This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrowReprints and Permissions
Right arrow Copyright Information
Right arrow Books from ASM Press
Right arrow MicrobeWorld
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Martin, H.
Right arrow Articles by Weese, J. S.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Martin, H.
Right arrow Articles by Weese, J. S.

 Previous Article  |  Next Article 

Journal of Clinical Microbiology, September 2008, p. 2999-3004, Vol. 46, No. 9
0095-1137/08/$08.00+0     doi:10.1128/JCM.02437-07
Copyright © 2008, American Society for Microbiology. All Rights Reserved.

Characterization of Clostridium difficile Strains Isolated from Patients in Ontario, Canada, from 2004 to 2006{triangledown}

H. Martin,1 B. Willey,2 D. E. Low,2,3 H. R. Staempfli,1 A. McGeer,2 P. Boerlin,4 M. Mulvey,4 and J. S. Weese4*

Department of Clinical Studies, University of Guelph, Guelph, Ontario, Canada,1 Department of Microbiology, Mt. Sinai Hospital, Toronto, Ontario, Canada,2 Ontario Public Health Laboratories, Toronto, Ontario, Canada,3 Department of Pathobiology, University of Guelph, Guelph, Ontario, and National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada4

Received 18 December 2007/ Returned for modification 18 March 2008/ Accepted 14 July 2008

Clostridium difficile is the bacterium most commonly surmised to cause antimicrobial- and hospital-associated diarrhea in developed countries worldwide, and such infections are thought to be increasing in frequency and severity. A laboratory-based study was carried out to characterize C. difficile strains isolated from persons in Ontario, Canada, during 2004 to 2006 according to toxin type (enterotoxin A, cytotoxin B, and binary toxin [CDT]), tcdC gene characterization, ribotyping, pulsed-field gel electrophoresis, and toxinotyping. Clostridium difficile was isolated from 1,080/1,152 (94%) samples from 21 diagnostic laboratories. Isolates with toxin profiles A+ B+ CDT–, A+ B+ CDT+, A– B+ CDT–, and A– B+ CDT+ accounted for 63%, 34%, 2.4%, and 0.6% of isolates, respectively. Alterations in tcdC were detected in six different ribotypes, including ribotype 027. A total of 39 different ribotypes were identified, with ribotype 027/North American pulsotype 1 (NAP1), an internationally recognized outbreak strain associated with severe disease, being the second most common ribotype (19% of isolates). Transient resistance to metronidazole was identified in 19 (1.8%) isolates. While a large number of ribotypes were found, a few predominated across the province. The high prevalence and wide distribution of ribotype 027/NAP1 are disconcerting in view of the severity of disease associated with it.

* Corresponding author. Mailing address: Department of Pathobiology, Ontario Veterinary College, University of Guelph, Guelph, Ontario N1G 2W1, Canada. Phone: (519) 824-4120, ext. 54064. Fax: (519) 763-9544. E-mail: jsweese{at}uoguelph.ca

{triangledown} Published ahead of print on 23 July 2008.

Journal of Clinical Microbiology, September 2008, p. 2999-3004, Vol. 46, No. 9
0095-1137/08/$08.00+0     doi:10.1128/JCM.02437-07
Copyright © 2008, American Society for Microbiology. All Rights Reserved.



This article has been cited by other articles:

  • Huang, H., Weintraub, A., Fang, H., Nord, C. E. (2009). Comparison of a Commercial Multiplex Real-Time PCR to the Cell Cytotoxicity Neutralization Assay for Diagnosis of Clostridium difficile Infections. J. Clin. Microbiol. 47: 3729-3731 [Abstract] [Full Text]  


Copyright © 2009 by the American Society for Microbiology.   For an alternate route to Journals.ASM.org, visit: http://intl-journals.asm.org | More Info»