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Following the first description of a Clostridium difficile case caused by ribotype 027 in Hungary in 2007, the rapid spread of C. difficile infection in different hospitals within the country was observed. The aim of this pilot study was to investigate the distribution of different PCR ribotypes among inpatient and outpatient isolates obtained in two geographically different parts of Hungary. One hundred and ninety-two toxigenic C. difficile isolates collected between 1 October and 1 December 2014 were PCR ribotyped using capillary gel electrophoresis and the database of WEBRIBO (http://webribo.ages.at), which allows the automatic analysis and comparison of capillary-sequencer-based PCR ribotyping data. Altogether, 31 different known ribotypes were found, and 16 isolates showed a novel banding pattern, not included in the current library. Besides the dominance of 027 (33.3 %) among all isolates, there were differences in its presence among isolates obtained from the two regions (45.8 % in the central region and 20.8 % in the south-east region, respectively), whereas the second most prevalent ribotype 036 (19.8 %) was more frequently found among isolates obtained in the south-east region compared with the central region of Hungary (29.1 versus 10.4 %). Similar differences in the spread of different ribotypes, in particular 027, which were found during earlier studies in Hungary may be due to the existing order for admissions of patients to hospitals. We also summarized the changing pattern of PCR ribotypes of Hungarian C. difficile isolates over time, based on earlier published data.

Gaucher disease is the most common lysosomal storage disorder caused by deficiency of the lysosomal enzyme glucocerebrosidase. By the end of 2006, the total enrollment in the international Gaucher Disease Registry included 4584 patients, 34 of them were Hungarian. The disease has three main types: non neuropathic (Type 1), acute neuropathic (Type 2), and chronic neuropathic (Type 3). The non-neuropathic type has the highest prevalence and also the greatest variability. The first symptoms occur before 10 years of age in more than 50% of the patients. Early onset of the clinical symptoms and signs predispose patients to severe phenotype and irreversible complications. Safe and efficient enzyme substitution therapy has been available from 1991 and applied since 1992 in Hungary. Optimal dose and early therapy are effective in stopping disease progression, leading to the regression of visceral and haematological abnormalities, preventing irreversible bone deformities, and providing a better quality of life. The authors present here three patients with Gaucher disease diagnosed in early childhood. They highlight the importance of early diagnosis and treatment before the development of severe co-morbidities or irreversible complications. They also analyse the challenges for pediatricians in establishing correct diagnosis of Gaucher disease in time.

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