Published Date: 2005-07-06 23:50:00
Subject: PRO/AH/EDR> Clostridium difficile, increased virulence - Netherlands
Archive Number: 20050706.1912

CLOSTRIDIUM DIFFICILE, INCREASED VIRULENCE - NETHERLANDS
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Date: Wed 6 Jul 2005
From: E. J. Kuijper <E.J.Kuijper@lumc.nl>

Isolation of _C. difficile_ ribotype 027, toxinotype III in the Netherlands
-----------------------------------------------
_Clostridium difficile_ ribotype 027, toxinotype III, which has caused
epidemics in North America and is now spreading in the UK, has been
detected in the Netherlands. In the St. Jans hospital in the city
Harderwijk, the incidence of CDAD increased from one per 10 000 patient
admissions to 8 per 10 000 during April and July 2005.
Of 29 patients infected, 2 died due to complications of _C.
difficile_-associated diarrhea and their underlying disease. 4 patients had
a relapse. The strain was further characterized as _C. difficile_ ribotype
027 and toxinotype III by the Department of Medical Microbiology at the
Leiden University Medical Center. As has been reported previously in
Canada, physicians noticed an absence of clinical response to
metronidazole, whereas the isolate was susceptible in vitro as determined
by E-test (minimal inhibitory concentration less than 0.1 mg/L).
The 2nd epidemic occurred in Amersfoort and is probably related to the
outbreak in Harderwijk. 5 isolates have been obtained and were identical as
the isolates from Harderwijk and the UK reference 027 strain (Dr. Jon
Brazier, Anaerobe Reference Laboratory, Cardiff). The outbreaks are under
further investigation.
[Submitted by: Debast S, N. Vaessen N, van Kregten E, van den Berg R and
Kuijper EJ, Departments of Medical Microbiol at St. Jansdal Hospital
Harderwijk, Meander hospital Amersfoort and Leiden University Medical
Center, The Netherlands]
--
E.J. Kuijper
<E.J.Kuijper@lumc.nl>
[The organism continues to spread, now to the Netherlands. ProMED thanks
the above scientists for reporting these cases to us. - Mod.LL]

See Also

Clostridium difficile, increased virulence - UK (England) (05) 20050630.1843
Clostridium difficile, increased virulence - UK (England) (04) 20050626.1794
Clostridium difficile, increased virulence - UK (England) (03) 20050624.1772
Clostridium difficile, increased virulence - UK (England)(02) 20050607.1582
Clostridium difficile, increased virulence - UK (England) 20050606.1572
Clostridium difficile, increased virulence, 2004 - USA, Canada 20050412.1055
2004
----
Clostridium difficile, increased virulence - USA 20041004.2735
Clostridium difficile, fatal - Canada (QC) 20040808.2191
.....................ll/msp/mpp

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