Publications

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diphtheria in the manchester area 1967-1971. 19744140991
toxigenic corynebacterium diphtheriae acquired in england. 19968754453
identification of is1356, a new insertion sequence, and its association with is402 in epidemic strains of burkholderia cepacia infecting cystic fibrosis patients.burkholderia cepacia is now recognized as an important opportunistic pathogen in cystic fibrosis (cf) and other compromised patients. epidemicity among cf patients has been attributed to at least one particularly infectious strain (strain et12), and both genetic evidence and anecdotal evidence suggest that this strain, currently endemic in ontario, and those causing an epidemic in the united kingdom, are indeed the same. our study was conducted to determine whether there was any association betw ...19968784555
nontoxigenic corynebacterium diphtheriae: an emerging pathogen in england and wales?confirmed isolates of nontoxigenic corynebacterium diphtheriae in england and wales increased substantially from 1986 to 1994. ribotyping of 121 isolates confirmed in 1995 showed that 90 were of a single strain isolated exclusively from the throat; none had previously been identified in toxigenic strains from u.k. or non-u.k. residents. the upward trend in nontoxigenic c. diphtheriae probably represented increased ascertainment, although dissemination of a particular strain or clone may have bee ...200011076724
immunogenicity of routine vaccination against diphtheria, tetanus, and haemophilus influenzae type b in asian infants born in the united kingdom.to determine the immunogenicity of routine vaccination against diphtheria, tetanus, and haemophilus influenzae type b (hib) in asian infants born in the uk, and whether maternal antibody suppression occurs.200515908622
toxigenic corynebacterium ulcerans infection in a veterinary student in london, united kingdom, may 2010.we report on a case of toxigenic corynebacterium ulcerans infection in a fully immunised veterinary student, investigated in london, united kingdom, in may 2010. there was no ongoing transmission in human contacts. possible animal sources were identified.201020738991
diphtheria presenting in the accident and emergency department.a case of diphtheria encountered in the accident and emergency department is described. in addition, 38 cases of diphtheria have been analysed, and demonstrate that, although now rare in this country, the disease still exists and its clinical features remain unchanged. it presents almost as often in the accident and emergency department as it does to the general practitioner and remains overwhelmingly a disease of children. diphtheria is still a notifiable disease. the diagnosis must be made cli ...19873107580
a report of the investigation and control measures instituted after the isolation of toxin-producing corynebacterium diphtheriae mitis from a child in leeds.this report describes the control measures instituted and further investigations undertaken after the isolation of toxin-producing corynebacterium diphtheriae from a throat swab taken routinely from a nine-year-old boy, recently returned from pakistan, who had been admitted to hospital in leeds with hepatitis a infection. four of his siblings were subsequently shown to have identical corynebacterium diphtheriae on throat swabbing, except that in one child the organism did not produce toxin. all ...19892517490
screening for corynebacterium diphtheriae.a throat swab from a 9 year old girl with pharyngitis yielded a non-toxigenic strain of corynebacterium diphtheriae var mitis and streptococcus group g. c pseudodiphtheriticum was isolated from the throats of two of her four brothers. in each case the isolate was sent to the reference laboratory before full identification. the growth was found to be mixed for one brother; the other isolate being a toxin producing c diphtheriae var gravis. the child was asymptomatic and the case proves that all c ...19921452782
non-toxigenic corynebacterium diphtheriae in a boarding school.a non-toxigenic strain of corynebacterium diphtheriae var. gravis was isolated from 31 boys during an outbreak of sore throats at a boarding school of 15 staff and 134 pupils. despite the non-toxigenicity of the strain involved, conventional isolation procedures were observed and all boys at the school were treated with antibiotics. restrictions on the school were only relaxed when no further carriers were detected. the rationale of such management of an episode involving a non-toxigenic strain ...197548687
epidemiology and molecular characterisation of toxigenic corynebacterium diphtheriae var mitis from a case of cutaneous diphtheria in manchester.diphtheria is now an uncommon disease in britain. we describe an imported case of cutaneous diphtheria in a previously immunised adult cause by c. diphtheriae var mitis. the control measures adopted to deal with the index case and two secondary cases so as to limit further spread among household and school contacts are outlined. molecular typing was used to study the mode of spread of the organism among contacts.19958666848
immunity to diphtheria in adults in england. 19948148699
non-toxigenic corynebacterium diphtheriae var gravis in england. 19938099660
diphtheria disaster relief. 19957585198
