Binary Toxin and Death after Clostridium difficile Infection
Binary Toxin and Death after Clostridium difficile Infection
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DOI：
10.3201/eid1706.101483
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发表时间：
2011-06-01
影响因子：
11.8
通讯作者：
Olsen, Katharine E. P.
中科院分区：
文献类型：
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作者：
Bacci, Sabrina;Molbak, Kare;Olsen, Katharine E. P.
我们比较了感染具有毒素 A 和 B 基因但不含二元毒素的艰难梭菌的患者 (n = 212) 与感染具有 A、B 和二元毒素基因的艰难梭菌的患者的 30 天病死率。后一组包括感染 PCR 核糖型 027（CD027，n = 193）或非 027（CD non-027，n = 72）菌株的患者。在单变量分析（相对风险 [RR] 1.8，95% 置信区间 [CI] 1.2-2.7）和调整年龄、性别和地理区域后的多变量分析（RR 1.6，95% CI 1.0-2.4）中，患有二元毒素的患者比没有二元毒素的患者具有更高的病死率。 CD027 或 CD non-027 感染患者的病死率相似（27.8%、28.0%）。二元毒素要么是毒性更强的艰难梭菌菌株的标记，要么直接导致菌株毒力。控制艰难梭菌感染的努力应针对所有强毒株，无论 PCR 核糖型如何。
We compared 30-day case-fatality rates for patients infected with Clostridium difficile possessing genes for toxins A and B without binary toxin (n = 212) with rates for patients infected with C. difficile possessing genes for A, B, and binary toxin. The latter group comprised patients infected with strains of PCR ribotype 027 (CD027, n = 193) or non-027 (CD non-027, n = 72). Patients with binary toxin had higher case-fatality rates than patients without binary toxin, in univariate analysis (relative risk [RR] 1.8, 95% confidence interval [CI] 1.2-2.7) and multivariate analysis after adjustment for age, sex, and geographic region (RR 1.6, 95% CI 1.0-2.4). Similar case-fatality rates (27.8%, 28.0%) were observed for patients infected with CD027 or CD non-027. Binary toxin either is a marker for more virulent C. difficile strains or contributes directly to strain virulence. Efforts to control C. difficile infection should target all virulent strains irrespective of PCR ribotype.