An outbreak of Clostridium difficile infections due to new PCR ribotype 826: epidemiologic and microbiologic analyses M.J.T. Crobach, A.F. Voor in 't.

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An outbreak of Clostridium difficile infections due to new PCR ribotype 826: epidemiologic and microbiologic analyses M.J.T. Crobach, A.F. Voor in 't holt, C.W. Knetsch, S.M. van Dorp, W. Bras, C. Harmanus, E.J. Kuijper, M.C. Vos Clinical Microbiology and Infection Volume 24, Issue 3, Pages 309.e1-309.e4 (March 2018) DOI: 10.1016/j.cmi.2017.08.014 Copyright © 2017 The Authors Terms and Conditions

Fig. 1 Epidemic curve of five patients infected with Clostridium difficile caused by PCR ribotype 826. Green, outbreak, non-ICU ward; orange, other non-ICU ward; blue, ICU; dark green, diarrhoeal episode; white +, positive culture for C. difficile and mild C. difficile infection; white ++, positive culture for C. difficile and severe C. difficile infection; black +, positive C. difficile culture without diarrhoea; white −, negative culture for C. difficile. C&D, cleaning and disinfection; ICU, intensive care unit; OMT, outbreak management team. Clinical Microbiology and Infection 2018 24, 309.e1-309.e4DOI: (10.1016/j.cmi.2017.08.014) Copyright © 2017 The Authors Terms and Conditions

Fig. 2 (a) PCR ribotyping patterns for ribotypes 066, 078, 126 and 826. Upper row indicates fragment sizes. (b) Phylogenetic tree of ribotype 826 outbreak isolates and related ribotypes. 078, reference ribotype 078 strain; 066, reference ribotype 066 strain; 045, reference ribotype 045 strain; 126078, reference ribotype 126/078 strain 7005405_078/10015222_078; 8051728_078, 6072310_078, clinical patient CDI samples with confirmed ribotype 078; 4_826, sample from patient A (recurrent episode); 3_826; sample from patient A (initial episode), 6_826, sample from patient C; 1_826, sample from patient D (recurrent episode); 2_826, sample from patient D (initial episode); 8_826, sample from patient D (initial episode, repeat sample); 5_826, sample from patient E. Isolate from patient B could not be sequenced. Clinical Microbiology and Infection 2018 24, 309.e1-309.e4DOI: (10.1016/j.cmi.2017.08.014) Copyright © 2017 The Authors Terms and Conditions