Hostname: page-component-7bb8b95d7b-l4ctd Total loading time: 0 Render date: 2024-09-06T16:12:48.190Z Has data issue: false hasContentIssue false

Identification of outbreak-associated and other strains of Clostridium difficile by numerical analysis of SDS-PAGE protein patterns

Published online by Cambridge University Press:  15 May 2009

M. Costas
Affiliation:
National Collection of Type Cultures, Central Public Health Laboratory, London NW9 5HT
B. Holmes
Affiliation:
National Collection of Type Cultures, Central Public Health Laboratory, London NW9 5HT
M. Ganner
Affiliation:
National Collection of Type Cultures, Central Public Health Laboratory, London NW9 5HT
S. L. W. On
Affiliation:
National Collection of Type Cultures, Central Public Health Laboratory, London NW9 5HT
P. N. Hoffman
Affiliation:
Laboratory of Hospital Infection, Central Public Health Laboratory, London NW9 5HT
M. A. Worsley
Affiliation:
Infection Control, North Manchester General Hospital, Crumpsall, Manchester M8 6RB, England
H. Panigrahi
Affiliation:
Department of Microbiology, North Manchester General Hospital, Crumpsall, Manchester M8 6RB, England
Rights & Permissions [Opens in a new window]

Summary

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Seventy-three cultures of Clostridium difficile isolated both during, and in the period immediately following, an outbreak of infection in a group of three hospitals, were characterized by one-dimensional sodium dodecyl sulphate–polyacrylamide gel electrophoresis (SDS–PAGE) of whole-cell proteins. Each protein pattern was characterized by the presence of one or two dense bands which were highly reproducible. The protein patterns were used as the basis for a numerical analysis which divided the strains into five phenons (electrophoretic or EP types). The majority, 60 of the 73 cultures, belonged to a single phenon which included strains from both patients and the environment. We conclude that high-resolution SDS–PAGE of proteins provides an effective method for typing C. difficile and therefore for tracing the possible spread of epidemic strains in hospitals and other institutions, thereby allowing a better understanding of the epidemiology of the organism.

