophils help DC to cross-present BCG antigens to T cells. Our results suggest that this "menage a trois" involving neutrophils, DC and T cells plays a major role in the immune response to BCG.

To the Editor: Corynebacterium diphtheriae is the agent of pharyngeal and cutaneous diphtheria. We did a retrospective analysis of the antimicrobial drug susceptibilities of 46 C. diphtheriae isolates sent during 1993 through 2010 to the French National Reference Centre of Toxigenic Corynebacteria. The isolates came from metropolitan France and French overseas departments and territories. Only 1 isolate, C. diphtheriae biovar mitis, FRC24, expressed the following antimicrobial drug susceptibility profile: susceptible to penicillin, amoxicillin, ciprofloxacin, clindamycin, erythromycin, gentamicin, imipenem, kanamycin, rifampin, tetracycline, and vancomycin and resistant at an uncommonly high level to trimethoprim, sulfamethoxazole, and co-trimoxazole with Etest (bioMerieux, Marcy l’Etoile, France) MICs of >32, >1,024, and >32 mg/L, respectively. This FRC24 isolate was isolated in 2008 from a cutaneous wound on a vaccinated 11-month-old child in Mayotte, an overseas department located in the Indian Ocean. Cutaneous carriage of C. diphtheriae is frequent in tropical countries where cutaneous diphtheria is endemic; cutaneous carriage represents a common mode of transmission of the bacterium. FRC24 was identified by using the API Coryne strip (bioMerieux). FRC24 is a toxigenic isolate; toxigenicity was confirmed by both tox gene detection and Elek test (1). Multilocus sequence typing was performed, and the sequence type (ST) of the isolate is ST91. This ST contains only this isolate and is part of lineage II, as are all mitis and gravis biovars (2). To date, resistance to trimethoprim, sulfamethoxazole, or co-trimoxazole seems to be rare among the C. diphtheriae species, but few data are available (3). As trimethoprim resistance is often encoded by integron-driven dfr determinants, we looked for integrons. Integrons are bacterial genetic elements able to capture and express antimicrobial drug resistance gene cassettes (GCs) (4). GC movements are catalyzed by an integron-encoded integrase IntI. GCs, mainly promoterless, are usually expressed through a common Pc promoter (5). Only rare GCs contain their own promoter (cmlA, qac, ereA1). Three main classes of integrons have been described and are involved in the dissemination of antimicrobial drug resistance; class 1 is the most widely found in clinical isolates. Integrons have been mainly described among gram-negative bacteria; only a few studies have reported integrons in Corynebacterium spp (6,7). After bacterial genomic DNA extraction (DNeasy Blood & Tissue Kit; QIAGEN, Courtaboeuf, France), a multiplex Taqman-based quantitative PCR approach able to detect the 3 main classes of integrons was performed (8). We found that FRC24 harbored a class 1 integron. Analysis of the GC array showed that this integron harbored 2 GCs: dfrA16 of 588 bp conferring resistance to trimethoprim and qacH of 511 bp conferring resistance to quaternary ammonium compounds (GenBank accession no. {"type":"entrez-nucleotide","attrs":{"text":"FR822749","term_id":"323714042"}}FR822749). To our knowledge, this GC array has not been previously reported, even among reports of other gram-negative isolates. Moreover, a qac determinant has been found only once in a Corynebacterium species, C. pseudogenitalium (which harbors a qacH variant in the chromosome [GenBank accession no. {"type":"entrez-nucleotide","attrs":{"text":"ABYQ02000013","term_id":"311303764"}}ABYQ02000013]), but not in an integron background. GC arrays were followed by the qacEΔ1 (which also confers resistance to quaternary ammonium compounds), sul1 (resistance to sulfamethoxazole), and orf5 determinants as found in most class 1 integrons (4). In class 1 integrons, 13 Pc variants have been described (5). In the FRC24 integron, the dfrA16 expression was mediated through a strong Pc variant (PcWTGN-10) (5) that enables the high-level resistance observed for trimethoprim. As previously demonstrated, the qacH GC possessed its own promoter (9). Trimethoprim is a commonly prescribed antimicrobial agent used in combination with sulfamethoxazole (co-trimoxazole) for the treatment of diarrheal diseases. This antimicrobial drug might have selected the emergence of such a strain expressing trimethoprim resistance. Furthermore, the FRC24 integron contains the antiseptic (quaternary ammonium compounds) resistance gene qacH. As cutaneous carriage of C. diphtheriae is frequent in tropical countries such as Mayotte, this bacterium could be exposed to quaternary ammonium compounds contained in disinfectants, hygienic hand washes, and cosmetic products. These products exert a selective pressure, which might play a role in selecting qac-containing strains, as has been suggested for Staphylococcus spp (10). For staphylococci, the MICs of quaternary ammonium compounds are >2 mg/L. With FRC24, we tested for the MIC of cetyltrimethylammmonium bromide and found a MIC of 4 mg/L, suggesting that qacH is expressed in FRC24. The sequencing of the genetic environment of this integron showed that it was framed by 2 copies of the insertion sequence IS6100 disrupting at the left-hand side the intI1 integrase gene (Figure A1). IS6100 has been described in a wide spectrum of host organisms, including Corynebacterium spp (6,7), thus enabling this integron to be efficiently transferred to various bacteria. Our findings show that C. diphtheriae is able to harbor integrons, which is of clinical relevance. Indeed, this genetic feature would give the isolates the capacity to easily acquire new GCs, such as ere GCs encoding resistance to erythromycin, which is one of the antimicrobial drugs recommended for diphtheria treatment.

