title: [A case of multiple recurrence of Clostridium difficile-associated diarrhea--analysis of isolates from the patient using PCR ribotyping].
abstract: Recurrence of Clostridium difficile-associated diarrhea (CDAD) is a serious and still unsolved problem. Little is known about the precise mechanism of the recurrence with CDAD. To elucidate the issue, we analyzed C. difficile strains obtained from the patient with multiple recurrence of CDAD. A 72-year-old female received rectoidectomy was developed CDAD after administration of cefmetazole sodium for 5 days. She was recovered from illness by the administration 2g of vancomycin hydrochloride for 2 weeks. However she was recurred CDAD twice within 2 months thereafter. Six C. difficile isolates recovered from the stool specimens obtained during each episode were typed by polymerase chain reaction amplifying of rRNA intergenic spacer regions 8 PCR ribotyping was carried out. The PCR ribotype of the first episode was identical (ribotype smz) to that of the second episode, and the PCR ribotype of the third were distinct (ribotype hr) from those on previous two episodes. These findings indicate that the second episode was caused by the reactivation of continuously infected C. difficile strain (relapse) and the third episode was by reinfection of the new
authors.affiliation: Department of Gastroenterology, Toyokawa City Hospital.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Kato
authors.forename: Yuji
authors.initials: Y
authors.lastname: Nishi
authors.forename: Makoto
authors.initials: M
authors.lastname: Ohyama
authors.forename: Makoto
authors.initials: M
authors.lastname: Nakamura
authors.forename: Sayuri
authors.initials: S
authors.lastname: Izumida
authors.forename: Seiji
authors.initials: S
authors.lastname: Hashimoto
authors.forename: Haru
authors.initials: H
authors.lastname: Kato
mesh_terms: D000368:Aged; D016360:Clostridioides difficile / Q000235:genetics / Q000302:isolation & purification*; D003967:Diarrhea / Q000382:microbiology; D004761:Enterocolitis, Pseudomembranous / Q000382:microbiology*; D005260:Female; D006801:Humans; D016133:Polymerase Chain Reaction; D012329:RNA, Bacterial / Q000302:isolation & purification; D012008:Recurrence
chemical_list: D012329:RNA, Bacterial