Prevalence and pathogenicity of binary toxin–positive Clostridium difficile strains that do not produce toxins A and B

Clostridium difficile causes antibiotic-associated diarrhoea and pseudomembranous colitis. The main virulence factors of C. difficile are the toxins A (TcdA) and B (TcdB). A third toxin, called binary toxin (CDT), can be detected in 17% to 23% of strains, but its role in human disease has not been c...

Full description

Bibliographic Details
Main Authors:	Eckert, C., Emirian, A., Le Monnier, A., Cathala, L., De Montclos, H., Goret, J., Berger, P., Petit, A., De Chevigny, A., Jean-Pierre, H., Nebbad, B., Camiade, S., Meckenstock, R., Lalande, V., Marchandin, H., Barbut, F.
Format:	Online
Language:	English
Published:	Elsevier 2014
Online Access:	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4337936/

id	pubmed-4337936
recordtype	oai_dc
spelling	pubmed-43379362015-03-09 Prevalence and pathogenicity of binary toxin–positive Clostridium difficile strains that do not produce toxins A and B Eckert, C. Emirian, A. Le Monnier, A. Cathala, L. De Montclos, H. Goret, J. Berger, P. Petit, A. De Chevigny, A. Jean-Pierre, H. Nebbad, B. Camiade, S. Meckenstock, R. Lalande, V. Marchandin, H. Barbut, F. Original Article Clostridium difficile causes antibiotic-associated diarrhoea and pseudomembranous colitis. The main virulence factors of C. difficile are the toxins A (TcdA) and B (TcdB). A third toxin, called binary toxin (CDT), can be detected in 17% to 23% of strains, but its role in human disease has not been clearly defined. We report six independent cases of patients with diarrhoea suspected of having C. difficile infection due to strains from toxinotype XI/PCR ribotype 033 or 033-like, an unusual toxinotype/PCR ribotype positive for CDT but negative for TcdA and TcdB. Four patients were considered truly infected by clinicians and were specifically treated with oral metronidazole. One of the cases was identified during a prevalence study of A−B−CDT+ strains. In this study, we screened a French collection of 220 nontoxigenic strains and found only one (0.5%) toxinotype XI/PCR ribotype 033 or 033-like strain. The description of such strains raises the question of the role of binary toxin as a virulence factor and could have implications for laboratory diagnostics that currently rarely include testing for binary toxin. Elsevier 2014-11-08 /pmc/articles/PMC4337936/ /pubmed/25755885 http://dx.doi.org/10.1016/j.nmni.2014.10.003 Text en © 2014 The Authors http://creativecommons.org/licenses/by-nc-nd/3.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/3.0/).
repository_type	Open Access Journal
institution_category	Foreign Institution
institution	US National Center for Biotechnology Information
building	NCBI PubMed
collection	Online Access
language	English
format	Online
author	Eckert, C. Emirian, A. Le Monnier, A. Cathala, L. De Montclos, H. Goret, J. Berger, P. Petit, A. De Chevigny, A. Jean-Pierre, H. Nebbad, B. Camiade, S. Meckenstock, R. Lalande, V. Marchandin, H. Barbut, F.
spellingShingle	Eckert, C. Emirian, A. Le Monnier, A. Cathala, L. De Montclos, H. Goret, J. Berger, P. Petit, A. De Chevigny, A. Jean-Pierre, H. Nebbad, B. Camiade, S. Meckenstock, R. Lalande, V. Marchandin, H. Barbut, F. Prevalence and pathogenicity of binary toxin–positive Clostridium difficile strains that do not produce toxins A and B
author_facet	Eckert, C. Emirian, A. Le Monnier, A. Cathala, L. De Montclos, H. Goret, J. Berger, P. Petit, A. De Chevigny, A. Jean-Pierre, H. Nebbad, B. Camiade, S. Meckenstock, R. Lalande, V. Marchandin, H. Barbut, F.
author_sort	Eckert, C.
title	Prevalence and pathogenicity of binary toxin–positive Clostridium difficile strains that do not produce toxins A and B
title_short	Prevalence and pathogenicity of binary toxin–positive Clostridium difficile strains that do not produce toxins A and B
title_full	Prevalence and pathogenicity of binary toxin–positive Clostridium difficile strains that do not produce toxins A and B
title_fullStr	Prevalence and pathogenicity of binary toxin–positive Clostridium difficile strains that do not produce toxins A and B
title_full_unstemmed	Prevalence and pathogenicity of binary toxin–positive Clostridium difficile strains that do not produce toxins A and B
title_sort	prevalence and pathogenicity of binary toxin–positive clostridium difficile strains that do not produce toxins a and b
description	Clostridium difficile causes antibiotic-associated diarrhoea and pseudomembranous colitis. The main virulence factors of C. difficile are the toxins A (TcdA) and B (TcdB). A third toxin, called binary toxin (CDT), can be detected in 17% to 23% of strains, but its role in human disease has not been clearly defined. We report six independent cases of patients with diarrhoea suspected of having C. difficile infection due to strains from toxinotype XI/PCR ribotype 033 or 033-like, an unusual toxinotype/PCR ribotype positive for CDT but negative for TcdA and TcdB. Four patients were considered truly infected by clinicians and were specifically treated with oral metronidazole. One of the cases was identified during a prevalence study of A−B−CDT+ strains. In this study, we screened a French collection of 220 nontoxigenic strains and found only one (0.5%) toxinotype XI/PCR ribotype 033 or 033-like strain. The description of such strains raises the question of the role of binary toxin as a virulence factor and could have implications for laboratory diagnostics that currently rarely include testing for binary toxin.
publisher	Elsevier
publishDate	2014
url	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4337936/
_version_	1613191644050358272

Prevalence and pathogenicity of binary toxin–positive Clostridium difficile strains that do not produce toxins A and B

Similar Items