This study examines the microbiological and epidemiological characteristics of toxigenic and nontoxigenic Corynebacterium isolates submitted to the national reference laboratory in Spain, between 2014 and 2019, in order to describe the current situation and improve our knowledge regarding these emerging pathogens. Epidemiological information was extracted from the Spanish Surveillance System. Microbiological and molecular characterization was carried out using phenotypic methods, multilocus sequence typing (MLST), whole-genome sequencing (WGS), and core genome MLST (cgMLST). Thirty-nine isolates were analyzed. Twenty-one isolates were identified as Corynebacterium diphtheriae (6 toxigenic), 14 as C. belfantii, 4 as C. ulcerans (3 toxigenic), and 1 as C. rouxii. One C. diphtheriae isolate was identified as nontoxigenic tox gene bearing (NTTB). Ages of patients ranged from 1 to 89 years, with 10% (3/30) of nontoxigenic and 22% (2/9) of toxigenic isolates collected from children less than 15 years. Twenty-five of the patients were males (17/30 in nontoxigenic; 8/9 in toxigenic). MLST identified 28 sequence types (STs), of which 7 were described for the first time in Spain. WGS analysis showed that 10 isolates, including 3 toxigenic isolates, harbored a variety of antibiotic resistance genes in addition to the high prevalence of penicillin resistance phenotypically demonstrated. Phylogenetic analysis revealed one cluster of isolates from family members. Risk information was available for toxigenic isolates (9/39); 3 patients reported recent travels to countries of endemicity and 3 had contact with cats/dogs. One unvaccinated child with respiratory diphtheria had a fatal outcome. Including nontoxigenic Corynebacterium infections in disease surveillance and using WGS could further improve current surveillance.

中文翻译：

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2014 年至 2019 年在西班牙发现的产毒和非产毒白喉棒状杆菌、贝尔凡提棒状杆菌、鲁氏棒状杆菌和溃疡棒状杆菌分离株的分子和流行病学特征

本研究检查了 2014 年至 2019 年间提交给西班牙国家参考实验室的产毒和非产毒棒状杆菌分离株的微生物学和流行病学特征，以描述当前情况并提高我们对这些新兴病原体的认识。流行病学信息是从西班牙监测系统中提取的。使用表型方法、多位点序列分型 (MLST)、全基因组测序 (WGS) 和核心基因组 MLST (cgMLST) 进行微生物学和分子表征。分析了 39 个分离株。21 个分离株被鉴定为白喉棒状杆菌（6 个产毒），14 个为C. belfantii，4 个为C.溃疡（3个产毒），1个为C. rouxii。一种C. diphtheriae分离物被鉴定为非产毒毒素基因轴承（NTTB）。患者的年龄范围为 1 至 89 岁，其中 10% (3/30) 的非产毒分离物和 22% (2/9) 的产毒分离物是从 15 岁以下的儿童中收集的。25 名患者为男性（17/30 为非产毒；8/9 为产毒）。MLST 确定了 28 种序列类型 (ST)，其中 7 种在西班牙首次被描述。WGS 分析表明，10 株，包括 3 株产毒株，除了青霉素耐药性的高流行率表型证明外，还含有多种抗生素耐药基因。系统发育分析揭示了一组来自家庭成员的分离株。可获取产毒分离物的风险信息 (9/39)；3 名患者报告最近曾到流行国家旅行，3 名患者曾与猫/狗接触。一名患有呼吸道白喉的未接种疫苗的儿童出现了致命的后果。包括无毒物疾病监测中的棒状杆菌感染和使用 WGS 可以进一步改善当前的监测。