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A Protein Microarray Assay for Serological Determination of Antigen-specific Antibody Responses Following Clostridium difficile Infection
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Clostridium difficile infection: monoclonal or polyclonal genesis?

M Hell1, M Permoser, G Chmelizek

  • 1Department of Hospital Epidemiology and Infection Control, University Hospital Salzburg, Salzburg, Austria. m.hell@salk.at

Infection
|August 10, 2011
PubMed
Summary

Clostridium difficile infection (CDI) is usually monoclonal, meaning it originates from a single source within patients. This finding supports using molecular tools like PCR ribotyping to track CDI outbreaks and differentiate reinfection from relapse.

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Generation of Discriminative Human Monoclonal Antibodies from Rare Antigen-specific B Cells Circulating in Blood

Published on: February 6, 2018

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Epidemiology

Background:

  • Clostridium difficile infection (CDI) is a major cause of hospital-acquired diarrhea with high recurrence rates.
  • Accurate differentiation between CDI relapse and reinfection is crucial for effective patient management.
  • Molecular epidemiologic tools, such as PCR ribotyping, are valuable for outbreak investigations but rely on a predominantly monoclonal origin of infection.

Purpose of the Study:

  • To investigate the origin of Clostridium difficile infections, determining if they are monoclonal or polyclonal within individual patients.
  • To assess the implications of CDI genesis for the reliability of molecular epidemiologic tools.

Main Methods:

  • Prospective study of 11 patients with nosocomial CDI between December 2009 and June 2010.
  • Isolation and PCR ribotyping of five C. difficile colonies from each patient's primary culture.
  • Analysis of 47 successfully ribotyped isolates from 55 initial isolates.

Main Results:

  • Eight distinct PCR ribotypes were identified among the 47 C. difficile isolates.
  • Predominantly monoclonal origin of CDI was observed in 10 out of 11 patients.
  • Polyclonal CDI was identified in one patient with recurrent diarrhea and underlying cancer.

Conclusions:

  • Clostridium difficile infections predominantly arise from a monoclonal origin within individual patients.
  • Polyclonal CDI can occur, although it appears to be less common.
  • The predominantly monoclonal nature of CDI supports the reliable use of molecular epidemiologic tools for outbreak investigations and distinguishing relapse from reinfection.