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Published in: Infection 6/2022

Open Access 02-09-2022 | Corynebacterium Diphtheriae | Brief Report

Detection of diphtheria toxin production by toxigenic corynebacteria using an optimized Elek test

Authors: Vyacheslav G. Melnikov, Anja Berger, Andreas Sing

Published in: Infection | Issue 6/2022

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Abstract

Purpose

Diphtheria, still present in many countries of the world, is caused by toxigenic strains of species of the Corynebacterium diphtheriae complex, mainly Corynebacterium diphtheriae and the emerging zoonotic pathogen C. ulcerans. The immunoprecipitation test according to Elek is the gold standard for detection of the major virulence factor diphtheria toxin (DT) in toxigenic corynebacteria. Due to its sophisticated methodological requirements, the classical Elek test is performed mainly by specialized reference laboratories. It was revealed that the current modification of the Elek test does not detect the toxin in weakly toxigenic isolates. Therefore, a more robust method for detecting free DT is urgently needed, especially for toxigenic C. ulcerans strains which are known to produce often much lower amounts of DT than C. diphtheriae.

Methods

Thirty-one tox-positive C. ulcerans isolates with a negative standard Elek test result previously determined as NTTB (non-toxigenic tox bearing) were re-analyzed in this study using a modified immunoprecipitation method optimized regarding different parameters including type and concentration of antitoxin, medium volume, inoculum distance from the antitoxin disk and position of controls.

Results

All 31 C. ulcerans strains tested positive in the optimized Elek test.

Conclusion

Only with a reliable and easy-to-handle method for detecting the toxigenicity of C. ulcerans, it is possible to assess the etiological role of this emerging zoonotic bacterium in human pathology.
Literature
1.
go back to reference Melnikov VG, Kombarova SIu, Borisova OIu, Volozhantsev NV, Verevkin VV, Volkovoi KI, Mazurova IK. Corynebacterium diphtheriae nontoxigenic strains carrying the gene of diphtheria toxin. Zhurnal Mikrobiol Epidemiol Immunobiol. 2004;(1):3–7. Russian. https://pubmed.ncbi.nlm.nih.gov/15024972/. Accessed 13 July 2022 Melnikov VG, Kombarova SIu, Borisova OIu, Volozhantsev NV, Verevkin VV, Volkovoi KI, Mazurova IK. Corynebacterium diphtheriae nontoxigenic strains carrying the gene of diphtheria toxin. Zhurnal Mikrobiol Epidemiol Immunobiol. 2004;(1):3–7. Russian. https://​pubmed.​ncbi.​nlm.​nih.​gov/​15024972/​. Accessed 13 July 2022
11.
go back to reference Möller J, Kraner M, Sonnewald U, Sangal V, Tittlbach H, Winkler J, Winkler T, Melnikov V, Lang R, Sing A, Mattos-Guaraldi AL, Burkovski A. Proteomics of diphtheria toxoid vaccines reveals multiple proteins that are immunogenic and may contribute to protection of humans against Corynebacterium diphtheriae. Vaccine. 2019;37(23):3061–70. https://doi.org/10.1016/j.vaccine.2019.04.059.CrossRefPubMed Möller J, Kraner M, Sonnewald U, Sangal V, Tittlbach H, Winkler J, Winkler T, Melnikov V, Lang R, Sing A, Mattos-Guaraldi AL, Burkovski A. Proteomics of diphtheria toxoid vaccines reveals multiple proteins that are immunogenic and may contribute to protection of humans against Corynebacterium diphtheriae. Vaccine. 2019;37(23):3061–70. https://​doi.​org/​10.​1016/​j.​vaccine.​2019.​04.​059.CrossRefPubMed
Metadata
Title
Detection of diphtheria toxin production by toxigenic corynebacteria using an optimized Elek test
Authors
Vyacheslav G. Melnikov
Anja Berger
Andreas Sing
Publication date
02-09-2022
Publisher
Springer Berlin Heidelberg
Published in
Infection / Issue 6/2022
Print ISSN: 0300-8126
Electronic ISSN: 1439-0973
DOI
https://doi.org/10.1007/s15010-022-01903-x

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