Hypervirulent Clostridium difficile Strains in Hospitalized Patients, Canada

EID Journal Home > Volume 16, Number 4–April 2010

Volume 16, Number 4–April 2010
Dispatch
Hypervirulent Clostridium difficile Strains in Hospitalized Patients, Canada1
Michael R. Mulvey, David A. Boyd, Denise Gravel, Jim Hutchinson, Sharon Kelly, Allison McGeer, Dorothy Moore, Andrew Simor, Kathryn N. Suh, Geoff Taylor, J. Scott Weese, Mark Miller, and the Canadian Nosocomial Infection Surveillance Program2
Author affiliations: Public Health Agency of Canada, Winnipeg, Manitoba, Canada (M.R. Mulvey, D.A. Boyd); Public Health Agency of Canada, Ottawa, Ontario, Canada (D. Gravel); Health Sciences Centre, St. John's, Newfoundland and Labrador, Canada (J. Hutchinson and S. Kelly); Mount Sinai Hospital, Toronto, Ontario, Canada (A. McGeer); Montreal Children's Hospital, Montreal, Quebec, Canada (D. Moore); Sunnybrook Health Science Centre, Toronto (A. Simor); The Ottawa Hospital, Ottawa (K.N. Suh); University of Alberta Hospital, Edmonton, Alberta, Canada (G. Taylor); University of Guelph, Geulph, Ontario, Canada (J.S. Weese); and Jewish General Hospital, Montreal (M. Miller)

Suggested citation for this article

Abstract
To determine the incidence rate of infections with North American pulsed-field types 7 and 8 (NAP7/NAP8) strains of Clostrodium difficile, ribotype 078, and toxinotype V strains, we examined data collected for the Canadian Nosocomial Infections Surveillance Program (CNISP) CDI surveillance project during 2004–2008. Incidence of human infections increased from 0.5% in 2004/2005 to 1.6% in 2008.

Clostridium difficile infections (CDIs) have increased in incidence and severity within the past decade in North America and Europe (1), in large part because of the emergence of the hypervirulent North American pulsed-field type 1 (NAP1/027/III) strains (2–5). Recently, interest has increased in the ribotype 078 strain. A 2007 North American study showed that ribotype 078 strains predominated in swine and cattle (83%–94% prevalence), but were rare in a group of hospitalized persons (4% prevalence) (6). However, in studies from Europe and the United States, 078/V strains were found at a prevalence ranging from 3% to 11% (7–9). In a subsequent study by the US group, analysis of the toxinotype V strains from humans and food animals showed that 83% of strains were either NAP7 or NAP8 (10). A Dutch group has recently shown that 078/V strains increased from 3% to 13% during February 2005–2008 and can be considered hypervirulent (11). Our study aimed to determine the incidence rate of infections attributed to hypervirulent NAP7/078/V and NAP8/078/V strains of C. difficile in hospitals in Canada.

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Suggested Citation for this Article
Mulvey MR, Boyd DA, Gravel D, Hutchinson J, Kelly S, McGeer A, et al. Hypervirulent Clostridium difficile strains in hospitalized patients, Canada. Emerg Infect Dis [serial on the Internet]. 2010 Apr [date cited]. http://www.cdc.gov/EID/content/16/4/678.htm

DOI: 10.3201/eid1604.091152