ORIGINAL RESEARCH article
Front. Bacteriol.
Sec. Molecular Bacteriology and Microbiome
This article is part of the Research TopicSurveillance and Control Strategies for Multidrug-Resistant BacteriaView all articles
GENOMIC CHARACTERIZATION OF Corynebacterium diphtheriae ISOLATES FROM HUMAN ORIGIN IN BRAZIL, 1974-2024
Provisionally accepted
Sergio Bokermann1,2
Claudio Tavares Sacchi3
Ana Paula Lemos1*Elizabeth Harummyy Takagi1Marlon Benedito Nascimento Santos3Rosemeire Capoani Almendros1
Karoline Campos3
Eneas Carvalho4
Carlos Henrique Camargo1,2- 1Center for Bacteriology, Adolfo Lutz Institute, Sao Paulo, Brazil
- 2Universidade de Sao Paulo Faculdade de Medicina, São Paulo, Brazil
- 3Laboratório Estratégico, Instituto Adolfo Lutz (, São Paulo, Brazil
- 4Laboratório de Bacteriologia, Instituto Butantan, São Paulo, Brazil, São Paulo, Brazil
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Introduction: Diphtheria is a potentially fatal disease that still causes deaths mainly in unvaccinated children. Over the last decades, the incidence of this disease has reduced drastically in face to the increase in vaccination coverage. Diphtheria is mainly caused by toxigenic Corynebacterium diphtheriae, however, in more recent years, invasive infections due to nontoxigenic Corynebacterium diphtheriae have emerged. Given this epidemiological threat, the continued surveillance remains essential to guide prevention and control measures. Methodology: Using whole genome sequencing, we characterized 299 Corynebacterium diphtheriae isolates, assessing their clinical origin, age distribution of patients, tox gene carriage, antimicrobial resistance markers, and phylogenetic relationships. Results: The tox gene was identified in 255 isolates (85.3%). Antimicrobial resistance genes aph(3'')- Ib, aph(3')-Ia, aph(6)Id, cmx, tet(33), tet(O), tet(W), and tet(Z) were detected in low (<10%) frequencies, but sul1 was found in 72 (24.1%) isolates. Phylogenetic analyses identified 11 main clades comprising 286 isolates, represented by 46 different sequence types (ST); the remaining 13 isolates were distributed in the other 12 ST. Twenty-one novel ST were described, comprising 51 isolates. Discussion: Our study represents the largest genomic survey of Corynebacterium diphtheriae in Latin America. These results enhance global understanding of diphtheria and reinforce the need for vigilance against reemergence in areas with suboptimal vaccination coverage.
Keywords: Corynebacterium diphtheriae, Diphtheria, Communicable disease, toxin, Antimicrobial susceptibility, Whole-genome sequencing
Received: 03 Oct 2025; Accepted: 17 Dec 2025.
Copyright: © 2025 Bokermann, Sacchi, Lemos, Takagi, Santos, Almendros, Campos, Carvalho and Camargo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Ana Paula Lemos
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