High prevalence of tcdC deletion-carrying Clostridium difficile and lack of association with disease severity

Diagn Microbiol Infect Dis. 2010 Jan;66(1):24-8. doi: 10.1016/j.diagmicrobio.2009.08.015. Epub 2009 Sep 23.


We assessed the prevalence of tcdC deletion-carrying Clostridium difficile using a stool polymerase chain reaction (PCR) assay that detects previously described 18- and 39-bp deletions (J. Clin. Microbiol. 2008;46:1996). We divided inpatients into 2 groups, those for whom the assay detected a deletion in tcdC and those for whom no deletion was detected. We compared risk factors (antibiotic use, hospitalization, nursing home stay, immunocompromise, age >65 years), complications (pseudomembranous colitis, toxic megacolon, colonic perforation, colectomy, and intensive care unit admission), duration of antibiotic treatment, and 30-day mortality between the groups. Forty-two of 141 patients had deletion-positive C. difficile. Prior nursing home stay and age >65 years were significantly more common in the deletion-positive group. Other risk factors, complications, antibiotic duration, and mortality did not differ significantly. Deletion-carrying C. difficile was commonly present but not associated with more severe disease and not markedly different in terms of risk factor profile. Severity of disease was relatively low, regardless of the presence or absence of a deletion.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Bacterial Proteins / genetics*
  • Chi-Square Distribution
  • Clostridium Infections / microbiology*
  • Clostridium difficile / genetics*
  • Gene Deletion*
  • Humans
  • Middle Aged
  • Polymerase Chain Reaction
  • Prevalence
  • Repressor Proteins / deficiency
  • Repressor Proteins / genetics*
  • Retrospective Studies
  • Risk Factors
  • Severity of Illness Index


  • Bacterial Proteins
  • Repressor Proteins
  • TcdC protein, Clostridium difficile