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Clostridium difficile plasmid isolation as an epidemiologic tool
1Infectious Disease Section, Veterans Administration Medical Center, Minneapolis, Minnesota 55417.
Abstract:
A large hospital outbreak of Clostridium difficile diarrhea at the Minneapolis Veterans Administration Medical Center (MVAMC) was studied by plasmid profile typing. Plasmids were obtained from 30 (37%) of 82 clinical isolates from MVAMC patients and 10 (67%) of 15 non-MVAMC isolates. While bacteriophage plus bacteriocin typing and polyacrylamide gel electrophoresis (PAGE) plus bacterial agglutination typing proved more universally applicable, plasmid profiles may be useful for tracing isolated epidemic outbreaks, reinfections and relapses caused by plasmid-bearing strains.
Insights
Plasmid profile typing helped trace a Clostridium difficile outbreak in a hospital. While other methods were more broadly applicable, plasmid analysis is useful for tracking specific Clostridium difficile infections, including reinfections and relapses.
Area of Science:
- Microbiology
- Infectious Diseases
- Epidemiology
Background:
- Clostridium difficile infection (CDI) is a significant cause of hospital-acquired diarrhea.
- Effective outbreak investigation tools are crucial for controlling CDI spread within healthcare settings.
Purpose of the Study:
- To evaluate the utility of plasmid profile typing for investigating a large hospital outbreak of Clostridium difficile.
- To compare plasmid profiling with other typing methods for Clostridium difficile isolates.
Main Methods:
- Plasmid DNA was extracted and analyzed from clinical isolates of Clostridium difficile obtained from patients during a hospital outbreak.
- Isolates were also typed using bacteriophage/bacteriocin typing and polyacrylamide gel electrophoresis (PAGE)/bacterial agglutination typing for comparison.
Main Results:
- Plasmids were successfully obtained from 37% of hospital outbreak isolates and 67% of non-hospital isolates.
- Bacteriophage/bacteriocin and PAGE/bacterial agglutination typing demonstrated broader applicability across all isolates.
Conclusions:
- Plasmid profile typing can be a valuable tool for tracing specific Clostridium difficile outbreaks, particularly for identifying reinfections and relapses caused by plasmid-bearing strains.
- While not universally applicable, plasmid profiling complements other epidemiological tools for CDI outbreak investigations.