2005
DOI: 10.1086/427113
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A Hospital Outbreak of Clostridium difficile Disease Associated with Isolates Carrying Binary Toxin Genes

Abstract: The binary toxin genes were present in nearly two-thirds of the C. difficile strains, and they were correlated with the REA group. Severity of CDD was not closely associated with a specific clone or underlying disease, but it may be associated with the presence of the binary toxin genes. Larger studies are needed to discern whether a true association exists and whether the binary toxin alters the pathogenicity of the C. difficile strain.

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Cited by 166 publications
(91 citation statements)
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“…Thus, the base pair deletions are probably reliable surrogate markers of the presence of the "epidemic" strain. Resistance to fluoroquinolone antimicrobials and the presence of a binary toxin are also characteristic of this strain (9,10,12,14,22).…”
mentioning
confidence: 93%
“…Thus, the base pair deletions are probably reliable surrogate markers of the presence of the "epidemic" strain. Resistance to fluoroquinolone antimicrobials and the presence of a binary toxin are also characteristic of this strain (9,10,12,14,22).…”
mentioning
confidence: 93%
“…Furthermore, other virulence factors have now been identified. Recently, an increase in the frequency and severity of C. difficile-associated colitis, which is associated with a new strain that produces binary toxin (actin-specific ADP-ribosyltransferase) and is resistant to fluoroquinolones in vitro, has refocused attention on early, accurate diagnosis (2,9,23,29,36).Cell culture cytotoxicity neutralization assays (CCNA), which detect the cytopathic effects of toxins in monolayers of cultured cells such as human diploid fibroblasts, are generally considered the best single standard for the detection of toxigenic C. difficile. CCNA can detect quantities of toxin as low as 1 pg (1, 21); results are considered positive if characteristic changes are seen in Ն50% of cells at 48 h and are neutralized by C. difficile antitoxin.…”
mentioning
confidence: 99%
“…Furthermore, other virulence factors have now been identified. Recently, an increase in the frequency and severity of C. difficile-associated colitis, which is associated with a new strain that produces binary toxin (actin-specific ADP-ribosyltransferase) and is resistant to fluoroquinolones in vitro, has refocused attention on early, accurate diagnosis (2,9,23,29,36).…”
mentioning
confidence: 99%
“…These isolates were used to determine the stability of the VNTR loci over time and to determine the ability of MLVA to identify highly related isolates. Study group B consisted of 40 C. difficile isolates-20 HVA reference isolates and 20 UPMC isolates representing the most prevalent Pitt REA types from the 2001 outbreak that were REA typed at HVA as part of another investigation (21). These isolates were used to correlate MLVA types with the well-established HVA REA-typing scheme and to determine the discriminatory power of MLVA relative to REA.…”
mentioning
confidence: 99%