ArticleInfection2022
Detection of diphtheria toxin production by toxigenic corynebacteria using an optimized Elek test.
Article in Infection, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 19 citations in OpenAlex.
- Emerging Corynebacterium diphtheriae ST-212 cluster with truncated tox gene linked by possible sexual transmission.Infection · 2026Article
- Detecting diphtheria is not enough: the missing toxigenicity link in outbreak surveillance.Tropical medicine and health · 2026Article
- Up-to-date MALDI-TOF MS-based identification of theJournal of clinical microbiology · 2026Article
- A case of fatal respiratory diphtheria imported from Poland to Germany: possible link to an undetected imported diphtheria cluster in Poland?Infection · 2025Article
- Two diphtheria sub-clusters with autochthonous cases in Germany and Poland within aEuro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2025Article
- Autochthonous outbreak of respiratory diphtheria caused byEuro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2025Article
- Toxigenic Corynebacterium ulcerans in raw milk of a cow with acute mastitis: case report and historical review on milk-transmitted diphtheria.Infection · 2025Review
- Diphtheria Outbreak among Persons Experiencing Homelessness, 2023, Linked to 2022 Diphtheria Outbreak, Frankfurt am Main, Germany.Emerging infectious diseases · 2025Article
- Örjan Ouchterlony and the antigen-antibody double diffusion-in-gel: a survey.APMIS : acta pathologica, microbiologica, et immunologica Scandinavica · 2025Review
- Challenges of Diphtheria Toxin Detection.Toxins · 2024Review
- Article
- Lateral flow immunoassay-based laboratory algorithm for rapid diagnosis of diphtheria.Open research Europe · 2023Article
- Determination of Diphtheria Toxin in Bacterial Cultures by Enzyme Immunoassay.Diagnostics (Basel, Switzerland) · 2022Article
- Cellulitis Caused by Mixed Infection with Group A Streptococci and Non-Toxigenic tox-Gene-BearingCase reports in dermatologyArticle
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
Abstract
purposeDiphtheria, 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.
methodsThirty-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.
resultsAll 31 C. ulcerans strains tested positive in the optimized Elek test.
conclusionOnly 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.
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