Berry, CE, Davies, KA orcid.org/0000-0001-6862-5355, Owens, DW orcid.org/0000-0001-6171-649X et al. (1 more author) (2017) Is there a relationship between the presence of the binary toxin genes in Clostridium difficile strains and the severity of Clostridium difficile infection (CDI)? European Journal of Clinical Microbiology and Infectious Diseases, 36 (12). pp. 2405-2415. ISSN 0934-9723
Abstract
Some strains of Clostridium difficile produce a binary toxin, in addition to the main C. difficile virulence factors (toxins A and B). There have been conflicting reports regarding the role of binary toxin and its relationship to the severity of C. difficile infection (CDI). Samples, isolates and clinical data were collected as part of a prospective multicentre diagnostic study. Clostridium difficile isolates (n = 1259) were tested by polymerase chain reaction (PCR) assay to detect binary toxin genes cdtA and cdtB. The PCR binary toxin gene results were compared with clinical severity and outcome data, including 30-day all-cause mortality. The 1259 isolates corresponded to 1083 different patients (October 2010 to September 2011). The prevalence of binary toxin positive strains was significantly higher in faecal samples with detectable toxin A/B than in those without toxin but that were positive by cytotoxigenic culture (26.3% vs. 10.3%, p < 0.001). The presence of binary toxin correlated moderately with markers of CDI severity (white cell count, serum albumin concentration and serum creatinine concentration). However, the risk ratio for all-cause mortality was 1.68 for binary toxin positive patients and patients were significantly less likely to survive if they had CDI caused by a binary toxin gene positive strain, even after adjusting for age (p < 0.001). The presence of binary toxin genes does not predict the clinical severity of CDI, but it is significantly associated with the risk of all-cause mortality.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © Springer-Verlag GmbH Germany 2017. This is an author produced version of a paper published in European Journal of Clinical Microbiology & Infectious Diseases. The final publication is available at Springer via https://doi.org/10.1007/s10096-017-3075-8. Uploaded in accordance with the publisher's self-archiving policy. |
Keywords: | Clostridium difficile; binary toxin; diagnosis; enzyme; immunoassay; molecular |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > Institute of Molecular Medicine (LIMM) (Leeds) > Section of Molecular Gastroenterology (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 24 Jul 2017 10:46 |
Last Modified: | 05 Aug 2018 00:38 |
Status: | Published |
Publisher: | Springer Verlag |
Identification Number: | 10.1007/s10096-017-3075-8 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:119319 |