The first case of antibiotic-associated colitis by Clostridium difficile PCR ribotype 027 in Korea.
Clostridium difficile (C. difficile) is a common causative agent of pseudomembranous colitis (PMC). C. difficile-associated diarrhea (CDAD) ranges from mild diarrhea to life threatening PMC. Recently, a highly virulent strain of C. difficile polymerase chain reaction ribotype 027 was found in North America, Europe, and Japan. A 52-yr-old woman with anti-tuberculosis medication and neurogenic bladder due to traffic accident experienced five episodes of C. difficile PMC after taking antibiotics for pneumonia along with septic shock and acute renal failure. She was readmitted to the intensive care unit and treated with oral vancomycin with refractory of oral metronidazole, inotropics and probiotics for over 60 days. C. difficile isolated both at the first and the last admission was identified as C. difficile ribotype 027 by ribotyping, toxinotyping, and tcdC gene sequencing, which turned out the same pathogen as the epidemic hypervirulent B1/NAP1 strain. This is the first case of C. difficile PCR ribotype 027 in Korea. After discharge, she was maintained on probiotics and rifaximin for 3 weeks. She had no relapse for 6 months.
Tae
Chung Hyun
CH
Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea.
Jung
Sung-Ae
SA
Song
Hyun Joo
HJ
Kim
Seong-Eun
SE
Choi
Hee Jung
HJ
Lee
Miae
M
Hwang
Yusun
Y
Kim
Heejung
H
Lee
Kyungwon
K
D000063:Accidents, Traffic; D058186:Acute Kidney Injury / Q000175:diagnosis; D000995:Antitubercular Agents / Q000627:therapeutic use; D001483:Base Sequence; D016360:Clostridioides difficile / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification; D004761:Enterocolitis, Pseudomembranous / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology*; D005260:Female; D006801:Humans; D007723:Korea; D008875:Middle Aged; D008969:Molecular Sequence Data; D016133:Polymerase Chain Reaction; D021521:Ribotyping; D012772:Shock, Septic / Q000175:diagnosis
D000995:Antitubercular Agents