title: Toxinotype V Clostridium difficile in humans and food animals.
abstract: Clostridium difficile is a recognized pathogen in neonatal pigs and may contribute to enteritis in calves. Toxinotype V strains have been rare causes of human C. difficile-associated disease (CDAD). We examined toxinotype V in human disease, the genetic relationship of animal and human toxinotype V strains, and in vitro toxin production of these strains. From 2001 through 2006, 8 (1.3%) of 620 patient isolates were identified as toxinotype V; before 2001, 7 (<0.02%) of approximately 6,000 isolates were identified as toxinotype V. Six (46.2%) of 13 case-patients for whom information was available had community-associated CDAD. Molecular characterization showed a high degree of similarity between human and animal toxinotype V isolates; all contained a 39-bp tcdC deletion and most produced binary toxin. Further study is needed to understand the epidemiology of CDAD caused by toxinotype V C. difficile, including the potential of foodborne transmission to humans.
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Jhung
authors.forename: Angela D
authors.initials: AD
authors.lastname: Thompson
authors.forename: George E
authors.initials: GE
authors.lastname: Killgore
authors.forename: Walter E
authors.initials: WE
authors.lastname: Zukowski
authors.forename: Glenn
authors.initials: G
authors.lastname: Songer
authors.forename: Michael
authors.initials: M
authors.lastname: Warny
authors.forename: Stuart
authors.initials: S
authors.lastname: Johnson
authors.forename: Dale N
authors.initials: DN
authors.lastname: Gerding
authors.forename: L Clifford
authors.initials: LC
authors.lastname: McDonald
authors.forename: Brandi M
authors.initials: BM
authors.lastname: Limbago
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D001426:Bacterial Proteins / Q000145:classification / Q000235:genetics; D001427:Bacterial Toxins / Q000145:classification* / Q000235:genetics; D002417:Cattle; D016360:Clostridioides difficile / Q000145:classification*; D003015:Clostridium Infections / Q000235:genetics / Q000382:microbiology* / Q000662:veterinary; D017714:Community-Acquired Infections / Q000235:genetics / Q000382:microbiology; D004197:Disease Reservoirs; D004768:Enterotoxins / Q000145:classification / Q000235:genetics; D005260:Female; D005767:Gastrointestinal Diseases / Q000382:microbiology / Q000662:veterinary; D006801:Humans; D008297:Male; D008875:Middle Aged; D012097:Repressor Proteins / Q000145:classification / Q000235:genetics; D021521:Ribotyping; D034421:Sus scrofa
chemical_list: D001426:Bacterial Proteins; D001427:Bacterial Toxins; D004768:Enterotoxins; D012097:Repressor Proteins; C105615:TcdC protein, Clostridium difficile; C041348:tcdA protein, Clostridium difficile; C031815:toxB protein, Clostridium difficile