Characterization of Cases of Clostridium difficile Infection (CDI) Presenting at an Emergency Room: Molecular and Clinical Features Differentiate Community-Onset Hospital-Associated and Community-Associated CDI in a Tertiary Care Hospital^▿

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   Fig. 1.

   Repetitive sequence-based PCR results for the 39 C. difficile isolates, including 3 isolates from the earlier hospitalization. A total of 28 different profile groups were found, and 1 major cluster (cases 32, 33, 34, 35, and 36) and 4 minor clusters (cases 3 and 4, 13 and 14, 26 and 27, and 30 and 31) were detected. Among A⁺B⁺ isolates (n = 25), 17 patterns were observed, and no identical patterns were seen in A⁻B⁻ isolates (n = 4). Among the 7 A⁻B⁺ isolates (cases 10, 20, 21, 25, 28, 30, and 31), only 2 isolates (cases 30 and 31) showed identical patterns. Isolates from three cases of recurrent CDI (cases 10, 19, and 35) showed rep-PCR patterns identical to those from the earlier episodes (*). PCR ribotyping revealed that 12, 1, and 3 patterns in A⁺B⁺, A⁻B⁺, and A⁻B⁻ isolates, respectively.
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   Fig. 2.

   PCR-ribotyping fingerprints of C. difficile isolates belonging to PCR ribotypes AB1 to AB12 (lane 1 to lane 12, respectively), aB (lane 13), and ab1 to ab3 (lane 14 to lane 16, respectively). Lanes M, 100-bp ladder.

• Copyright © 2011, American Society for Microbiology