Borgmann S, Kist M, Jakobiak T, Reil M, Scholz E, von Eichel-Streiber C, Gruber H, Brazier J S, Schulte B
Synlab Medical Care Service, Medical Care Centre Weiden, Weiden, Germany.
Euro Surveill. 2008 Dec 4;13(49):19057.
In recent years, Clostridium difficile infection (CDI) has emerged as an increasing problem, both in in- and outpatients. In a rural region of southern Germany, the annual number of C. difficile toxin (Tcd)-positive patients has increased from 95 to 796 in the period from 2000 to 2007. Simultaneously, the proportion of positive tests among all Tcd examinations has risen from 7.0% to 12.8%, indicating that the higher number of affected patients was not solely due to an increase in the number of assays. Elevated numbers of CDI have recently been associated with outbreaks of the ribotype 027 strain, particularly in North America. This strain has also been isolated in Europe, including in Germany. Ribotyping and PCR testing for binary toxin genes of C. difficile strains isolated from in- and outpatients demonstrate a predominance (59%) of C. difficile ribotype 001, which exhibits antibiotic resistance to erythromycin, ciprofloxacin, and moxifloxacin, but lacks binary toxin genes. In summary, in our region of Germany, the number of patients affected by CDI has increased, probably due to spread of C. difficile ribotype 001.
近年来，艰难梭菌感染（CDI）无论是在门诊还是住院患者中，都已成为一个日益严重的问题。在德国南部的一个农村地区，2000年至2007年期间，艰难梭菌毒素（Tcd）检测呈阳性的患者年度数量从95例增至796例。同时，在所有Tcd检测中，阳性检测比例从7.0%升至12.8%，这表明受影响患者数量的增加并非仅仅是由于检测数量的增加。最近，CDI病例数的增加与核糖体分型027菌株的暴发有关，尤其是在北美。该菌株在欧洲也有分离，包括在德国。对从门诊和住院患者中分离出的艰难梭菌菌株进行核糖体分型和二元毒素基因的PCR检测表明，艰难梭菌核糖体分型001占主导地位（59%），该分型对红霉素、环丙沙星和莫西沙星具有抗生素抗性，但缺乏二元毒素基因。总之，在我们德国的这个地区，受CDI影响的患者数量有所增加，这可能是由于艰难梭菌核糖体分型001的传播所致。
