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[Update on Clostridium difficile infections].

K Blanckaert1, B Coignard, B Grandbastien

  • 1Centre de coordination de la lutte contre les infections nosocomicales Paris-Nord, 15, rue de L'école-de-médecine, 75006 Paris, France. k-blanckaert@chru-lille.fr

La Revue De Medecine Interne
|November 21, 2007
PubMed
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Clostridium difficile infections (CDI) cause significant antibiotic-associated diarrhea and colitis. A hypervirulent strain (NAP1/027) has emerged, driving severe outbreaks globally, necessitating improved surveillance.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Epidemiology

Background:

  • Clostridium difficile is an anaerobic, gram-positive, spore-forming bacterium.
  • It causes 15-25% of antibiotic-associated diarrhea and over 95% of pseudomembranous colitis (PMC).
  • Since 2003, severe Clostridium difficile-associated diarrhea (CDAD) outbreaks have increased, linked to the emergence of the NAP1/027 clone.

Purpose of the Study:

  • To review current knowledge on Clostridium difficile infections (CDI).
  • To examine the recent evolution and spread of CDI.
  • To highlight the impact of the emerging NAP1/027 strain.

Main Methods:

  • Literature review of Clostridium difficile infections.
  • Analysis of epidemiological trends and outbreak data.

Related Experiment Videos

  • Characterization of the emerging NAP1/027 strain.

    • Main Results:

    • The NAP1/027 clone overproduces toxins A and B and produces binary toxin.
    • This hypervirulent strain has spread internationally, causing significant outbreaks.
    • Notable outbreaks have occurred in North America, the UK, Belgium, the Netherlands, and France.

    Conclusions:

    • The emergence and spread of the NAP1/027 strain represent a significant challenge in managing CDI.
    • Enhanced surveillance and reporting are crucial for understanding and controlling CDI.
    • Systematic reporting of C. difficile incidence by health facilities is recommended for better assessment in France.