Clinical features of Clostridium difficile-associated diarrhoea due to binary toxin (actin-specific ADP-ribosyltransferase)-producing strains

被引:155
作者
Barbut, F
Decré, D
Lalande, V
Burghoffer, A
Noussair, L
Gigandon, A
Espinasse, F
Raskine, L
Robert, J
Mangeol, A
Branger, C
Petit, JC
机构
[1] Hop St Antoine, Microbiol Serv, F-75012 Paris 12, France
[2] Hop Beaujon, F-92118 Clichy, France
[3] Hop Cochin, F-75679 Paris 14, France
[4] Hop Ambroise Pare, F-92104 Boulogne, France
[5] Hop Lariboisiere, F-75475 Paris 10, France
[6] Hop La Pitie Salpetriere, F-75651 Paris, France
[7] Ctr Hosp Montfermeil, F-93370 Montfermeil, France
[8] Univ Paris 06, UPRES,EA2392, Fac Med, UFR St Antoine, Paris, France
关键词
D O I
10.1099/jmm.0.45804-0
中图分类号
Q93 [微生物学];
学科分类号
071005 [微生物学]; 100705 [微生物与生化药学];
摘要
Toxins A and B are known to be the primary virulence factors of Clostridium difficile. Other potential virulence factors have been identified such as binary toxin (actin-specific ADP-ribosyltransferase toxin, or CDT). A retrospective case-control study was performed in order to identify clinical features and risk factors of C. difficile-associated diarrhoea due to binary toxin-producing strains. Each case (a patient with diarrhoea due to binary toxin-producing strain) was compared with two controls (patients with diarrhoea due to a C. difficile strain that did not produce binary toxin) matched for ward and date of hospitalization. cdtA and cdtB genes were screened by PCR. Production of CDT was studied by Western blotting using an antiserum against la and lb from the Clostridium perfringens iota toxin, and the activity of the binary toxin was assessed using an ADP-ribosyltransferase assay. Twenty-six cases (14 males and 12 females) were identified in 1999 and 2000. Cases and controls did not differ significantly for sex, age, previous administration of antibiotics or frequency of endoscopic examination, Diarrhoea was community-acquired more often in cases than in controls (65.4 vs 35.7%, P = 0.017) and more often represented the cause of hospitalization (61.5 vs 26.2 %, P = 0.003). Moreover, diarrhoea in cases was more frequently associated with abdominal pain (63.6 vs 39.4%, P = 0.07) and with liquid stools (76.9 vs 59.5 P = 0.14) than in controls. These results suggest that there could be a correlation between the production of binary toxin and the severity of diarrhoea.
引用
收藏
页码:181 / 185
页数:5
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