Epidemiology and Trends of Corynebacterium diphtheriae in the United States, 2016—2023

Vollständiger Abstract

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Abstract Background Diphtheria, commonly resulting in severe respiratory or cutaneous disease, is caused by toxigenic strains of Corynebacterium diphtheriae; non-toxigenic strains can also cause disease. In the United States, only toxigenic disease is reportable, and the Centers for Disease Control and Prevention (CDC) perform the only Elek testing to confirm diphtheria toxin production. We examine the epidemiology, toxigenicity, and trends of C. diphtheriae isolates reported during 2016—2023 in the United States. Methods C. diphtheriae isolates submitted to CDC were cultured and tested by PCR and Elek. Laboratory and epidemiological data were linked; we conducted descriptive statistics by toxigenicity status. Results A total of 1155 C. diphtheriae isolates were submitted during 2016—2023; 96.1% (n=1110) were non-toxigenic, 3.0% (n=35) were non-toxigenic tox-bearing (NTTB), and 0.9% (n=10) were toxigenic. From 2016 to 2023, the annual number of reported isolates increased over 10-fold. Median patient age was 43 years (range: