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Updated: Feb 9, 2026
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A Protocol to Characterize the Morphological Changes of Clostridium difficile in Response to Antibiotic Treatment
Published on: May 25, 2017
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Multidrug resistant Clostridium difficile ribotype 027 in southwestern Virginia, 2007 to 2013
R J Carman1, H M Daskalovitz1, M W Lyerly1
1TechLab, Inc., 2001 Kraft Drive, Blacksburg, VA 24060-6358, USA.
Anaerobe
|June 5, 2018
Summary
The fluoroquinolone-resistant 027 (027FQR) Clostridium difficile ribotype was most common and associated with symptomatic infection features. This ribotype showed higher fecal bioburden and toxin levels compared to other C. difficile strains.
Area of Science:
- Microbiology
- Infectious Diseases
- Gastroenterology
Background:
- Clostridium difficile infection (CDI) is a significant healthcare-associated infection.
- Understanding the prevalence and characteristics of different C. difficile ribotypes is crucial for effective management.
- The fluoroquinolone-resistant 027 (027FQR) strain has been identified as a particularly virulent and prevalent ribotype.
Purpose of the Study:
- To determine the frequency of Clostridium difficile ribotypes in fecal samples.
- To investigate the association of specific ribotypes with clinical features of symptomatic infection.
- To compare the fecal bioburden, toxin levels, and inflammatory markers between dominant C. difficile ribotypes.
Main Methods:
- Analysis of excess fecal samples submitted for routine C. difficile testing.
- Ribotyping of C. difficile isolates to identify different strains.
- Quantification of fecal bioburden, toxin A (TcdA), and toxin B (TcdB) levels.
- Measurement of fecal lactoferrin as an indicator of intestinal inflammation.
Main Results:
- The 027FQR ribotype was the most common (32%) among 3118 C. difficile isolates between 2007 and 2013.
- 027FQR isolates were significantly associated with cytotoxin-positive and unformed stool samples, indicative of symptomatic infection.
- Compared to the 014/020 ribotype, 027FQR exhibited higher fecal bioburdens, toxin levels (TcdA and TcdB), and fecal lactoferrin levels.
Conclusions:
- The 027FQR ribotype is a dominant and clinically significant strain of C. difficile.
- Higher bioburden and toxin production by 027FQR contribute to its association with symptomatic infections and increased intestinal inflammation.
- Further research into the virulence factors and treatment strategies for 027FQR is warranted.
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