An epidemic, toxin gene-variant strain of Clostridium difficile
An epidemic, toxin gene-variant strain of Clostridium difficile
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DOI：
10.1056/nejmoa051590
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发表时间：
2005-12-08
影响因子：
158.5
通讯作者：
Gerding, DN
中科院分区：
文献类型：
--
作者：
McDonald, LC;Killgore, GE;Gerding, DN
背景：最近的报道表明，美国与艰难梭菌相关疾病的速度和严重程度正在增加，并且增加可能与新的艰难梭菌菌株的出现有关，并增加了毒力，抗性或两者。宾夕法尼亚州）在2000年至2003年之间发生了与艰难梭菌相关的疾病的爆发。分离株的特征是通过限制性 - 核酸内切酶分析（REA），脉冲场凝胶电泳（PFGE）（PFGE）和毒素分型的特征，并将结果与在2001年隔离的数据库中进行了比较。二进制毒素CDT和致病基因座基因TCDC中的缺失可能导致毒素A和B的产生增加：属于一个REA组（BI）的分离株，并在所有八个设施中收集的样本中都鉴定出了一个相同的PFGE类型（BI）（BI）（NAP1），至少是从五个设施中收集的五个设施，从五个设施中收集到了五个设施。 Rea组BI于1984年首次确定，在历史数据库中的分离株中很少见（14例）。历史和电流（自2001年以来获得）BI/NAP1分离株均为毒素III，对二元毒素CDT呈阳性，并包含18 bp的TCDC缺失。在当前的BI/NAP1分离株中，对加替氧法和莫西法沙星的抗性比非BI/NAP1分离株更为普遍（100％vs. 42％，P
BACKGROUND:Recent reports suggest that the rate and severity of Clostridium difficile-associated disease in the United States are increasing and that the increase may be associated with the emergence of a new strain of C. difficile with increased virulence, resistance, or both.METHODS:A total of 187 C. difficile isolates were collected from eight health care facilities in six states (Georgia, Illinois, Maine, New Jersey, Oregon, and Pennsylvania) in which outbreaks of C. difficile-associated disease had occurred between 2000 and 2003. The isolates were characterized by restriction-endonuclease analysis (REA), pulsed-field gel electrophoresis (PFGE), and toxinotyping, and the results were compared with those from a database of more than 6000 isolates obtained before 2001. The polymerase chain reaction was used to detect the recently described binary toxin CDT and a deletion in the pathogenicity locus gene, tcdC, that might result in increased production of toxins A and B.RESULTS:Isolates that belonged to one REA group (BI) and had the same PFGE type (NAP1) were identified in specimens collected from patients at all eight facilities and accounted for at least half of the isolates from five facilities. REA group BI, which was first identified in 1984, was uncommon among isolates from the historic database (14 cases). Both historic and current (obtained since 2001) BI/NAP1 isolates were of toxinotype III, were positive for the binary toxin CDT, and contained an 18-bp tcdC deletion. Resistance to gatifloxacin and moxifloxacin was more common in current BI/NAP1 isolates than in non-BI/NAP1 isolates (100 percent vs. 42 percent, P