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

 30 March 2015

Advanced search
 30 March 2015 
Treatment of pediatric IBD
 30 March 2015 
Minimally invasive approach in colorectal procedures
 30 March 2015 
Prevalence of IBD in USA residents of Indian ancestry
 27 March 2015 
Screening for fecal incontinence
 27 March 2015 
Deep remission in Crohn's disease
 27 March 2015 
Sexual functioning in IBD
 26 March 2015 
Survival of untreated hepatocellular carcinoma
 26 March 2015 
Antimicrobial therapy in cirrhosis with spontaneous bacterial peritonitis
 26 March 2015 
Metformin as a chemopreventive agent for Barrett's
 25 March 2015 
Genetics and Crohn's disease
 25 March 2015 
Mortality in Barrett’s–related T1 esophageal adenocarcinoma
 25 March 2015 
Cytomegalovirus and IBD
 24 March 2015 
Prevention of colorectal cancer after screening
 24 March 2015 
Functional GI disorders and body mass index
 24 March 2015 
Quality of life in children with fecal incontinence
 23 March 2015 
Fibrosis in NAFLD vs NASH
 23 March 2015 
The unmasking of Whipple's disease
 23 March 2015 
Predicting the quality of colon cancer care
 20 March 2015 
Interventions for eosinophilic esophagitis
 20 March 2015 
Colorectal cancer risk and genetic variants
 20 March 2015 
Screening for Barrett's esophagus
 19 March 2015 
Hypnotherapy for IBS
 19 March 2015 
Poor mental and physical health in HCV
 19 March 2015 
Dedicated care for diverticular disease
 18 March 2015 
Practice guidelines for colorectal polyps
 18 March 2015 
Out-of-hours endoscopy for upper GI bleeding
 18 March 2015 
H. pylori eradication and lipids
 17 March 2015 
H. pylori test-and-treat program and gastric cancer
 17 March 2015 
Adalimumab in Crohn’s disease
 17 March 2015 

Low-dose PPIs and GI bleeding in patients receiving aspirin

 16 March 2015 
Cholestasis of pregnancy with HCV
 16 March 2015 
Microscopic colitis
 16 March 2015 
Hybrid therapy for H. pylori
 13 March 2015 
Medicare patients and payments to gastroenterologists
 13 March 2015 
Appendectomy in ulcerative colitis
 13 March 2015 

Racial disparities in gluten-sensitive problems

 12 March 2015 
Predicting IBD in IBS patients
 12 March 2015 
Patient knowledge of IBS
 12 March 2015 
Nonceliac gluten sensitivity
 11 March 2015 

Prediction of malignant bile duct obstruction

 11 March 2015 
NAFLD–related hepatocellular carcinoma
 11 March 2015 
Assessment of eosinophilic esophagitis
 10 March 2015 
Risk for gastroesophageal reflux symptoms
 10 March 2015 
Poor disease course in pediatric ulcerative colitis
 10 March 2015 
Outcomes in Crohn's therapy
 09 March 2015 
Fibre usage in ulcerative colitis in remission
 09 March 2015 
Risk of C. difficile upon hospital admission
 09 March 2015 
Gastric Cancer detection during GI endosocopy
 06 March 2015 
Steroid therapy for eosinophilic esophagitis
 06 March 2015 
Second anti-TNF in IBD
 06 March 2015 
Efficacy of Hep E vaccine
 05 March 2015 
EPHXI polymorphism and esophageal cancer risk
 05 March 2015 
Infliximab and immunosuppressant therapy in ulcerative colitis
 05 March 2015 
Neuroendocrine carcinoma of the colon and rectum
 04 March 2015 
Multidisciplinary management of rectal cancer
 04 March 2015 
Management of IBD
 04 March 2015 
Progression of Barrett's
 03 March 2015 
EPHX1 polymorphism and esophageal cancer risk
 03 March 2015 
GI bleeding in chronic kidney disease patients on aspirin
 03 March 2015 
Risk of anastomotic leak after colectomy

Blackwell Publishing


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