ArticleJournal of clinical microbiology2004
Characterization of toxin A-negative, toxin B-positive Clostridium difficile isolates from outbreaks in different countries by amplified fragment length polymorphism and PCR ribotyping.
Article in Journal of clinical microbiology, 2004. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers.
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Who cites it
44 citing papers in PubMed, 112 citations in OpenAlex.
- A longitudinal analysis of Clostridioides difficile virulence profiles across three geographic regions in Israel (2020-2022).Annals of clinical microbiology and antimicrobials · 2026Article
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- Production ofFrontiers in cellular and infection microbiology · 2021Article
- Clostridioides difficile Infection Induces an Inferior IgG Response to That Induced by Immunization and Is Associated with a Lack of T Follicular Helper Cell and Memory B Cell Expansion.Infection and immunity · 2020Article
- High-Level Resistance of ToxigenicInfection and drug resistance · 2020Article
- Review
- Evaluation of the Liat Cdiff Assay for Direct Detection of Clostridioides difficile Toxin Genes within 20 Minutes.Journal of clinical microbiology · 2019Article
- Review
- Diagnosis ofIranian journal of microbiology · 2018Article
- Genomic Study of aFrontiers in microbiology · 2018Article
- Incidence and Outbreak of Healthcare-Onset Healthcare-AssociatedFrontiers in microbiology · 2018Article
- Surveillance of antibiotic resistance among common Clostridium difficile ribotypes in Hong Kong.Scientific reports · 2017Article
- Predominance and high antibiotic resistance of the emerging Clostridium difficile genotypes NAPCR1 and NAP9 in a Costa Rican hospital over a 2-year period without outbreaks.Emerging microbes & infections · 2016Article
- The emergence of Clostridium difficile PCR-ribotype 001 in Slovakia.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2015Article
- A chimeric protein comprising the glucosyltransferase and cysteine proteinase domains of toxin B and the receptor binding domain of toxin A induces protective immunity against Clostridium difficile infection in mice and hamsters.Human vaccines & immunotherapeutics · 2015Article
- Sequence variation in tcdA and tcdB of Clostridium difficile: ST37 with truncated tcdA is a potential epidemic strain in China.Journal of clinical microbiology · 2014Article
- Comparison of polymerase chain reaction ribotyping, toxinotyping and nutritional aspects of toxin production ofBiomedical reports · 2014Article
- Vaccines against Clostridium difficile.Human vaccines & immunotherapeutics · 2014Review
- Protective efficacy induced by recombinant Clostridium difficile toxin fragments.Infection and immunity · 2013Article
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Clinical Clostridium difficile isolates of patients with diarrhea or pseudomembranous colitis usually produce both toxin A and toxin B, but an increasing number of reports mention infections due to toxin A-negative, toxin B-positive (A(-)/B(+)) strains. Thirty-nine clinical toxin A(-)/B(+) isolates, and 12 other unrelated isolates were obtained from Canada, the United States, Poland, the United Kingdom, France, Japan, and The Netherlands. The isolates were investigated by high-resolution genetic fingerprinting by use of amplified fragment length polymorphism (AFLP) and two well-described PCR ribotyping methods. Furthermore, the toxin profile and clindamycin resistance were determined. Reference strains of C. difficile representing 30 known serogroups were also included in the analysis. AFLP discriminated 29 types among the reference strains, whereas the two PCR ribotyping methods distinguished 25 and 26 types. The discriminatory power of AFLP and PCR ribotyping among 12 different unrelated isolates was similar. Typing of 39 toxin A(-)/B(+) isolates revealed 2 AFLP types and 2 and 3 PCR ribotypes. Of 39 toxin A(-)/B(+) isolates, 37 had PCR ribotype 017/20 and AFLP type 20 (95%). A deletion of 1.8 kb was seen in 38 isolates, and 1 isolate had a deletion of approximately 1.7 kb in the tcdA gene, which encodes toxin A. Clindamycin resistance encoded by the erm(B) gene was found in 33 of 39 toxin A(-)/B(+) isolates, and in 2 of the 12 unrelated isolates (P < 0.001, chi-square test). We conclude that clindamycin-resistant C. difficile toxin A(-)/B(+) strain (PCR ribotype 017/20, AFLP type 20, serogroup F) has a clonal worldwide spread.
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