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Clostridium difficile ribotype 027, toxinotype III, the Netherlands
Ed J Kuijper1, Renate J van den Berg, Sylvia Debast
1Department of Medical Microbiology, National Reference Library for Clostridium difficile, Leiden University Medical Center, 2300 RC Leiden, the Netherlands. e.j.kuijper@lumc.nl
Emerging Infectious Diseases
|May 18, 2006
Summary
Clostridium difficile outbreaks, particularly the PCR ribotype 027 strain, occurred in seven Dutch hospitals. These challenging infections involved multiple strains, including a toxin A-negative variant, complicating control efforts.
Area of Science:
- Infectious Diseases
- Microbiology
- Epidemiology
Background:
- Clostridium difficile is a significant cause of healthcare-associated infections.
- Specific hypervirulent strains, such as PCR ribotype 027, are associated with severe outbreaks.
- Understanding outbreak dynamics and causative agents is crucial for effective control.
Purpose of the Study:
- To report and characterize Clostridium difficile outbreaks in Dutch hospitals.
- To identify the specific strains involved in the observed outbreaks.
- To highlight the challenges in controlling these C. difficile infections.
Main Methods:
- Surveillance of Clostridium difficile infections across seven hospitals.
- Identification of outbreak strains using polymerase chain reaction (PCR) ribotyping.
- Toxinotyping to further characterize the identified C. difficile strains.
Main Results:
- Seven hospitals in the Netherlands experienced outbreaks of Clostridium difficile PCR ribotype 027, toxinotype III, between April 2005 and February 2006.
- One hospital concurrently faced a separate outbreak involving a toxin A-negative C. difficile PCR ribotype 017, toxinotype VIII strain.
- The study highlights the difficulty in controlling these C. difficile outbreaks.
Conclusions:
- Multiple Clostridium difficile strains, including the virulent PCR ribotype 027, caused significant outbreaks in Dutch hospitals.
- The co-occurrence of different C. difficile strains, such as ribotype 017, complicates infection control.
- Effective strategies are needed to manage and control challenging Clostridium difficile outbreaks.