Clostridium difficile infection in Australia

Niki F Foster; Thomas V Riley

doi:10.1071/MA14008

RESEARCH ARTICLE

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Clostridium difficile infection in Australia

Niki F Foster ^A ^C and Thomas V Riley ^A ^B ^D

+ Author Affiliations

- Author Affiliations

^A School of Pathology and Laboratory Medicine
The University of Western Australia
35 Stirling Highway
Nedlands, WA 6009, Australia

^B PathWest Laboratory Medicine WA
Nedlands, WA 6009, Australia

^C Tel: +61 8 6383 4361
Email: niki.foster@uwa.edu.au

^D Tel: +61 8 6383 4355
Email: thomas.riley@uwa.edu.au

Microbiology Australia 35(1) 26-28 https://doi.org/10.1071/MA14008
Published: 5 February 2014

Abstract

Clostridium difficile is the most common cause worldwide of infectious diarrhoea in hospitalised patients. It is also thought to be the number one healthcare-related infection in the USA costing >US$3 billion annually. In a recent report from the Centers for Disease Control and Prevention, C. difficile was described as ‘an immediate public health threat that requires urgent and aggressive action'¹. Infection occurs following ingestion of C. difficile, probably as a spore, and usually after exposure to antibiotics. Since 2002 there has been a worldwide escalation in rates of C. difficile infection (CDI) with an epidemic strain of C. difficile (PCR ribotype [RT] 027) responsible for outbreaks of severe infection in North America and Europe. This strain is characterised by the production of greater amounts of toxins A and B, the putative major virulence factors and an additional toxin (binary toxin or CDT), as well as resistance to fluoroquinolone antimicrobials. In Quebec Province in Canada (population 7.5 million in 2003) the Health Ministry reported a total of 7004 cases of CDI between 1 April 2003 and 31 March 2004, with 1270 deaths (a crude mortality rate of 18%) and an attributable mortality of greater than 10% in those aged over 60 years – a remarkably high figure. RT 027 then spread quickly to the UK where it caused several highly publicised outbreaks with significant mortality, increasing in prevalence to 26% of all C. difficile in 2005–06 and rising to 42% in 2007–08².

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