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Coinfection with 2 Clostridium difficile ribotypes in China: A case report
Liqian Wang1, Yun Luo, Chen Huang
1Department of Laboratory Medicine, Zhejiang Chinese Medical University Affiliated Hangzhou First Hospital Department of Microbiology, Zhejiang Provincial Center for Disease Control and Prevention Department of Laboratory Medicine, Hangzhou First Hospital, Huansha road, Hangzhou, Zhejiang, China.
Medicine
|March 30, 2018
Summary
This case study highlights a severe Clostridium difficile infection (CDI) in China, coinfected by two ribotypes. Ribotype 017 was associated with more severe symptoms and higher inflammatory markers than ribotype 001.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Clinical Medicine
Background:
- Clostridium difficile infections (CDIs) are a growing concern globally.
- Limited data exists on coinfections by multiple C. difficile ribotypes in China.
- Understanding specific ribotype contributions to disease severity is crucial.
Observation:
- An 83-year-old male presented with prolonged diarrhea and urinary tract infection after ofloxacin treatment.
- Elevated white blood cell (WBC), serum creatinine (Scr), and C-reactive protein (CRP) levels indicated a severe condition.
- Rapid detection identified Clostridium difficile, leading to a diagnosis of severe CDI.
Findings:
- Polymerase chain reaction (PCR) ribotyping revealed coinfection with two distinct C. difficile ribotypes: RT 017 and RT 001.
- RT 017 was detected in the initial stool samples, followed by RT 001.
- RT 017 was associated with significantly higher elevations in WBC, Scr, and CRP compared to RT 001.
Implications:
- This case highlights the importance of recognizing and differentiating the clinical impact of various C. difficile ribotypes.
- Increased clinician awareness of CDI, particularly concerning severe presentations linked to specific ribotypes like RT 017, is necessary in China.
- Effective management strategies may need to consider the specific ribotype involved in CDI to optimize patient outcomes.
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