Surveillance snapshot of Clostridium difficile infection in hospitals across Queensland detects binary toxin producing ribotype UK 244

Authors

  • Charlotte A Huber University of Queensland Centre for Clinical Research, Royal Brisbane and Women’s Hospital, Brisbane, Queensland
  • Lisa Hall Centre for Healthcare Related Infection Surveillance and Prevention, Queensland Health, Brisbane, Queensland; Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland
  • Niki F Foster School of Pathology and Laboratory Medicine, University of Western Australia, Crawley, Western Australia
  • Mareeka Gray Centre for Healthcare Related Infection Surveillance and Prevention, Queensland Health, Brisbane, Queensland
  • Michelle Allen Centre for Healthcare Related Infection Surveillance and Prevention, Queensland Health, Brisbane, Queensland; Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland
  • Leisha J Richardson University of Queensland Centre for Clinical Research, Royal Brisbane and Women’s Hospital, Brisbane, Queensland
  • Jennifer Robson Sullivan Nicolaides Pathology, Brisbane, Queensland
  • Renu Vohra Queensland Medical Laboratories, Brisbane, Queensland
  • Sanmarie Schlebusch Mater Pathology, Brisbane, Queensland; University of Queensland, Brisbane, Queensland
  • Narelle George Central Microbiology Laboratory, Pathology Queensland, Brisbane, Queensland
  • Graeme R Nimmo Central Microbiology Laboratory, Pathology Queensland, Brisbane, Queensland
  • Thomas V Riley School of Pathology and Laboratory Medicine, University of Western Australia, Crawley, Western Australia; PathWest Laboratory Medicine WA, Nedlands, Western Australia
  • David L Paterson University of Queensland Centre for Clinical Research, Royal Brisbane and Women’s Hospital, Brisbane, Queensland; Centre for Healthcare Related Infection Surveillance and Prevention, Queensland Health, Brisbane, Queensland; Central Microbiology Laboratory, Pathology Queensland, Brisbane, Queensland

DOI:

https://doi.org/10.33321/cdi.2014.38.46

Keywords:

Clostridium difficile, disease surveillance, hospitals

Abstract

In North America and Europe, the binary toxin positive Clostridium difficile strains of the ribotypes 027 and 078 have been associated with death, toxic megacolon and other adverse outcomes. Following an increase in C. difficile infections (CDIs) in Queensland, a prevalence study involving 175 hospitals was undertaken in early 2012, identifying 168 cases of CDI over a 2 month period. Patient demographics and clinical characteristics were recorded, and C. difficile isolates were ribotyped and tested for the presence of binary toxin genes. Most patients (106/168, 63.1%) were aged over 60 years. Overall, 98 (58.3%) developed symptoms after hospitalisation; 89 cases (53.0%) developed symptoms more than 48 hours after admission. Furthermore, 27 of the 62 (67.7%) patients who developed symptoms in the community ad been hospitalised within the last 3 months. Thirteen of the 168 (7.7%) cases identified had severe disease, resulting in admission to the Intensive Care Unit or death within 30 days of the onset of symptoms. The 3 most common ribotypes isolated were UK 002 (22.9%), UK 014 (13.3%) and the binary toxin-positive ribotype UK 244 (8.4%). The only other binary toxin positive ribotype isolated was UK 078 (n = 1). Of concern was the detection of the binary toxin positive ribotype UK 244, which has recently been described in other parts of Australia and New Zealand. No isolates were of the international epidemic clone of ribotype UK 027, although ribotype UK 244 is genetically related to this clone. Further studies are required to track the epidemiology of ribotype UK 244 in Australia and New Zealand. Commun Dis Intell 2014;38(4):E279–E284.

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Published

01/12/14

How to Cite

Huber, Charlotte A, Lisa Hall, Niki F Foster, Mareeka Gray, Michelle Allen, Leisha J Richardson, Jennifer Robson, et al. 2014. “Surveillance Snapshot of Clostridium Difficile Infection in Hospitals across Queensland Detects Binary Toxin Producing Ribotype UK 244”. Communicable Diseases Intelligence 38 (December):279-84. https://doi.org/10.33321/cdi.2014.38.46.

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Vol. 38 (2014)

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Original article

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