Internal Medicine, Asahi General Hospital, Chiba, Japan.
Department of Bacteriology II, National Institute of Infectious Diseases, Tokyo, Japan.
J Med Microbiol. 2013 Sep;62(Pt 9):1486-1489. doi: 10.1099/jmm.0.057968-0. Epub 2013 Apr 4.
Two cases of fulminant colitis due to Clostridium difficile occurred within ten weeks of each other on the same ward of a hospital in Japan. The patients died 2 and 4 days after the onset of colitis. C. difficile isolates obtained from both patients were toxin A-positive, toxin B-positive and binary toxin-positive. These isolates yielded identical results by both PCR ribotyping and slpA sequence typing. However, the banding patterns and slpA sequences of the isolates differed from those of PCR ribotype 027, as well as those of PCR ribotype 078. The tcdC sequences of the isolate differed from those of C. difficile 027, but a single base-pair deletion at position 117 and an 18 bp deletion, both of which were identical to the sequence of the reference strain of 027, were found. This type may be a new hypervirulent strain, but further studies of the epidemiology and pathogenicity of the strain are needed.
日本某医院同一病房在 10 周内相继发生 2 例艰难梭菌相关性暴发性结肠炎，患者分别于发病后 2 天和 4 天死亡。从 2 例患者中分离出的艰难梭菌均为产毒 A、产毒 B 和二元毒素阳性。PCR 核糖体分型和 slpA 序列分型这两种方法均显示，这两种分离株的结果完全一致。然而，分离株的条带模式和 slpA 序列与 PCR 核糖体分型 027 以及 PCR 核糖体分型 078 不同。该分离株的 tcdC 序列与艰难梭菌 027 不同，但在位置 117 处有单个碱基缺失，在位置 117 处有 18 个碱基缺失，这两个缺失均与 027 的参考株序列相同。这种类型可能是一种新的高毒力菌株，但需要进一步研究该菌株的流行病学和致病性。
