Occurrence of Clostridium difficile infections due to PCR ribotype 027 in Bucharest, Romania

  • Alexandru Rafila National Institute for Infectious Diseases Matei Bals, Bucharest, Romania
  • Alexander Indra Institute for Medical Microbiologyand Hygiene,Vienna, Austria
  • Gabriel Adrian Popescu National Institute for Infectious Diseases Matei Bals, Bucharest, Romania
  • Günther Wewalka Institute for Medical Microbiologyand Hygiene,Vienna, Austria
  • Franz Allerberger Institute for Medical Microbiologyand Hygiene,Vienna, Austria
  • Serban Benea National Institute for Infectious Diseases Matei Bals, Bucharest, Romania
  • Ioana Badicut National Institute for Infectious Diseases Matei Bals, Bucharest, Romania
  • Richard Aschbacher Laboratorio Aziendale di Microbiologia e Virologia, Comprensorio Sanitario di Bolzano
  • Steliana Huhulescu Laboratorio Aziendale di Microbiologia e Virologia, Comprensorio Sanitario di Bolzano, Italy
Keywords: Clostridium difficile, ribotype 027, Romania

Abstract

Introduction: Little is known about prevailing ribotypes of Clostridium difficile infection in Romania where CDI is not a mandatory notifiable disease.

Methodology: We studied 64 non-duplicate C. difficile isolates from patients hospitalised at the National Institute of Infectious Diseases, Bucharest, Romania between March 2011 and March 2012.

Results: Sixty-three of the 64 C. difficile isolates produced toxins A and B whereas 44 (69%) isolates produced a binary toxin. Ribotype 027 accounted for 43 (68%) of the 63 toxigenic strains. The remaining 20 isolates belonged to ribotypes 018 (n = 9), 012 (n = 3), and, with one isolate each, 014, 031, 081, 416, 433, 500, 507 and PR03035 (new ribotype). Information on hospital mortality was available for 62 of the 64 patients; among these 62 cases, 4 (6.4%) ended fatal. Recurrence was documented for 11 (18.3%) of the 60 patients for whom this information was available. Multilocus variable-number tandem repeat analysis of the 43 isolates of ribotype 027 yielded a unique cluster for the Romanian isolates when compared to Austrian or Italian isolates.

Conclusion: Our findings sustain the hypothesis of a recent emerged outbreak of C. difficile PCR ribotype 027 infections in the area of Bucharest.

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Author Biographies

Alexandru Rafila, National Institute for Infectious Diseases Matei Bals, Bucharest, Romania
Associate Professor of Microbiology
Alexander Indra, Institute for Medical Microbiologyand Hygiene,Vienna, Austria
Professor
Gabriel Adrian Popescu, National Institute for Infectious Diseases Matei Bals, Bucharest, Romania
Associate Professor of Infectious Diseases
Günther Wewalka, Institute for Medical Microbiologyand Hygiene,Vienna, Austria
Professor
Franz Allerberger, Institute for Medical Microbiologyand Hygiene,Vienna, Austria
Professor
Serban Benea, National Institute for Infectious Diseases Matei Bals, Bucharest, Romania
Matei Bals Infectious Diseases Institute, Bucharest, Romania
Ioana Badicut, National Institute for Infectious Diseases Matei Bals, Bucharest, Romania
Assistant Professor
Published
2014-06-11
How to Cite
1.
Rafila A, Indra A, Popescu GA, Wewalka G, Allerberger F, Benea S, Badicut I, Aschbacher R, Huhulescu S (2014) Occurrence of Clostridium difficile infections due to PCR ribotype 027 in Bucharest, Romania. J Infect Dev Ctries 8:694-698. doi: 10.3855/jidc.4435
Section
Original Articles