[Clostridium difficile ribotype 027, toxinotype III in The Netherlands]

Area of Science:

• Infectious Diseases
• Microbiology
• Hospital Epidemiology

Background:

• Clostridium difficile ribotype 027 (also known as toxinotype III) outbreaks have been reported in Dutch hospitals.
• This specific strain, previously identified in North America and the UK, is associated with severe diarrhea.
• A genetic defect in the toxin-regulating gene leads to excessive toxin production by this C. difficile strain.

Purpose of the Study:

• To report on recent outbreaks of Clostridium difficile ribotype 027 in the Netherlands.
• To highlight the characteristics of this virulent strain and associated risk factors.
• To discuss challenges in controlling C. difficile outbreaks.

Main Methods:

• Epidemiological surveillance of Clostridium difficile infections.
• Clinical case reporting and strain characterization.
• Review of existing diagnostic, prevention, and control protocols.

Main Results:

• Two Dutch hospitals experienced outbreaks of Clostridium difficile ribotype 027.
• Fluoroquinolone antibiotic use identified as a significant risk factor for infection.
• The environmental persistence of C. difficile spores and their resistance to standard disinfectants pose control challenges.

Conclusions:

• Clostridium difficile ribotype 027 outbreaks require vigilant monitoring and control strategies.
• Effective management necessitates understanding the strain's virulence and spore characteristics.
• Established protocols for diagnostics, prevention, and control are crucial for mitigating outbreaks.