ArticleEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology2003
High frequency of antibiotic-associated diarrhea due to toxin A-negative, toxin B-positive Clostridium difficile in a hospital in Japan and risk factors for infection.
Article in European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2003. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.
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24 citing papers in PubMed, 78 citations in OpenAlex.
- Observational
- Review
- Prevalence of binary-toxin genes (Gastroenterology and hepatology from bed to bench · 2018Article
- Article
- Review
- Comparative Genome Analysis and Global Phylogeny of the Toxin Variant Clostridium difficile PCR Ribotype 017 Reveals the Evolution of Two Independent Sublineages.Journal of clinical microbiology · 2017Article
- Evaluation of Xpert C. difficile, BD MAX Cdiff, IMDx C. difficile for Abbott m2000, and Illumigene C. difficile Assays for Direct Detection of Toxigenic Clostridium difficile in Stool Specimens.Annals of laboratory medicine · 2016Article
- Clinical Characteristics and Treatment Outcomes of Clostridium difficile Infections by PCR Ribotype 017 and 018 Strains.PloS one · 2016Article
- Asymptomatic Clostridium difficile colonization: epidemiology and clinical implications.BMC infectious diseases · 2015Review
- Genomic Epidemiology of a Protracted Hospital Outbreak Caused by a Toxin A-Negative Clostridium difficile Sublineage PCR Ribotype 017 Strain in London, England.Journal of clinical microbiology · 2015Article
- Multiplex Real-Time PCR Method for Simultaneous Identification and Toxigenic Type Characterization of Clostridium difficile From Stool Samples.Annals of laboratory medicine · 2015Article
- Variations in virulence and molecular biology among emerging strains of Clostridium difficile.Microbiology and molecular biology reviews : MMBR · 2013Review
- Epidemiology of Clostridium difficile infection in Asia.Antimicrobial resistance and infection control · 2013Article
- Article
- Clinical and microbiologic characteristics of tcdA-negative variant Clostridium difficile infections.BMC infectious diseases · 2012Article
- Clinical importance and representation of toxigenic and non-toxigenic Clostridium difficile cultivated from stool samples of hospitalized patients.Brazilian journal of microbiology : [publication of the Brazilian Society for Microbiology] · 2012Article
- The changing epidemiology of Clostridium difficile infections.Clinical microbiology reviews · 2010Review
- Human alpha-defensins inhibit hemolysis mediated by cholesterol-dependent cytolysins.Infection and immunity · 2009Article
- Algorithm combining toxin immunoassay and stool culture for diagnosis of Clostridium difficile infection.Journal of clinical microbiology · 2009Article
- Article
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Authors and funding
11 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Patients hospitalized in a hospital with a high incidence of antibiotic-associated diarrhea due to toxin A-negative, toxin B-positive (A-/B+) Clostridium difficile were retrospectively investigated to determine the clinical manifestations and risk factors for infection. Of 77 Clostridium difficile isolates obtained from 77 patients during the 1-year investigation period, 30 were A-/B+ and 47 were toxin A-positive, toxin B-positive (A+/B+). By pulsed-field gel electrophoresis analysis, 23 of the 30 A-/B+ strains were outbreak-related, suggesting nosocomial spread of a single type of bacterium, which mainly affected patients in the wards of respiratory medicine, hematology and neurology. Using regression analysis, three factors were found to be associated with infection by A-/B+ isolates: (i) exposure to antineoplastic agents ( P=0.01, odds ratio [OR]=5.1), (ii) the use of nasal feeding tubes ( P=0.008, OR=5.2), and (iii) assignment to a certain internal medicine ward ( P=0.05, OR=3.0). Between patients with Clostridium difficile-associated diarrhea caused by A-/B+ strains and those with A+/B+ strains, no statistically significant difference was found in body temperature, serum concentration of C-reactive protein, leukocyte count in whole blood, frequency of diarrhea, or type of underlying disease. These results indicate that A-/B+ strains of Clostridium difficile can cause intestinal infection in humans and they spread nosocomially in the same manner as A+/B+ strains.
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