title: Typing scheme for Clostridium difficile: its application in clinical and epidemiological studies.
abstract: Epidemiological studies of Clostridium difficile diarrhoeal disease have been hindered by the lack of a typing scheme for this organism. A typing method based on the incorporation of sulphur-35-labelled methionine into cellular proteins and their separation by sodium dodecylsulphate/polyacrylamide gel electrophoresis showed clear pattern differences between strains, and nine distinct groups within the C difficile species were established. 98% of 250 clinical strains derived from four hospitals were typable. Group X was the commonest group and was associated with outbreaks of pseudomembranous colitis and antibiotic-associated colitis in two hospitals. Groups A-D were isolated predominantly from mothers and newborn infants. In outbreaks of antibiotic-associated colitis in oncology and orthopaedic wards the same strains, group X and group E, respectively, were isolated from patients and their environment, providing strong evidence of cross-infection between patients and of hospital acquisition of C difficile.
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000009:adverse effects; D001345:Autoradiography; D001426:Bacterial Proteins / Q000032:analysis*; D001431:Bacteriological Techniques; D003013:Clostridium / Q000145:classification*; D003092:Colitis / Q000382:microbiology*; D003428:Cross Infection / Q000382:microbiology*; D004591:Electrophoresis, Polyacrylamide Gel; D004761:Enterocolitis, Pseudomembranous / Q000382:microbiology*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008715:Methionine; D012967:Sodium Dodecyl Sulfate; D013462:Sulfur Radioisotopes
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D013462:Sulfur Radioisotopes; D012967:Sodium Dodecyl Sulfate; D008715:Methionine