The First Case of Antibiotic-associated Colitis by Clostridium difficile PCR Ribotype 027 in Korea.
10.3346/jkms.2009.24.3.520
- Author:
Chung Hyun TAE
1
;
Sung Ae JUNG
;
Hyun Joo SONG
;
Seong Eun KIM
;
Hee Jung CHOI
;
Miae LEE
;
Yusun HWANG
;
Heejung KIM
;
Kyungwon LEE
Author Information
1. Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea. jassa@ewha.ac.kr
- Publication Type:Case Report
- Keywords:
Enterocolitis, Pseudomembranous;
Clostridium difficile;
Ribotype 027
- MeSH:
Accidents, Traffic;
Antitubercular Agents/therapeutic use;
Base Sequence;
Clostridium difficile/*classification/genetics/isolation & purification;
Enterocolitis, Pseudomembranous/*diagnosis/drug therapy/*microbiology;
Female;
Humans;
Kidney Failure, Acute/diagnosis;
Korea;
Middle Aged;
Molecular Sequence Data;
Polymerase Chain Reaction;
Ribotyping;
Shock, Septic/diagnosis
- From:Journal of Korean Medical Science
2009;24(3):520-524
- CountryRepublic of Korea
- Language:English
-
Abstract:
Clostridium difficile (C. difficile) is a common causative agent of pseudomembranous colitis (PMC). C. difficile-associated diarrhea (CDAD) ranges from mild diarrhea to life threatening PMC. Recently, a highly virulent strain of C. difficile polymerase chain reaction ribotype 027 was found in North America, Europe, and Japan. A 52-yr-old woman with anti-tuberculosis medication and neurogenic bladder due to traffic accident experienced five episodes of C. difficile PMC after taking antibiotics for pneumonia along with septic shock and acute renal failure. She was readmitted to the intensive care unit and treated with oral vancomycin with refractory of oral metronidazole, inotropics and probiotics for over 60 days. C. difficile isolated both at the first and the last admission was identified as C. difficile ribotype 027 by ribotyping, toxinotyping, and tcdC gene sequencing, which turned out the same pathogen as the epidemic hypervirulent B1/NAP1 strain. This is the first case of C. difficile PCR ribotype 027 in Korea. After discharge, she was maintained on probiotics and rifaximin for 3 weeks. She had no relapse for 6 months.
