A New and Nasty C. Difficile

A new virulent strain of C. difficile is associated with high mortality rates and might have emerged, in part, because of widespread fluoroquinolone use.

In two recent reports, investigators describe epidemics involving a new, highly virulent strain of Clostridium difficile that is resistant to fluoroquinolones.

One report provides a detailed genetic analysis of 187 C. difficile isolates that were obtained during outbreaks at eight healthcare facilities in six U.S. states (Georgia, Illinois, Maine, New Jersey, Oregon, and Pennsylvania) between 2001 and 2004. These isolates were compared with more than 6000 historic isolates that were obtained before 2001. One particular strain, designated BI/NAP1, accounted for 51% of the current isolates but for only a very small percentage of the historic control isolates. Notably, all of the current — but none of the historic — BI/NAP1 isolates were resist…

Reviewing Author

Douglas K. Rex, MD