The development of a malaria preerythrocytic vaccine has been greatly influenced by the observation that sterile immunity could be experimentally induced in humans by immunization with Plasmodium falciparum radiation-attenuated sporozoites (9). The critical role of liver-stage trophozoites (reviewed in reference 16) led researchers to initiate a detailed study of the antigens expressed in P. falciparum preerythrocytic stages (22). To date, scientists have identified a series of new molecules expressed at sporozoite and/or liver stage (14). Liver-stage antigen 3 (LSA3), expressed on both the sporozoite surface and in the liver forms, was found to be of particular interest. LSA3 was identified by differential screening of immune responses from protected versus nonprotected volunteers (11). A number of dominant B- and T-cell epitopes to which a high prevalence of responses is detected in individuals exposed to malaria or in LSA3-immunized animals were identified (1, 2). The vaccine potential of this molecule has been recently demonstrated in the chimpanzee model, an animal susceptible and fully receptive to P. falciparum preerythrocytic stages and whose immune system is closest to that of humans. In this model, protection against successive challenges with P. falciparum sporozoites was obtained (11). However, the use of this primate for research purposes is severely hampered by cost and ethical constraints. Several homologues of P. falciparum antigens have been identified, through a variety of immunological and molecular cross-reactivity assays, in other Plasmodium species and particularly in those infecting rodents (5, 10, 12, 13, 27, 28). The identification of structurally and functionally conserved homologues of P. falciparum proteins in rodent malaria species might help to better understand the role of these molecules in the P. falciparum parasite life cycle. This is particularly true for preerythrocytic stages, where the relative ease of obtaining sporozoites and mouse primary hepatocytes would allow more extensive investigations to be carried out. In the process of identification of LSA3, a preerythrocytic subset of P. falciparum genomic fragments (22) was used to affinity purify antibodies (Abs) from sera of individuals with hyperimmunity to malaria. These Abs were consequently checked for immunofluorescence antibody test (IFAT) cross-reactivity with rodent malaria sporozoites, and in this assay Abs against all clones coding for various fragments of LSA3 proved to be strongly reactive with Plasmodium yoelii sporozoites but not with those from Plasmodium berghei. The present study was undertaken to investigate the extent of antigenic cross-reactivity between the LSA3 molecule and its putative homologue in P. yoelii and to determine whether specific human Abs are of biological significance in the mouse model. We show that such cross-reactivity exists for human anti-LSA3 Abs, which encompass four distinct LSA3 epitopes, including both nonrepeated and repeated domains, and extend to both sporozoite and liver stages of P. yoelii. A similar result was obtained using Abs from chimpanzees immunized with LSA3. Moreover, P. yoelii, but not P. berghei, sporozoites were able to induce dose-dependent proliferation of T cells collected from one of these animals. Finally, we have established that these homologous epitopes are targets for immune responses which have a biological consequence, since LSA3-specific human Abs inhibit the invasion of P. yoelii sporozoites into mouse hepatocytes both in vitro and in vivo.

