The gut-infecting bacterium C. difficile
is evolving into two separate species, with one group highly adapted to spread in hospitals, according to a new study.
The research is the largest ever genomic study of C. difficile
showing how bacteria can evolve into a new species, and demonstrates that C.
infection can cause diarrhea, fever, rapid heartbeat, intestinal inflammation and kidney failure.
The researchers found that two strains of C. difficile
, NCTC 11209 and ribotype 001/072, survived the simulated washer extractor cycle with an industrial detergent.
There are reports of genetic overlap between toxigenic C. difficile
strains isolated from animal and humans, suggesting that the transmission of the pathogen may occur as a zoonotic disease process.
Recognition of C. difficile
as an emerging pathogen quickly coalesced with the appearance of the hypervirulent strain 027, a fluoroquinolone-resistant strain of C.
Stool samples were collected from the first 20 consecutive patients diagnosed with CDI and sent to the Cantacuzino National Institute for Research (NIR) for ribotyping and to the National Institute for Infectious Diseases (NIID) for real-time PCR identification and moxifloxacin susceptibility testing of C. difficile
The exquisite sensitivity of the test, however, has created an unexpected problem for C. difficile
diagnosis: the test cannot distinguish patients with active disease from those who are asymptomatic carriers.
However, stool C. difficile
toxin B assay returned positive.
infection (CDI) can result in asymptomatic carriage, mild diarrhea, or pseudomembranous colitis (PMC).
The most likely diagnosis in otherwise unexplained leukocytosis in a hospitalized patient is C. difficile