title: Fulminant pseudomembranous colitis caused by Clostridium difficile PCR ribotype 027 in a healthy young woman in Japan.
abstract: In the past two decades, Clostridium difficile polymerase chain reaction ribotype 027 strain has rapidly emerged as the leading cause of antibiotic-associated colitis in North America and Europe; however, it has been reported only occasionally in Japan. We report a case of fulminant pseudomembranous colitis caused by this strain in a healthy young woman in Japan without any previous medical history. The strain isolated from our patient was susceptible to both gatifloxacin and moxifloxacin, thus representing a historic strain. The acquisition of fluoroquinolone resistance was reported as the important key genetic event linked to the virulence of this strain. It is noteworthy that the fluoroquinolone-susceptible 027 strain caused fulminant colitis in a healthy young woman in a non-endemic area. Our experience suggests that C. difficile PCR ribotype 027 has the potential virulence factors that are not associated with a fluoroquinolone resistance-conferring mutation.
authors.affiliation: Digestive Disease Center, The Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Nishimura
authors.affiliation: Digestive Disease Center, The Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, Japan.
authors.forename: Tadayuki
authors.initials: T
authors.lastname: Kou
authors.affiliation: Department of Bacteriology II, National Institute of Infectious Diseases, Tokyo, Japan.
authors.forename: Haru
authors.initials: H
authors.lastname: Kato
authors.affiliation: Digestive Disease Center, The Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Watanabe
authors.affiliation: Department of Infectious Diseases, The Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, Japan.
authors.forename: Shoichi
authors.initials: S
authors.lastname: Uno
authors.affiliation: Department of Bacteriology II, National Institute of Infectious Diseases, Tokyo, Japan.
authors.forename: Mitsutoshi
authors.initials: M
authors.lastname: Senoh
authors.affiliation: Department of Bacteriology II, National Institute of Infectious Diseases, Tokyo, Japan.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Fukuda
authors.affiliation: Department of Infectious Diseases, The Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, Japan.
authors.forename: Atsuko
authors.initials: A
authors.lastname: Hata
authors.affiliation: Digestive Disease Center, The Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, Japan. Electronic address: s-yazumi@kitano-hp.or.jp.
authors.forename: Shujiro
authors.initials: S
authors.lastname: Yazumi
mesh_terms: D000328:Adult; D001426:Bacterial Proteins / Q000235:genetics*; D016360:Clostridioides difficile / Q000145:classification / Q000235:genetics*; D004761:Enterocolitis, Pseudomembranous / Q000175:diagnosis / Q000382:microbiology*; D005260:Female; D006801:Humans; D007564:Japan; D016133:Polymerase Chain Reaction; D021521:Ribotyping; D017422:Sequence Analysis, DNA
chemical_list: D001426:Bacterial Proteins; C070683:surface layer protein A, Bacteria
keywords: Clostiridium difficile; PCR ribotype 027; Pseudomembranous colitis