Type
Research Article
Copyright
Copyright © Cambridge University Press 1994

References

REFERENCES

1.Bartlett, JG. Clostridium difficile: clinical considerations. Rev Infect Dis 1990; 12 (Suppl. 2): S24351.CrossRefGoogle ScholarPubMed
2.McFarland, LV, Elmer, GW, Stamm, WE, Mulligan, ME. Correlation of immunoblot type, enterotoxin production, and cytotoxin production with clinical manifestations of Clostridium difficile infection in a cohort of hospitalized patients. Infect Immun 1991; 59: 2456–62.Google Scholar
3.Bartlett, JG. Antibiotic-associated diarrhoea. Clin Infect Dis 1992; 15: 573–81.Google Scholar
4.Kamthan, AG, Bruckner, HW, Hirschman, SZ, Agus, SG. Clostridium difficile diarrhea induced by cancer chemotherapy. Arch Intern Med 1992; 152: 1715–7.Google Scholar
5.McFarland, LV, Stamm, WE. Review of Clostridium difficile-associated diseases. Am J Infect Control 1986; 14: 99109.Google Scholar
6.Delmée, M, Avesani, V. Correlation between serogroup and susceptibility to chloramphenicol. clindamycin, erythromycin, rifampicin and tetracycline among 308 isolates of Clostridium difficile. J Antimicrob Chemother 1988; 22: 325–31.CrossRefGoogle ScholarPubMed
7.Pantosti, A, Cerquetti, M, Gianfrilli, PM. Electrophoretic characterization of Clostridium difficile strains isolated from antibiotic-associated colitis and other conditions. J Clin Microbiol 1988; 26: 540–3.Google Scholar
8.Testore, GP, Pantosti, A, Cerquetti, M, Babudieri, S, Panichi, G, Gianfrilli, PM. Evidence for cross-infection in an outbreak of Clostridium difficile-associated diarrhoea in a surgical unit. J Med Microbiol 1988; 26: 125–8.Google Scholar
9.Wren, B, Heard, SR, Tabaqchali, S. Association between production of toxins A and B and types of Clostridium difficile. J Clin Pathol 1987; 40: 13971401.CrossRefGoogle Scholar
10.Tedesco, FJ. Antibiotics associated with Clostridium difficile mediated diarrhea and/or colitis. In: Borriello, SP, ed. Antibiotic associated diarrhea and colitis. Boston: Martinus Nijhoff Publishers, 1984: 48.Google Scholar
11.Degl'Innocenti, R, De Santis, M, Berdondini, I, Dei, R. Outbreak of Clostridium difficile diarrhoea in an orthopaedic unit: evidence by phage-typing for cross-infection. J Hosp Infect 1989; 13: 309–14.CrossRefGoogle Scholar
12.Heard, SR, O'Farrell, S, Holland, D, Crook, S, Barnett, MJ, Tabaqchali, S. The epidemiology of Clostridium difficile with use of a typing scheme: nosocomial acquisition and cross-infection among immunocompromised patients. J Infect Dis 1986; 153: 159–62.Google Scholar
13.Kaatz, GW, Gitlin, SD, Schaberg, DR et al. , Acquisition of Clostridium difficile from the hospital environment. Am J Epidemiol 1988; 127: 1289–94.Google Scholar
14.Kuijper, EJ. Oudbier, JH. Suifbergen, WNHM. Jansz, A. Zanen, HC. Application of whole-cell DXA restriction endonuclease profiles to the epidemiology of Clostridium difficile-induced diarrhea. J Clin Microbiol 1987; 25: 751–3.Google Scholar
15.McKay, I, Coia, JE, Poxton, IR. Typing of Clostridium difficile causing diarrhoea in an orthopaedic ward. J Clin Pathol 1989; 42: 511–5.Google Scholar
16.Tabaqchali, S, Holland, D, O'Farrell, S, Silman, R. Typing scheme for Clostridium difficile: its application in clinical and epidemiological studies. Lancet 1984; i: 935–8.Google Scholar
17.Dei, R. Observations on phage-typing of Clostridium difficile: preliminary evaluation of a phage panel. Eur J Epidemiol 1989; 5: 351–4.CrossRefGoogle ScholarPubMed
18.Mahoney, DE, Clow, J, Atkinson, L, Vakharia, N, Schlech, WF. Development and application of a multiple typing system for Clostridium difficile. Appl Environ Microbiol 1991; 57: 1873–9.CrossRefGoogle Scholar
19.Delmée, M. Avesani, V. Virulence of ten serogroups of Clostridium difficile in hamsters. J Med Microbiol 1990; 33: 8590.CrossRefGoogle ScholarPubMed
20.Meisel-Mikolajczyk, F, Sokól, B. New Clostridium difficile serotypes in Poland. Eur J Epidemiol 1991; 7: 434–6.CrossRefGoogle ScholarPubMed
21.Toma, S. Lesiak, G, Magus, M. Lo, H-L, Delmée, M. Serotyping of Clostridium difficile. J Clin Microbiol 1988; 26: 426–8.Google Scholar
22.Ehret, W, Turba, M, Pfaller, P, Heizmann, W, Ruckdeschel, G. Computer-aided densitometric analysis of protein patterns of Clostridium difficile. Eur J Clin Microbiol Infect Dis 1988; 7: 285–90.Google Scholar
23.Delmée, M. Laroche, Y, Avesani, V, Cornelis, G. Comparison of serogrouping and polyacrylamide gel electrophoresis for typing Clostridium difficile. J Clin Microbiol 1986; 24: 991–4.CrossRefGoogle ScholarPubMed
