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Increasing Prevalence of Toxin A-Negative, Toxin B-Positive Isolates of Clostridium difficile in Korea: Impact on Laboratory Diagnosis

Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, Korea,¹ Microbiology and Immunology, The University of Western Australia, Perth, Western Australia,² Department of Laboratory Medicine, Chungnam National University, College of Medicine, Daejeon, Korea³

Received 13 June 2007/ Returned for modification 20 August 2007/ Accepted 8 January 2008

Of 462 Korean Clostridium difficile isolates, 77.5% were toxin B positive but 21.4% were toxin A negative (A^– B⁺). The binary toxin gene was detected in nine isolates. A higher fluoroquinolone resistance of A^– B⁺ strains may contribute to the increase of these strains. Toxin A detection alone may underdiagnose C. difficile-associated disease.

Published ahead of print on 16 January 2008.