Fatal Pseudomembranous Colitis Associated with a Variant Clostridium difficile Strain Not Detected by Toxin A Immunoassay

来自 EBSCO

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作者：

S Johnson，SA Kent，KJ O'Leary，MM Merrigan，SP Sambol，LR Peterson，DN Gerding

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摘要：

Many clinical laboratories use toxin A immunoassays to test for Clostridium difficile.To describe the clinical course of a patient infected with a toxin variant strain of C. difficile that was not detected by toxin A immunoassay; to genetically characterize this strain; and to estimate the number of laboratories that use only toxin A immunoassays.Case report, molecular investigation, and laboratory survey.Tertiary care hospital in Chicago, Illinois.An 86-year-old man.Restriction endonuclease analysis, polymerase chain reaction, and survey of regional clinical laboratories.An elderly hospitalized man died of advanced pseudomembranous colitis. Four stool specimens submitted over a 2-month period had tested negative on toxin A immunoassay, but a strain of C. difficile with a 1.8-kb deletion of the toxin A gene was recovered from each specimen. This strain, identified as restriction endonuclease analysis type CF4, is closely related to a widely disseminated variant, toxinotype VIII. Toxin A immunoassay was the only test being performed for detection of C. difficile at 31 of 67 (46%) regional clinical laboratories.Toxin A variant strains of C. difficile cause serious disease and are undetectable in clinical laboratories that use only toxin A immunoassays for C. difficile testing.

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关键词：

antibody titer hemagglutination-immune status inhibition measles vaccine measles virus

DOI：

10.7326/0003-4819-135-6-200109180-00012

被引量：

955

年份：

2001