Skip to main content

Advertisement

SpringerLink
Log in

Clostridium difficile ribotype 078 cultured from post-surgical non-healing wound in a patient carrying ribotype 014 in the intestinal tract

  • Published:
Folia Microbiologica Aims and scope Submit manuscript

Abstract

Extra-intestinal infections caused by Clostridium difficile are rare. The risk of extra-intestinal infections associated with C. difficile may be particularly relevant in environments contaminated with C. difficile spores. This paper describes the case of a non-diarrheic patient colonized with C. difficile ribotype 014 in the intestinal tract who developed a post-surgical wound infection by C. difficile ribotype 078. The infection responded to metronidazole administered first intravenously and then orally. This case indicates that C. difficile may not only be related to diarrheic diseases, but also to infections of non-healing wounds, especially in situations when C. difficile is the only isolated pathogen.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

References

  • Al-Najjar A, Al-Rawahi GN, Hoang LM, Kollmann TR (2013) Clostridium difficile vertebral osteomyelitis. Pediatr Infect Dis J 32(9):1030–2

    Article  PubMed  Google Scholar 

  • Bakker D, Corver J, Harmanus C, Goorhuis A, Keessen EC, Fawley WN et al (2010) Relatedness of human and animal Clostridium difficile PCR ribotype 078 isolates determined on the basis of multilocus variable-number tandem-repeat analysis and tetracycline resistance. Clin Microbiol 48(10):3744–9

    Article  CAS  Google Scholar 

  • Bedimo R, Weinsten J (2003) Recurrent extraintestinal Clostridium difficile infection. Am J Med 114(9):770–1

    Article  PubMed  Google Scholar 

  • Bhargava A, Sen P, Swaminathan A, Ogbolu C, Chechko S, Stone F (2000) Rapidly progressive necrotizing fasciitis and gangrene due to Clostridium difficile: case report. Clin Infect Dis 30(6):954–5

    Article  CAS  PubMed  Google Scholar 

  • Birnbaum J, Bartlett JG, Gelber AC (2008) Clostridium difficile: an under-recognized cause of reactive arthritis? Clin Rheumatol 27(2):253–5

    Article  PubMed  Google Scholar 

  • Choi JL, Kim BR, Kim JE, Woo KS, Kim KH, Kim JM et al (2013) A case of Clostridium difficile bacteremia in a patient with loop ileostomy. Ann Lab Med 33(3):200–2

    Article  PubMed Central  PubMed  Google Scholar 

  • Deptula A, Kruszynska E, Mikucka A, Gospodarek E, Olszewski K, Kruczynski J et al (2009) Toxin A-producing Clostridium difficile as an aetiological factor of post-traumatic wound infection. J Med Microbiol 58(Pt 7):963–4

    Article  CAS  PubMed  Google Scholar 

  • Duburcq T, Parmentier-Decrucq E, Poissy J, Mathieu D (2013) Pseudomembranous colitis due to Clostridium difficile as a cause of perineal necrotising fasciitis. BMJ Case Rep 2013

  • Dumford DM 3rd, Nerandzic M, Chang S, Richmond MA, Donskey C (2011) Epidemiology of Clostridium difficile and vancomycin-resistant Enterococcus colonisation in patients on a spinal cord injury unit. J Spinal Cord Med 34(1):22–7

    Article  PubMed Central  PubMed  Google Scholar 

  • Feldman RJ, Kallich M, Weinstein MP (1995) Bacteremia due to Clostridium difficile: case report and review of extraintestinal C. difficile infections. Clin Infect Dis 20(6):1560–2

    Article  CAS  PubMed  Google Scholar 

  • Gerard M, Defresne N, van der Auwera P, Meunier F (1989) Polymicrobial septicemia with Clostridium difficile in acute diverticulitis. Eur J Clin Microbiol Infect Dis 8(4):300–2

    Article  CAS  PubMed  Google Scholar 

  • Goorhuis A, Bakker D, Cover J, Debast SB, Harmanus C, Notermans DW et al (2008) Emergence of Clostridium difficile infection due to a new hypervirulent strain, polymerase chain reaction ribotype 078. Clin Infect Dis 47(9):1162–70

    Article  CAS  PubMed  Google Scholar 

  • Gravisse J, Barnaud G, Hanau-Berçot B, Raskine L, Riahi J, Gaillard JL et al (2003) Clostridium difficile brain empyema after prolonged intestinal carriage. J Clin Microbiol 41(1):509–11

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Hemminger J, Balada-Llasat JM, Raczkowski M, Buckosh M, Pancholi P (2011) Two case reports of Clostridium difficile bacteremia, one with the epidemic NAP-1 strain. Infection 39(4):371–3

    Article  CAS  PubMed  Google Scholar 

  • Indra A, Huhulescu S, Schneeweis M, Hasenberger P, Kernbichler S, Fiedler A et al (2008) Characterization of Clostridium difficile isolates using capillary gel electrophoresis-based PCR ribotyping. J Med Microbiol 57(Pt 11):1377–82

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Kikkawa H, Miyamoto K, Takiguchi N, Kondo T, Hitomi S (2008) Surgical-site infection with toxin A-nonproducing and toxin B-producing Clostridium difficile. J Infect Chemother 14(1):59–61