24.Guinet, RMF, Marlier, H, de Barbeyrac, B, Sabbagh, I. Clostridium difficile electrophoretic typing. FEMS Microbiol Lett 1988; 50: 289–93.CrossRefGoogle Scholar
25.Miscopein, G, Delmée, M. Sedallian, A. Clostridium difficile: mise au point d'une méthode de typage pour les études épidémiologiques. Path Biol 1991; 39: 551–4.Google Scholar
26.Kato, H, Cavallaro, JJ, Kato, N et al. , Typing of Clostridium difficile by Western immunoblotting with 10 different antisera. J Clin Microbiol 1993; 31: 413–15.Google Scholar
27.McFarland, LV, Mulligan, ME. Kwok, RYY, Stamm, WE. Nosocomial acquisition of Clostridium difficile infection. New Engl J Med 1989; 320: 204–10.CrossRefGoogle ScholarPubMed
28.Poxton, IR, Aronsson, B, Möllby, R, Nord, CE, Collee, JG. Immunochemical fingerprinting of Clostridium difficile strains isolated from an outbreak of antibiotic-associated colitis and diarrhoea. J Med Microbiol 1984; 17: 317–24.Google Scholar
29.Clabots, C, Lee, S, Gerding, D et al. , Clostridium difficile plasmid isolation as an epidemiologic tool. Eur J Clin Microbiol Infect Dis 1988; 7: 312–5.Google Scholar
30.Getchell-White, SI, Barrett, LJ, Barton, BA et al. , Nosocomial significance of Clostridium difficile: an epidemiologic study using molecular markers. Med Microbiol Lett 1992; 1: 4955.Google Scholar
31.Peerbooms, PGH, Kuijt, P, Maclaren, DM. Application of chromosomal restriction endonuclease digest analysis for use as typing method for Clostridium difficile. J Clin Pathol 1987: 40: 771–6.Google Scholar
32.Bowman, RA, O'neill, GL, Riley, TV. Non-radioactive restriction fragment length polymorphism (RFLP) typing of Clostridium difficile. FEMS Microbiol Lett 1991; 79: 269–72.Google Scholar
33.McMillin, DE. Muldrow, LL. Typing of toxic strains of Clostridium difficile using DNA fingerprints generated with arbitrary polymerase chain reaction primers. FEMS Microbiol Lett 1992; 92: 510.Google Scholar
34.Cartmill, TDI, Orr, K, Freeman, R, Sisson, PR, Lightfoot, NF. Nosocomial infection with Clostridium difficile investigated by pyrolvsis mass spectrometry. J Med Microbiol 1992; 37: 352–6.Google Scholar
35.Cartmill, TDI, Panigrahi, H, Worsley, MA, McCann, DC, Nice, CN, Keith, E. Management and control of a large outbreak of Clostridium difficile mediated diarrhoea. J Hosp Infect. In press.Google Scholar
36.Costas, M. Classification, identification and typing of bacteria by the analysis of their one-dimensional polyacrylamide gel electrophoretic protein patterns. In: Chrambach, A, Dunn, MJ, Radola, BJ, eds. Advances in electrophoresis, vol. 5. Weinheim: VCH Verlags-gesellschaft mbH, 1992: 351408.Google Scholar
37.Cartmill, TDI, Shrimpton, SB, Panigrahi, H, Khanna, V, Brown, R, Poxton, IR. Nosocomial diarrhoea due to a single strain of Clostridium difficile: a prolonged outbreak in elderly patients. Age Ageing 1992; 21: 245–9.Google Scholar
38.Costas, M, Holmes, B, On, SLW, Ganner, M, Kelly, MC, Nath, SK. Investigation of an outbreak of Clostridium difficile infection in a general hospital by numerical analysis of protein patterns by sodium dodecyl sulfate–polyacrylamide gel electrophoresis. J Clin Microbiol 1994; 32: 759–65.Google Scholar
39.Chang, T, Lauermann, M, Bartlett, JG. Cytotoxicity assay in antibiotic-associated colitis. J Infect Dis 1979; 140: 765–70.Google Scholar
40.Costas, M, Holmes, B, Wood, AC, On, SLW. Numerical analysis of electrophoretic protein patterns of Providencia rettgeri strains from human faeces, urine and other specimens. J Appl Bacteriol 1989; 67: 441–52.Google Scholar
41.Mulligan, ME, George, WL, Rolfe, RD, Finegold, SM. Epidemiological aspects of Clostridium difficile, induced diarrhea and colitis. Am J Clin Nutrit 1980; 33: 2533–8.Google Scholar
42.Fekety, R, Kim, K-H, Brown, D, Batts, DH, Cudmore, M. Silva, J. Epidemiology of antibiotic-associated colitis. Isolation of Clostridium difficile from the hospital environment. Am J Med 1981; 70: 906–8.CrossRefGoogle ScholarPubMed
43.Johnson, S, Adelmann, A, Clabots, CR, Peterson, LR, Gerding, DN. Recurrences of Clostridium difficile diarrhoea not caused by the original infecting organism. J Infect Dis 1989; 159: 340–3.CrossRefGoogle Scholar
44.O'neill, GL, Beaman, MH, Riley, TV. Relapse versus reinfection with Clostridium difficile. Epidemiol Infect 1991; 107: 627–35.Google Scholar
45.Clabots, CR, Johnson, S, Bettin, KM et al. , Development of a rapid and efficient restriction endonuclease analysis typing system for Clostridium difficile and correlation with other typing systems. J Clin Microbiol 1993; 31: 1870–5.Google Scholar