Corynebacterium diphtheriae , the agent of diphtheria, is rarely responsible for bacteremia. However, high numbers of bacteremia have been reported in countries with extensive immunization coverage. Here, we used molecular and phenotypic tools to characterize and compare 42 invasive isolates collected in France (including New Caledonia) and Poland over a 23-year period.

Early immune response to the largely used Mycobacterium bovis bacillus Calmette-Guérin (BCG) intradermal vaccine remains ill defined. Three days after BCG inoculation into the mouse ear, in addition to neutrophils infiltrating skin, we observed CD11b+Ly-6CintLy-6G− myeloid cells. Neutrophil depletion markedly enhanced their recruitment. These cells differed from inflammatory monocytes and required MyD88-dependent BCG-specific signals to invade skin, whereas neutrophil influx was MyD88 independent. Upon BCG phagocytosis, CD11b+Ly-6CintLy-6G− cells produced NO, which required the IL-1 receptor. Despite NO production, they were unable to kill BCG or the nonpathogenic Mycobacterium smegmatis. However, they markedly impaired T cell priming in the draining lymph node. Their elimination by all-trans retinoid acid treatment increased the number of IFN-γ–producing CD4 T cells. Thus, BCG vaccination recruits innate myeloid-derived suppressor cells, akin to mouse tumor-infiltrating cells. These propathogenic cells dampen the early T cell response and might facilitate BCG persistence.

Bivalent recombinant strains ofMycobacterium bovisBCG (rBCG) expressing the early regulatorynefand the structuralgag(p26) genes from the simian immunodeficiency virus (SIV) SIVmac251 were engineered so that both genes were cotranscribed from a synthetic operon. The expression cassette was cloned into a multicopy-replicating vector, and the expression levels of bothnefandgagin the bivalent rBCG(nef-gag) strain were found to be comparable to those of monovalent rBCG(nef) or rBCG(gag) strains. However, extrachromosomal cloning of thenef-gagoperon into a replicative plasmid resulted in strains of low genetic stability that rapidly lost the plasmid in vivo. Thus, thenef-gagoperon was inserted site specifically into the BCG chromosome by means of mycobacteriophage Ms6-derived vectors. The resulting integrative rBCG(nef-gag) strains showed very high genetic stability both in vitro and in vivo. The in vivo expression of the heterologous genes was much longer lived when the expression cassette was inserted into the BCG chromosome. In one of the strains obtained, integrative cloning did not reduce the expression levels of the genes even though a single copy was present. Accordingly, this strain induced cellular immune responses of the same magnitude as that of the replicative rBCG strain containing several copies of the genes.

A group of six clinical isolates previously identified asCorynebacterium diphtheriaebiovar Belfanti, isolated from human cutaneous or peritoneum infections and from one dog, were characterized by genomic sequencing, biochemical analysis and MALDI-TOF mass spectrometry. The six isolates were negative for the diphtheria toxin gene. Phylogenetic analyses showed that the six isolates (including FRC0190T) are clearly demarcated fromC.diphtheriae, Corynebacterium belfantii, Corynebacterium ulceransandCorynebacterium pseudotuberculosis. The average nucleotide identity of FRC0190TwithC.diphtheriaeNCTC11397Twas 92.6%, and was 91.8% withC.belfantiiFRC0043T.C.diphtheriaesubsp.lausannensestrain CHUV2995Tappeared to be a later heterotypic synonym ofC.belfantii(ANI, 99.3%). Phenotyping data revealed an atypical negative or heterogeneous intermediate maltose fermentation reaction for the six isolates. MALDI-TOF mass spectrometry differentiated the new group from the otherCorynebacteriumtaxa by the presence of specific spectral peaks.rpoBsequences showed identity to atypical, maltose-negativeC.diphtheriaebiovar Belfanti isolates previously described from two cats in the USA. We propose the nameCorynebacterium rouxiisp. nov. for the novel group, with FRC0190T(= CIP 111752T=DSM 110354T) as type strain.

In March 2014, a person in their eighties who was diagnosed with extensive cellulitis due to toxigenic Corynebacterium ulcerans died from multiple organ failure. Environmental investigation also isolated C. ulcerans in biological samples from two stray cats in contact with the case. This finding provides further evidence that pets can carry toxigenic C. ulcerans and may be a source of the infection in humans.