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C. difficile ribotype 027 or 176?

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Abstract

Clostridium difficile is a major nosocomial pathogen of present times. The analysis of 624 C. difficile strains from 11 hospitals in the Czech Republic in 2013 revealed that 40 % of isolates belonged to ribotype 176. These results suggest that the incidence of CDI (C. difficile infection) in the Czech Republic has increased probably in connection with C. difficile ribotype 176. The molecular systems Xpert C. difficile Epi assay (Cepheid Inc., Sunnyvale, CA) diagnoses toxigenic strains and supports C. difficile ribotype 027 determination based on three specific target places in the toxigenic C. difficile genome. Twenty-nine strains cultivated from stool specimens were evaluated by the Xpert systems as presumed C. difficile PCR ribotype 027 were confirmed as a C. difficile ribotype 176 based on ribotyping. A further 120 C. difficile strains of ribotype 176 were examined for the presence of genes tcdB, cdtB and deletion in position 117 in the tcdC gene. Our experience shows that due to the correspondence of the target places, C. difficile ribotype 176 may be interpreted as ribotype 027 by Xpert C. difficile Epi assay (Cepheid Inc., Sunnyvale, CA). Further molecular analysis as ribotyping based on capillary electrophoresis is needed to differentiate between C. difficile ribotypes 027 and 176 for appropriate epidemiological situation control on local and national levels.

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Acknowledgments

We would like to thank the European C. difficile infection surveillance network for their professional support. This work was supported by Ministry of Health, Czech Republic - conceptual development of research organization, University Hospital in Motol, Prague, Czech Republic 00064203 and MH CZ IGA NT/14209 – 3. We would like to thank Jamie Byrne for the English revision of this text.

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Authors and Affiliations

  1. Department of Medical Microbiology, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, V Uvalu 84, 150 06, Prague 5, Czech Republic

    Marcela Krutova, Jana Matejkova & Otakar Nyc

  2. DNA Laboratory, Department of Paediatric Neurology, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, V Uvalu 84, 150 06, Prague 5, Czech Republic

    Marcela Krutova

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  1. Marcela Krutova
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  2. Jana Matejkova
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  3. Otakar Nyc
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Correspondence to Marcela Krutova.

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Krutova, M., Matejkova, J. & Nyc, O. C. difficile ribotype 027 or 176?. Folia Microbiol 59, 523–526 (2014). https://doi.org/10.1007/s12223-014-0323-5

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  • DOI: https://doi.org/10.1007/s12223-014-0323-5

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