Affiliation:
1. UPRES EA2392, Faculté de Médecine, UFR Saint-Antoine, Université Paris 6
2. Laboratoire de Bactériologie
3. Unité d'Hygiène et de Lutte contre les Infections Nosocomiales (UHLIN), Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Paris, France
Abstract
ABSTRACT
In addition to the two large clostridial cytotoxins (TcdA and TcdB), some strains of
Clostridium difficile
also produce an actin-specific ADP-ribosyltransferase, called binary toxin CDT. We used a PCR method and Southern blotting for the detection of genes encoding the enzymatic (CDTa) and binding (CDTb) components of the binary toxin in 369 strains isolated from patients with suspected
C. difficile
-associated diarrhea or colitis. Twenty-two strains (a prevalence of 6%) harbored both genes. When binary toxin production was assessed by Western blotting, 19 of the 22 strains reacted with antisera against the iota toxin of
C. perfringens
(anti-Ia and anti-Ib). Additionally, binary toxin activity, detected by the ADP-ribosyltransferase assay, was present in only 17 of the 22 strains. Subsequently, all 22 binary toxin-positive strains were tested for the production of toxins TcdA and TcdB, toxinotyped, and characterized by serogrouping, PCR ribotyping, arbitrarily primed PCR, and pulsed-field gel electrophoresis. All binary toxin-positive strains also produced TcdB and/or TcdA. However, they had significant changes in the
tcdA
and
tcdB
genes and belonged to variant toxinotypes III, IV, V, VII, IX, and XIII. We could differentiate 16 profiles by using typing methods, indicating that most of the binary toxin-positive strains were unrelated.
Publisher
American Society for Microbiology
Cited by
137 articles.
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