    Article  PubMed  Google Scholar 

  • Lee NY, Huang YT, Hsueh PR, Ko WC (2010) Clostridium difficile bacteremia, Taiwan. Emerg Infect Dis 16(8):1204–10

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Libby DB, Bearman G (2009) Bacteremia due to Clostridium difficile review of the literature. Int J Infect Dis 13(5):e305–9

    Article  PubMed  Google Scholar 

  • Loffler HA, Pron B, Mouy R, Wulffraat NM, Prieur AM (2004) Clostridium difficile associated reactive arthritis in two children. Joint Bone Spine 71(1):60–2

    Article  PubMed  Google Scholar 

  • Mattila E, Arkkila P, Mattila PS, Tarkka E, Tissari P, Anttila VJ (2013) Extraintestinal Clostridium difficile infections. Clin Infect Dis 57(6):e148–53

    Article  PubMed  Google Scholar 

  • McCarthy J, Stingemore N (1999) Clostridium difficile infection of a prosthetic joint presenting 12 months after antibiotic-associated diarrhoea. J Infect 39(1):94–6

    Article  CAS  PubMed  Google Scholar 

  • Persson S, Torpdahl M, Olsen KEP (2008) New multiplex PCR method for the detection of Clostridium difficile toxin A (tcdA) and toxin B (tcdB) and the binary toxin (cdtA/cdtB) genes applied to a Danish strain collection. Clin Microbiol Infect 14(11):1057–64

    Article  CAS  PubMed  Google Scholar 

  • Prati C, Bertolini E, Toussirot E, Wendling D (2010) Reactive arthritis due to Clostridium difficile. Joint Bone Spine 77(2):190–2

    Article  PubMed  Google Scholar 

  • Pron B, Merckx J, Touzet P, Ferroni A, Poyart C, Berche P et al (1995) Chronic septic arthritis and osteomyelitis in a prosthetic knee joint due to Clostridium difficile. Eur J Clin Microbiol Infect Dis 14(7):599–601

    Article  CAS  PubMed  Google Scholar 

  • Ranganath S, Midturi JK (2013) Unusual case of prosthetic shoulder joint infection due to Clostridium difficile. Am J Med Sci 346(5):422–3

    Article  PubMed  Google Scholar 

  • Riley TV, Karthigasu KT (1982) Chronic osteomyelitis due to Clostridium difficile. Br Med J (Clin Res Ed) 284(6324):1217–8

    Article  CAS  Google Scholar 

  • Saginur R, Fogel R, Begin L, Cohen B, Mendelson J (1983) Splenic abscess due to Clostridium difficile. J Infect Dis 147(6):1105

    Article  CAS  PubMed  Google Scholar 

  • Stieglbauer KT, Gruber SA, Johnson S (1995) Elevated serum antibody response to toxin A following splenic abscess due to Clostridium difficile. Clin Infect Dis 20(1):160–2

    Article  CAS  PubMed  Google Scholar 

  • Studemeister AE, Beilke MA, Kirmani N (1987) Splenic abscess due to Clostridium difficile and Pseudomonas paucimobilis. Am J Gastroenterol 82(4):389–90

    CAS  PubMed  Google Scholar 

  • Urbán E, Terhes G, Markotics A, Sóki J, Nagy E (2010) Rare extraintestinal infection caused by toxin-producing Clostridium difficile. Anaerobe 16(3):301–3

    Article  PubMed  Google Scholar 

  • van den Berg RJ, Ameen HA, Furusawa T, Claas EC, van der Vorm ER, Kuijper EJ (2005) Coexistence of multiple PCR-ribotype strains of Clostridium difficile in faecal samples limits epidemiological studies. J Med Microbiol 54(Pt 2):173–9

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We would like to thank James Partridge for proofreading the text. This study is supported by the Ministry of Health, Czech Republic-conceptual development of research organization, University Hospital Motol, Prague, Czech Republic, 00064203 and MH CZ IGA NT/14209-3.

Author information

Authors and Affiliations

  1. Department of Medical Microbiology, 2nd Faculty of Medicine, Charles University and University Hospital Motol, V Uvalu 84, 150 06, Prague 5, Czech Republic

    Otakar Nyc, Marcela Krutova, Jana Matejkova & Eliska Bebrova

  2. DNA Laboratory, Department of Child Neurology, 2nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic

    Marcela Krutova

  3. Spinal Cord Unit, 2nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic

    Jiri Kriz & Veronika Hysperska

  4. Department of Medical Microbiology, Leiden University Medical Centre, Leiden, Netherlands

    Ed J. Kuijper

Authors
  1. Otakar Nyc
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Marcela Krutova
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jiri Kriz
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jana Matejkova
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Eliska Bebrova
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Veronika Hysperska
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Ed J. Kuijper
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Marcela Krutova.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Nyc, O., Krutova, M., Kriz, J. et al. Clostridium difficile ribotype 078 cultured from post-surgical non-healing wound in a patient carrying ribotype 014 in the intestinal tract. Folia Microbiol 60, 541–544 (2015). https://doi.org/10.1007/s12223-015-0392-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12223-015-0392-0

Keywords

Search

Navigation