Corynebacterium of the diphtheriae complex in companion animals: clinical and microbiological characterization of 64 cases from France

Objectives: Corynebacteria of the diphtheriae complex (Cdc) can cause diphtheria in humans and have been reported from companion animals. We aimed to describe animal infection cases caused by Cdc isolates. Methods: 18 308 animals (dogs, cats, horses and small mammals) with rhinitis, dermatitis, non-healing wounds and otitis were sampled in metropolitan France (August 2019 to August 2021). Data on symptoms, age, breed, and the administrative region of origin were collected. Cultured bacteria were analyzed for tox gene presence, for production of the diphtheria toxin, for antimicrobial susceptibility, and genotyped by multilocus sequence typing. Results: C. ulcerans was identified in 51 cases, 24 of which were toxigenic. Rhinitis was the most frequent presentation (18/51). Eleven cases (6 cats, 4 dogs, 1 rat) were mono-infections. Large breed dogs, especially German Shepherds (9 of 28 dogs; p < 0.00001) were overrepresented. C. ulcerans isolates were susceptible to all tested antibiotics. tox-positive C. diphtheriae was identified in 2 horses. Last, 11 infections cases (9 dogs, 2 cats; mostly chronic otitis, and 2 sores) had tox-negative C. rouxii, a recently defined species. C. rouxii and C. diphtheriae isolates were susceptible to most antibiotics tested, and almost all of these infections were polymicrobial. Conclusions: Monoinfections with C. ulcerans point towards a primary pathogenic potential to animals. C. ulcerans represents an important zoonotic risk, and C. rouxii may represent a novel zoonotic agent. This case series provides novel clinical and microbiological data on Cdc infections, and underlines the need for management of animals and their human contacts.