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Nosocomial outbreak of Clostridium difficile-associated diarrhoea due to a clindamycin-resistant enterotoxin A-negative strain.
- Source :
-
European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology [Eur J Clin Microbiol Infect Dis] 2001 Aug; Vol. 20 (8), pp. 528-34. - Publication Year :
- 2001
-
Abstract
- A clindamycin-resistant toxin A-negative, toxin B-positive Clostridium difficile strain caused an outbreak among 24 hospitalized patients at the Department of Surgery, the Intensive Care unit, and the Department of Internal Medicine of an 800-bed academic hospital. Nineteen patients had undergone a surgical intervention and all 24 patients received at least one dose of antibiotics prior to the development of Clostridium difficile-associated diarrhoea. Twenty-seven episodes of Clostridium difficile-associated diarrhoea in 24 patients were categorized as mild (n=19), severe (n=7), or fatal (n=1). Relapses occurred in three patients. Nineteen of the 27 episodes required anti-Clostridium difficile treatment. Molecular typing performed by arbitrary primer polymerase chain reaction (PCR) and PCR amplification of rRNA intergenic spacer regions revealed that the outbreak strains recovered from culture were identical. The outbreak strain belonged to serogroup F and was resistant to erythromycin, clindamycin, and tetracycline, whereas susceptibility to chloramphenicol varied. No phenotypic activity of enterotoxin A was detected. A deletion of approximately 1.7 kb was found in the toxin A gene. Cytotoxin B had an unusual effect on cell culture assays that, at first, was not recognized as Clostridium difficile specific but could be neutralized with anti-Clostridium difficile B cytotoxin.
- Subjects :
- Adult
Aged
Anti-Bacterial Agents pharmacology
Bacterial Toxins genetics
Bacterial Toxins toxicity
Clindamycin pharmacology
Clostridioides difficile classification
Clostridioides difficile genetics
Clostridioides difficile isolation & purification
Cross Infection microbiology
Diarrhea microbiology
Drug Resistance, Bacterial
Enterocolitis, Pseudomembranous microbiology
Enterotoxins genetics
Female
Humans
Male
Middle Aged
Polymerase Chain Reaction
Prevalence
Bacterial Proteins
Clostridioides difficile drug effects
Cross Infection epidemiology
Diarrhea epidemiology
Disease Outbreaks
Enterocolitis, Pseudomembranous epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 0934-9723
- Volume :
- 20
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology
- Publication Type :
- Academic Journal
- Accession number :
- 11681431
- Full Text :
- https://doi.org/10.1007/s100960100550