Emerging toxin A-B+ variant strain of Clostridium difficile responsible for pseudomembranous colitis at a tertiary care hospital in Korea.
Sixty percent to 80% of Clostridium difficile isolates in Korea have been reported to be toxigenic. However, over 1 year, we encountered a high number of tcdA-tcB+ strains associated with pseudomembranous colitis (PMC). C. difficile was isolated from 224 of 471 specimens (47.6%) from 371 patients. A subset of the culture-positive specimens (n = 106), containing no duplicate cases, was randomly selected for tcdA and tcdB polymerase chain reaction (PCR) assays. PCR results showed that tcdA+tcdB+ and tcdA-tcdB+ strains accounted for 39.6% (42/106) and 50.9% (54/106), respectively. Endoscopy, performed on 55/106 patients, revealed 29 with PMC, 5 with colitis, 14 with other colon diseases, and 7 normal cases. Among the 29 PMC cases, 21 (72.4%) were associated with tcdA-tcdB+ strains (P = 0.0016). These results revealed the possible emergence of tcdA-tcdB+ C. difficile strains in Korea, and these variant strains could evoke a higher rate of PMC than tcdA+tcdB+ strains.
Shin
Bo-Moon
BM
Department of Laboratory Medicine, Sanggye Paik Hospital, Inje University, Seoul 139-707, South Korea. bmshin@unitel.co.kr
Kuak
Eun Young
EY
Yoo
Soo Jin
SJ
Shin
Won Chang
WC
Yoo
Hyeon Mi
HM
D001426:Bacterial Proteins / Q000235:genetics*; D001427:Bacterial Toxins / Q000235:genetics*; D016360:Clostridioides difficile / Q000145:classification / Q000235:genetics* / Q000302:isolation & purification; D003428:Cross Infection / Q000382:microbiology* / Q000473:pathology; D004269:DNA, Bacterial / Q000235:genetics; D016099:Endoscopy, Gastrointestinal; D004761:Enterocolitis, Pseudomembranous / Q000382:microbiology* / Q000473:pathology; D004768:Enterotoxins / Q000235:genetics*; D006761:Hospitals; D006801:Humans; D007723:Korea; D016133:Polymerase Chain Reaction; D021521:Ribotyping
D001426:Bacterial Proteins; D001427:Bacterial Toxins; D004269:DNA, Bacterial; D004768:Enterotoxins; C041348:tcdA protein, Clostridium difficile; C031815:toxB protein, Clostridium difficile