Nyč O, Pituch H, Matějková J, Obuch-Woszczatynski P, Ed Kuijper J. The Lancet, Volume 377, Issue 9775, Page 1407, 23 April 2011. IF: 30.758
Abstract:
After completion of the European survey in the Czech Republic, outbreaks of C difficile infection suspected as being of type 027 were found in some areas of the country (eastern Bohemia and Moravia). Detailed analysis of ten isolates showed that the strains belonged to PCR ribotype 176 but shared many similarities with PCR ribotype 027, including the presence of binary toxin genes and a single-base-pair deletion at nucleotide 117 within the gene encoding a negative regulator of toxin production. In Poland, PCR ribotype 176 was detected during two outbreaks in hospitals in the region of Mazovia in late 2008 and early 2009.
To investigate the relatedness of type 176 with type 027 isolates, we applied multiple-locus variable-number tandem-repeat analysis 2 to59 type 027 strains collected in 14 different European countries, 11 type 176 isolates from Poland, and ten 176 isolates from the Czech Republic. Type 176 isolates clearly differed from 027 isolates in three of the seven loci tested, with a sum tandem repeat difference of 14, whereas all tested type 176 isolates correlated with one another (see webappendix).
We conclude that a new C difficile type highly related to 027 has emerged in the Czech Republic and Poland, underscoring the need for local and regional surveillance to detect and control C difficile infection 3. The commercially available molecular diagnostic tests are unable to differentiate between these types.
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