Related Experiment Video
Updated: Feb 24, 2026
Cefoperazone-treated Mouse Model of Clinically-relevant Clostridium difficile Strain R20291
Published on: December 10, 2016
An outbreak of Clostridium difficile infections due to new PCR ribotype 826: epidemiologic and microbiologic analyses
M J T Crobach1, A F Voor In 't Holt2, C W Knetsch1
1Department of Medical Microbiology, Leiden University Medical Center, Leiden, The Netherlands.
Objectives:
To investigate an unusual outbreak of five patients with a total of eight episodes of a Clostridium difficile infection on a gastrointestinal surgical ward of a Dutch tertiary-care, university-affiliated hospital.
Methods:
Clinical case investigations and laboratory analyses were performed. Laboratory analyses included PCR ribotyping, multiple-locus variable-number tandem repeat analysis typing, toxin typing, antimicrobial susceptibility testing and whole genome sequencing.
Results:
The outbreak was associated with recurrent and severe disease in two of five patients. All episodes were due to a unique ribotype that was not recognized in the collection of an international network of reference laboratories and was assigned PCR ribotype 826. PCR ribotype 826 is a toxin A-, toxin B- and binary toxin-positive ribotype which according to molecular typing belongs to clade 5 and resembles the so-called hypervirulent ribotype 078. The presence of a clonal outbreak was confirmed by whole genome sequencing, yet the source of this newly identified ribotype remained unclear.
Conclusions:
This newly identified C. difficile PCR ribotype 826 is part of clade 5 and might also have increased virulence. The recognition of this outbreak highlights the need for ongoing C. difficile infection surveillance to monitor new circulating ribotypes with assumed increased virulence.
Insights
A new Clostridium difficile (C. diff) PCR ribotype 826 caused an unusual outbreak, leading to severe infections. Ongoing surveillance is crucial for detecting emerging C. diff strains with potential increased virulence.
Area of Science:
- Infectious Diseases
- Microbiology
- Genomics
Background:
- Clostridium difficile infection (CDI) poses a significant challenge in healthcare settings.
- Surveillance for novel C. difficile strains is essential for effective infection control.
Observation:
- An unusual outbreak of eight CDI episodes across five patients occurred on a gastrointestinal surgical ward.
- The outbreak involved recurrent and severe disease in two patients.
Findings:
- All CDI episodes were linked to a unique, previously unrecognized C. difficile PCR ribotype 826.
- This novel ribotype, belonging to clade 5, is toxin A-, toxin B-, and binary toxin-positive, resembling hypervirulent ribotype 078.
- Whole genome sequencing confirmed a clonal outbreak, but the source of the new ribotype remains unidentified.
Implications:
- The newly identified C. difficile PCR ribotype 826 may possess increased virulence.
- This outbreak underscores the importance of continuous C. difficile infection surveillance to identify and monitor emerging ribotypes with potentially enhanced pathogenicity.
More Related Videos
12:58A Protocol to Characterize the Morphological Changes of Clostridium difficile in Response to Antibiotic Treatment
Published on: May 25, 2017
09:12A Protein Microarray Assay for Serological Determination of Antigen-specific Antibody Responses Following Clostridium difficile Infection
Published on: June 15, 2018
