Binary Toxin and Death after Clostridium difficile Infection

Bacci, Sabrina; Mølbak, Kåre; Kjeldsen, Marianne K.; Olsen, Katharina E.P.

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Binary Toxin and Death after Clostridium difficile Infection

Published Date:

Jun 2011

Source:

Emerg Infect Dis. 17(6):976-982.

[PDF - 172.95 KB]

Details:

Personal Authors:

Bacci, Sabrina ; Mølbak, Kåre ; Kjeldsen, Marianne K. ; Olsen, Katharina E.P. ;

Keywords:

[+]

Document Type:

Journal Article

Collection(s):

Emerging Infectious Diseases

Description:

We compared 30-day case-fatality rates for patients infected with Clostridium difficile possessing genes for toxins A and B without binary toxin (n = 212) with rates for patients infected with C. difficile possessing genes for A, B, and binary toxin. The latter group comprised patients infected with strains of PCR ribotype 027 (CD027, n = 193) or non-027 (CD non-027, n = 72). Patients with binary toxin had higher case-fatality rates than patients without binary toxin, in univariate analysis (relative risk [RR] 1.8, 95% confidence interval [CI] 1.2-2.7) and multivariate analysis after adjustment for age, sex, and geographic region (RR 1.6, 95% CI 1.0-2.4). Similar case-fatality rates (27.8%, 28.0%) were observed for patients infected with CD027 or CD non-027. Binary toxin either is a marker for more virulent C. difficile strains or contributes directly to strain virulence. Efforts to control C. difficile infection should target all virulent strains irrespective of PCR ribotype.

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