Help
Subscribe


Submit Videos to GastroHep Read For FREE - Our full range of review articles
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Guido Tytgat Profile of Pete Peterson Profile of Peter Cotton Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Toxins produced by C difficile effect disease severity

Research in this week's Lancet shows that the severity of C difficile-associated disease caused by polymerase chain reaction-ribotype 027 could result from hyperproduction of toxins A and B.

News image

Toxins A and B are the primary virulence factors of Clostridium difficile.

Since 2002, an epidemic of C difficile-associated disease with increased morbidity and mortality has been present in Quebec province, Canada.

Dr Michel Warny and colleagues characterized the dominant strain of this epidemic.

The researchers determined whether the dominant strain produces higher amounts of toxins A and B than those produced by non-epidemic strains.

The research team obtained isolates from 124 patients from Centre Hospitalier Universitaire de Sherbrooke in Quebec.

Additional isolates from the USA, Canada, and the United Kingdom were included to increase the genetic diversity of the toxinotypes tested.

The epidemic strain was isolated from 72 with C difficile-associated disease
The Lancet

Isolate characterization included toxinotyping, pulsed-field gel electrophoresis, and polymerase chain reaction ribotyping.

The isolate characterization also included the detection of a binary toxin gene, and detection of deletions in a putative negative regulator for toxins A and B.

By use of an enzyme-linked immunoassay, the team measured the in-vitro production of toxins A and B by epidemic strain and non-dominant strain isolates.

The team found that the epidemic strain was characterized as toxinotype III, and North American pulsed-field gel electrophoresis type 1.

The polymerase chain reaction-ribotype 027 was also characterized by the epidemic strain.

The researchers noted that this strain carried the binary toxin gene cdtB and an 18-bp deletion in a putative negative regulator for toxins A and B.

The research team isolated this strain from 72 patients with C difficile-associated disease.

Peak median toxin A concentrations produced in vitro by polymerase chain reaction-ribotype 027 were 16 times higher than those measured in isolates.

The team observed that peak median toxin B concentrations produced in vitro by polymerase chain reaction-ribotype 027 were 23 times higher than those measured in isolates.

The isolates represented 12 different pulsed-field gel electrophoresis types, known as toxinotype 0.

Dr Warny's team concludes, “The severity of C difficile-associated disease caused by polymerase chain reaction-ribotype 027 could result from hyperproduction of toxins A and B.”

“Dissemination of this strain in North America and Europe could lead to important changes in the epidemiology of C difficile-associated disease.”

Lancet 2005: 366(9491):1079-84
27 September 2005

Go to top of page Email this page Email this page to a colleague

 29 January 2015

Advanced search
 29 January 2015 
Gastric cancer in peptic ulcer disease
 29 January 2015 
Genetics and risk of Barrett's
 29 January 2015 
Pyloric compliance in gastroparesis
 28 January 2015 
Surgery and quality of life in rectal cancer
 28 January 2015 
Metabolic syndrome in celiac disease
 28 January 2015 
Remission in Crohn's disease
 27 January 2015 
Outcomes for liver transplantation
 27 January 2015 
Psychological distress and fecal composition in IBS
 27 January 2015 
Risk of upper GI cancers in GERD
 26 January 2015 
Breath analysis for IBD
 26 January 2015 
Fecal microbiota transplantation
 26 January 2015 
Antidepressants and GERD
 23 January 2015 
Liver transplant outcomes
 23 January 2015 
Breath analysis in IBD
 23 January 2015 
Fecal microbiota transplantation
 22 January 2015 
NASH and lipid improvements
 22 January 2015 
NAFLD and NASH with psoriasis
 22 January 2015 
Predicting outcomes in HCV-related advanced liver disease
 21 January 2015 
Colon capsule versus CT colonography
 21 January 2015 
Barrett's esophagus screening in the community
 21 January 2015 
Portal vein obstruction
 20 January 2015 
Modulating mucosal damage in Crohn's
 20 January 2015 
Novel techniques for Barrett's screening
 20 January 2015 
Food intolerance
 19 January 2015 
Treatment of fecal incontinence
 19 January 2015 
Hepatic cyst infection
 19 January 2015 
Risk of IBS among relatives
 16 January 2015 
Colorectal cancer screening uptake
 16 January 2015 
NAFLD and NASH in patients with psoriasis
 16 January 2015 
Fecal incontinence
 15 January 2015 
Coffee intake and liver disease
 15 January 2015 
NAFLD in primary care practice
 15 January 2015 
Management of univestigated dyspepsia
 14 January 2015 
Missed colorectal cancers after colonoscopy with polypectomy
 14 January 2015 
Inflixmab response in Crohn's
 14 January 2015 
Statins and liver injury in chronic liver disease
 13 January 2015 
Cytomegalovirus in IBD
 13 January 2015 
Helicobacter-negative gastritis
 13 January 2015 
Hep B vaccine in IBD
 12 January 2015 
Survival in Hep B virus-related hepatocellular carcinoma
 12 January 2015 
Relapse of Crohn's disease after surgery
 12 January 2015 
Late liver metastases of colorectal cancer
 09 January 2015 
Fecal microbiota transplantation for refractory Crohn's
 09 January 2015 
Hypercoagulability after liver resection
 09 January 2015 
Naps and gastroesophageal reflux vs nocturnal sleep
 08 January 2015 
Post-infectious functional dyspepsia
 08 January 2015 
Diagnosis of liver iron overload
 08 January 2015 
Digestive tract damage in Crohn's disease
 07 January 2015 
Early-onset colorectal cancer
 07 January 2015 
SSRIs for noncardiac chest pain
 07 January 2015 
SSRIs and upper GI bleeds
 06 January 2015 
Detection of inflammation in Crohn's
 06 January 2015 
Leptin and early-onset extreme obesity
 06 January 2015 
Goals of IBD treatment
 19 December 2014 
Thiopurine treatment and colectomy in ulcerative colitis
 19 December 2014 
Idiopathic inflammatory demyelinating disease in IBD
 19 December 2014 
Colorectal cancer risk for first-degree relatives
 18 December 2014 
Vitamin D and sustained virologic response in HCV
 18 December 2014 
Factor for treatment in IBS
 18 December 2014 
Assessment of Crohn's disease activity

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2015 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us