First detection of Clostridium difficile ribotype 027 in Bochum, Germany, confirmed by slpA sequencing
Abstract number: P2042
Kaase M., Szabados F., Anders A., Sakinc T., Gatermann S.
Objectives: Due to its increased virulence reliable detection of C. difficile Type 027 is necessary. In Germany C. difficile ribotype 027 has been described only in the south-west.
Methods:C. difficile was cultured from stool samples of hospitalised patients using selective media. C. difficile isolates were tested for the presence of tcdB by PCR. Susceptibility testing for erythromycin and moxifloxacin was used to screen for ribotype 027 and all isolates resistant to erythromycin or moxifloxacin were further characterised. A duplex PCR for cdtA and cdtB was performed. Isolates with positive results were typed by PCR ribotyping according to Stubbs et al. If results suggested ribotype 027 we performed slpA and tcdC sequencing to confirm the results.
Results: Of 130 tcdB positive C. difficile isolates resistant to erythromycin and moxifloxacin collected between April and December 2008 we could demonstrate the genes for the binary toxins cdtA and cdtB in 47 (36.2%) isolates. PCR ribotyping gave the same banding patterns as in a ribotype 027 reference strain in 9 isolates. All those isolates showed slpA sequences typical of ribotype 027 and deletions at position 117 and 330 to 347 of the tcdC gene.
Three cases of C. difficile ribotype 027 occured in the same hospital ward. The remaining cases were found in different hospitals. The mean age of cases was 68.6 years (range 12 to 90).
Conclusion: For the first time cases of C. difficile ribotype 027 could be demonstrated in our area. All isolates carried the genes for the binary toxins cdtA and cdtB and deletions in the gene for the negative regulator of toxin production tcdC.
|Session name:||19th European Congress of Clinical Microbiology and Infectious Diseases|
|Location:||Helsinki, Finland, 16 - 19 May 2009|
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