the return of corynebacterium diphtheriae: the rise of non-toxigenic strains.with the decline in incidence of diphtheria in europe and the usa, many laboratories no longer routinely culture throat swabs for corynebacterium diphtheriae. however, there is an outbreak of infection with toxigenic strains in russia and most adults do not have protective levels of antibody. non-toxigenic strains are known to cause local disease and lysogenic conversion probably occurs in vivo as well as in vitro. non-toxigenic c. diphtheriae var. gravis, formerly quite rare, has been isolated ...19957560966
isolation of c. diphtheriae gravis in leeds. 19826821100
an experience of diphtheria in westminster. 19846424155
studies on the molecular epidemiology of diphtheria.dna was extracted from toxigenic and nontoxigenic (tox+ and tox-) diphtheria bacilli isolated during a carrier survey that followed recovery of a tox+ corynebacterium diphtheriae mitis from a baby with membranous tonsillitis. the electrophoretic gel patterns of restriction enzyme digests were indistinguishable from one another. they were, however, readily distinguishable from similar gels of dnas extracted from diphtheria bacilli associated with outbreaks elsewhere. hybridisation of a labelled n ...19836138500
diphtheria carriers in manchester: simultaneous infection with toxigenic and non-toxigenic mitis strains.a toxigenic strain of corynebacterium diphtheriae mitis was isolated from a 10-week-old baby with membranous tonsillitis, and over the next 6 months thirty-nine symptom-free carriers of nitrate-positive mitis strains were found. all carriers were cleared by 14 days' treatment with erythromycin, though several relapsed after a 5-day course. four contacts carried both toxigenic and non-toxigenic mitis strains; epidemiological evidence and phage studies suggest that these had a common origin. these ...19806101751
investigations and control measures following a non-travel-associated case of toxigenic cornyebacterium diphtheriae, london, united kingdom, december 2009-january 2010.this article reports the investigation and control measures undertaken following the identification of a toxigenic strain of cornyebacterium diphtheriae var gravis, designated ribotype minsk , in a partially vaccinated teenager born in the united kingdom with no recent history of travel or known contact with a case of diphtheria or a carrier. this case highlights the need for ongoing work to improve vaccine uptake rates to ensure children receive all scheduled vaccinations.201020430002
infections with corynebacterium diphtheriae: six years' experience at an inner london teaching hospital.recently, a preponderance of non-toxigenic strains of corynebacterium diphtheriae has been reported, as has the broadening spectrum of disease caused by these strains. this study presents data on 85 isolates of c. diphtheriae over a six year period (1998-2003). eighty were non-toxigenic isolates from patients with sore throat, and five (one toxigenic) were from cutaneous ulcers in travellers returning from endemic areas. when examined in relation to denominator data provided by the health protec ...200515816203
misdiagnosis of diphtheria: laboratory errors due to toxigenic control strains of corynebacterium diphtheriae. 19979057340
enhanced surveillance of non-toxigenic corynebacterium diphtheriae infections. 19968821021
cutaneous diphtheria in bristol. 19947520805
development, validation and implementation of a quadruplex real-time pcr assay for identification of potentially toxigenic corynebacteria.toxigenic corynebacteria are uncommon in the uk; however, laboratory confirmation by the national reference laboratory can inform public health action according to national guidelines. standard phenotypic tests for identification and toxin expression of isolates can take from ≥24 to ≥48 h from receipt. to decrease the time to result, a real-time pcr (qpcr) assay was developed for confirmation of both identification of corynebacterium diphtheriae and corynebacterium ulcerans/corynebacterium pseud ...201627902437
molecular and epidemiological review of toxigenic diphtheria infections in england between 2007 and 2013.human infections caused by toxigenic corynebacteria occur sporadically across europe. in this report, we undertook the epidemiological and molecular characterization of all toxigenic corynebacterium strains isolated in england between january 2007 and december 2013. epidemiological aspects include case demographics, risk factors, clinical presentation, treatment, and outcome. molecular characterization was performed using multilocus sequence typing (mlst) alongside traditional phenotypic methods ...201525502525
emergence and molecular characterisation of non-toxigenic tox gene-bearing corynebacterium diphtheriae biovar mitis in the united kingdom, 2003-2012.non-toxigenic corynebacterium diphtheriae have become increasingly recognised as emerging pathogens across europe causing severe invasive disease. a subset of non-toxigenic c. diphtheriae are ‘non-toxigenic tox gene-bearing’ (nttb) strains; these strains are genotypically toxpositive, but do not express the protein. the circulation of nttb strains was first observed during the 1990s upsurge of diphtheria in eastern europe but has not been reported in other european countries. circulation of nttb ...201424925458
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