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Journal of Clinical Microbiology, September 2003, p. 4184-4187, Vol. 41, No. 9
0095-1137/03/$08.00+0     DOI: 10.1128/JCM.41.9.4184-4187.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.

Recent Emergence of an Epidemic Clindamycin-Resistant Clone of Clostridium difficile among Polish Patients with C. difficile-Associated Diarrhea

Hanna Pituch,^1* Alex van Belkum,² Nicole van den Braak,² Piotr Obuch-Woszczatynski,¹ Henri Verbrugh,² Felicja Meisel-Mikoajczyk,¹ and Mirosaw uczak¹

Department of Medical Microbiology, Centre of Biostructure Research, The Medical University of Warsaw, Warsaw, Poland,¹ Erasmus University Medical Centre Rotterdam (EMCR), Department of Medical Microbiology & Infectious Diseases, 3015 GD Rotterdam, The Netherlands²

Received 17 March 2003/ Returned for modification 2 June 2003/ Accepted 27 June 2003

Analysis of both the antibiotic resistance and the virulence characteristics of anaerobic human microbial pathogens is important in order to improve our understanding of a number of clinically significant infectious diseases, including Clostridium difficile-associated diarrhea (CDAD). We determined the presence of the clindamycin resistance-associated gene ermB and the ribotype of 33 C. difficile strains isolated from Polish patients suffering from CDAD. While all strains produced cytotoxin B (TcdB), enterotoxin A (TcdA) was produced by a subset of 15 strains only. The results showed that a single ermB-positive, TcdA^-B⁺ C. difficile strain with ribotype A has disseminated widely in the two Warsaw hospitals under investigation. Although different strains with the same phenotype were detected, the genotype A strain appeared to be the only one with a clear epidemic character. Apparently, enhanced local spread of CDAD-causing C. difficile may be restricted to a limited number of bacterial genotypes only.

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