title: Clinical features of Clostridium difficile infection and molecular characterization of the isolated strains in a cohort of Danish hospitalized patients.
abstract: The purpose of this study was to compare clinical features of Clostridium difficile infection (CDI) to toxin gene profiles of the strains isolated from Danish hospitalized patients. C. difficile isolates were characterized by PCR based molecular typing methods including toxin gene profiling and analysis of deletions and truncating mutations in the toxin regulating gene tcdC. Clinical features were obtained by questionnaire. Thirty percent of the CDI cases were classified as community-acquired. Infection by C. difficile with genes encoding both toxin A, toxin B and the binary toxin was significantly associated with hospital-acquired/healthcare-associated CDI compared to community-acquired CDI. Significantly higher leukocyte counts and more severe clinical manifestations were observed in patients infected by C. difficile containing genes also encoding the binary toxin together with toxin A and B compared to patients infected by C. difficile harbouring only toxin A and B. In conclusion, infection by C. difficile harbouring genes encoding both toxin A, toxin B and the binary toxin were associated with hospital acquisition, higher leukocyte counts and severe clinical disease.
authors: Department of Microbiological Diagnostics, Statens Serum Institut, Bldg. 43/317, Artillerivej 5, 2300 Copenhagen S, Denmark. lms@ssi.dk
authors: L M
authors: LM
authors: Søes
authors: I
authors: I
authors: Brock
authors: S
authors: S
authors: Persson
authors: J
authors: J
authors: Simonsen
authors: K E
authors: KE
authors: Pribil Olsen
authors: M
authors: M
authors: Kemp
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001426:Bacterial Proteins / Q000235:genetics; D001427:Bacterial Toxins / Q000235:genetics; D002648:Child; D002675:Child, Preschool; D016360:Clostridioides difficile / Q000145:classification* / Q000235:genetics* / Q000302:isolation & purification; D003015:Clostridium Infections / Q000382:microbiology* / Q000473:pathology; D015331:Cohort Studies; D017714:Community-Acquired Infections / Q000382:microbiology / Q000473:pathology; D003428:Cross Infection / Q000382:microbiology / Q000473:pathology; D003718:Denmark; D004761:Enterocolitis, Pseudomembranous / Q000382:microbiology* / Q000473:pathology; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D012097:Repressor Proteins / Q000235:genetics; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D001426:Bacterial Proteins; D001427:Bacterial Toxins; D012097:Repressor Proteins; C105615:TcdC protein, Clostridium difficile