Clostridium difficile ribotypes 001, 017, and 027 are associated with lethal C. difficile infection in Hesse, Germany

Hesse State Health Office, Centre for Health Protection, Dillenburg, Germany.
Eurosurveillance: bulletin europeen sur les maladies transmissibles = European communicable disease bulletin (Impact Factor: 5.72). 01/2009; 14(45).
Source: PubMed


From January 2008 to April 2009, 72 cases of severe Clostridium difficile infection were reported from 18 different districts in the state of Hesse, Germany. A total of 41 C. difficile isolates from 41 patients were subjected to PCR ribotyping. PCR ribotype (RT) 027 was the most prevalent strain accounting for 24 of 41 (59%) of typed isolates, followed by RT 001 (eight isolates, 20%), RT 017 and 042 (two isolates each), and RT 003, 066, 078, 081, and RKI-034 (one isolate each). Eighteen patients had died within 30 days after admission. C. difficile was reported as underlying cause of or contributing to death in 14 patients, indicating a case fatality rate of 19%. The patients with lethal outcome attributable to C. difficile were 59-89 years-old (median 78 years). Ribotyping results were available for seven isolates associated with lethal outcome, which were identified as RT 027 in three and as RT 001 and 017 in two cases each. Our data suggest that C. difficile RT 027 is prevalent in some hospitals in Hesse and that, in addition to the possibly more virulent RT 027, other toxigenic C. difficile strains like RT 001 and 017 are associated with lethal C. difficile infections in this region.

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Available from: Mardjan Arvand, Oct 29, 2014
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    • "In 2008 the proportion of A−B+ isolates recovered from Korean CDI cases was 25.7% compared to 4.2% of isolates recovered in 1995 [10], [11]. After initially being thought as non-pathogenic it is now known that A−B+ toxinotypes can cause a wide spectrum of disease including pseudomembranous colitis and mortality [12], [13]. Toxin A−B+ isolates have typically been typed as Ribotype 017, however, in recent years some A−B+ strains isolated in China & Australia appear as distinctly separate ribotypes [14], [6]. "
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