Association of Clostridium difficile ribotype 078 with detectable toxin in human stool specimens.

Association of Clostridium difficile ribotype 078 with detectable toxin in human stool specimens. J Med Microbiol. 2015 Sep 8; Authors: Fairley DJ, McKenna JP, Stevenson M, Weaver J, Gilliland C, Watt A, Coyle PV Abstract Using a C. difficile glutamate dehydrogenase (GDH) immunoassay and a sensitive C. difficile toxin A/B immunoassay, human stool specimens from patients with diarrhoea (n=1085) were classified as either GDH-positive / toxin-negative, or GDH-positive / toxin positive. 528/725 (73%) of the GDH-positive / toxin-negative specimens contained viable C. difficile, and 433/528 (82%) of these C. difficile isolates were PCR positive for the toxin gene pathogenicity locus. Overall, 867/1078 (80%) of the GDH-positive specimens contained viable C. difficile, and 433/725 (60%) of the GDH-positive / toxin-negative specimens contained a toxigenic C. difficile strain. The diversity of toxigenic C. difficile ribotypes isolated from toxin-negative specimens (n=433) and toxin-positive specimens (n=339) was significantly different (p<0.0001). Specifically, presence of ribotype 078 strains was very strongly associated (p<0.0001) with detection of toxin in clinical specimens using a sensitive toxin immunoassay. Specimens positive for ribotype 078 were almost twice as likely to be toxin positive as opposed to toxin negative (RR=1.90, 95% CI 1.64-2.19). In contrast, other circulating ribotypes were seen with similar frequency in specime...
Source: Journal of Medical Microbiology - Category: Microbiology Authors: Tags: J Med Microbiol Source Type: research