Infection with Toxin A-Negative, Toxin B-Negative, Binary Toxin-Positive Clostridium difficile in a Young Patient with Ulcerative Colitis

Grace O Androga; Julie Hart; Niki F Foster; Adrian Charles; David Forbes; Thomas V Riley

doi:10.1128/JCM.01810-15

Infection with Toxin A-Negative, Toxin B-Negative, Binary Toxin-Positive Clostridium difficile in a Young Patient with Ulcerative Colitis

J Clin Microbiol. 2015 Nov;53(11):3702-4. doi: 10.1128/JCM.01810-15. Epub 2015 Sep 9.

Authors

Grace O Androga¹, Julie Hart², Niki F Foster³, Adrian Charles⁴, David Forbes⁵, Thomas V Riley⁶

Affiliations

¹ School of Pathology and Laboratory Medicine, The University of Western Australia, Crawley, Western Australia, Australia.
² Department of Microbiology, PathWest Laboratory Medicine, Queen Elizabeth II Medical Centre, Nedlands, Western Australia, Australia.
³ School of Pathology and Laboratory Medicine, The University of Western Australia, Crawley, Western Australia, Australia Department of Microbiology, PathWest Laboratory Medicine, Queen Elizabeth II Medical Centre, Nedlands, Western Australia, Australia.
⁴ Princess Margaret Hospital for Children, Subiaco, Western Australia, Australia.
⁵ Princess Margaret Hospital for Children, Subiaco, Western Australia, Australia School of Paediatrics and Child Health, The University of Western Australia, Crawley, Western Australia, Australia.
⁶ School of Pathology and Laboratory Medicine, The University of Western Australia, Crawley, Western Australia, Australia Department of Microbiology, PathWest Laboratory Medicine, Queen Elizabeth II Medical Centre, Nedlands, Western Australia, Australia thomas.riley@uwa.edu.au.

Abstract

Large clostridial toxin-negative, binary toxin-positive (A(-) B(-) CDT(+)) strains of Clostridium difficile are almost never associated with clinically significant C. difficile infection (CDI), possibly because such strains are not detected by most diagnostic methods. We report the isolation of an A(-) B(-) CDT(+) ribotype 033 (RT033) strain of C. difficile from a young patient with ulcerative colitis and severe diarrhea.

Publication types

Case Reports

MeSH terms

ADP Ribose Transferases / genetics*
ADP Ribose Transferases / metabolism
Adolescent
Anti-Bacterial Agents / therapeutic use*
Australia
Bacterial Proteins / genetics*
Bacterial Proteins / metabolism
Bacterial Toxins / genetics*
Clostridioides difficile / genetics*
Clostridioides difficile / isolation & purification
Clostridioides difficile / pathogenicity
Colitis, Ulcerative / microbiology
Enterocolitis, Pseudomembranous / drug therapy*
Enterocolitis, Pseudomembranous / microbiology
Enterotoxins / genetics*
Feces / microbiology
Humans
Male
Microbial Sensitivity Tests
Recurrence

Substances

Anti-Bacterial Agents
Bacterial Proteins
Bacterial Toxins
Enterotoxins
tcdA protein, Clostridium difficile
toxB protein, Clostridium difficile
ADP Ribose Transferases
actin-specific ADP-ribosyltransferase, Clostridium