Coexistence of multiple PCR-ribotype strains of Clostridium difficile in faecal samples limits epidemiological studies
- 1 February 2005
- journal article
- Published by Microbiology Society in Journal of Medical Microbiology
- Vol. 54 (2) , 173-179
- https://doi.org/10.1099/jmm.0.45825-0
Abstract
Clostridium difficile is an important cause of antibiotic-associated diarrhoea. The simultaneous presence of different strains in individual faecal samples has not yet been established, but is important for epidemiological studies. Recurrences of Clostridium difficile-associated diarrhoea (CDAD) are observed in 15–20 % of patients and have been reported as relapses or reinfections with a new strain. In a period of 1 year, 28 faecal samples from 23 patients with a first episode of CDAD were collected at the Leiden University Medical Centre. In addition, 52 faecal samples from 23 patients, from three different hospitals, with one (n = 19), two (n = 2) or three (n = 2) recurrences were studied. PCR-ribotyping was applied as the standard typing method for the isolates. The toxinogenic and clindamycin-resistance profiles of the isolates was determined by PCR. Of 23 patients with a first episode of CDAD, two (8.7 %) harboured two different types, with no differences in toxinogenicity or clindamycin resistance, within one faecal sample. One of these 23 patients showed two types in three faecal samples from the same episode. Of the 23 patients with recurrences, six (26 %) showed a different strain type isolated in a recurrent episode. The number of cases of multiple C. difficile strains in faecal samples from patients with a first episode of CDAD did not differ significantly from the number of different strains present in recurrent episodes (chi-square test, P ⩽ 0.2). This observation limits the application of typing methods for studying the epidemiology of CDAD.Keywords
This publication has 18 references indexed in Scilit:
- Frequency of Binary Toxin Genes among Clostridium difficile Strains That Do Not Produce Large Clostridial ToxinsJournal of Clinical Microbiology, 2003
- International Typing Study of Toxin A-Negative, Toxin B-Positive Clostridium difficile VariantsJournal of Clinical Microbiology, 2003
- Molecular typing methods for the epidemiological identification of Clostridium difficile strainsExpert Review of Molecular Diagnostics, 2001
- Epidemiology of Recurrences or Reinfections of Clostridium difficile -Associated DiarrheaJournal of Clinical Microbiology, 2000
- Development of a new PCR-ribotyping method forClostridium difficilebased on ribosomal RNA gene sequencingFEMS Microbiology Letters, 1999
- Deletions in the repeating sequences of the toxin A gene of toxin A-negative, toxin B-positiveClostridium difficilestrainsFEMS Microbiology Letters, 1999
- Risk Factors for Early RecurrentClostridium difficile–Associated DiarrheaClinical Infectious Diseases, 1998
- Recurrent Clostridium difficile Diarrhea: Characteristics of and Risk Factors for Patients Enrolled in a Prospective, Randomized, Double-Blinded TrialClinical Infectious Diseases, 1997
- New selective medium for isolating Clostridium difficile from faeces.Journal of Clinical Pathology, 1992
- Nucleotide sequence ofClostridium difficiletoxin B geneNucleic Acids Research, 1990