Fulminant pseudomembranous colitis caused by Clostridium difficile PCR ribotype 027 in a healthy young woman in Japan

Abstract In the past two decades, Clostridium difficile polymerase chain reaction ribotype 027 strain has rapidly emerged as the leading cause of antibiotic-associated colitis in North America and Europe; however, it has been reported only occasionally in Japan. We report a case of fulminant pseudom...

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Bibliographic Details
Published in:Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 2014-11, Vol.20 (11), p.729-731
Main Authors: Nishimura, Satoshi, Kou, Tadayuki, Kato, Haru, Watanabe, Masaki, Uno, Shoichi, Senoh, Mitsutoshi, Fukuda, Tadashi, Hata, Atsuko, Yazumi, Shujiro
Format: Article
Language:English
Subjects:
Adult
Bacterial Proteins - genetics
Clostiridium difficile
Clostridium difficile - classification
Clostridium difficile - genetics
Enterocolitis, Pseudomembranous - diagnosis
Enterocolitis, Pseudomembranous - microbiology
Female
Hematology, Oncology and Palliative Medicine
Humans
Japan
PCR ribotype 027
Polymerase Chain Reaction
Pseudomembranous colitis
Ribotyping
Sequence Analysis, DNA
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Summary:Abstract In the past two decades, Clostridium difficile polymerase chain reaction ribotype 027 strain has rapidly emerged as the leading cause of antibiotic-associated colitis in North America and Europe; however, it has been reported only occasionally in Japan. We report a case of fulminant pseudomembranous colitis caused by this strain in a healthy young woman in Japan without any previous medical history. The strain isolated from our patient was susceptible to both gatifloxacin and moxifloxacin, thus representing a historic strain. The acquisition of fluoroquinolone resistance was reported as the important key genetic event linked to the virulence of this strain. It is noteworthy that the fluoroquinolone-susceptible 027 strain caused fulminant colitis in a healthy young woman in a non-endemic area. Our experience suggests that C. difficile PCR ribotype 027 has the potential virulence factors that are not associated with a fluoroquinolone resistance-conferring mutation.
ISSN:1341-321X
1437-7780
DOI:10.1016/j.jiac.2014.07.004