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Predominance of a Single Restriction Endonuclease Analysis Group with Intrahospital Subgroup Diversity Among Clostridium difficile Isolates at Two Chicago Hospitals

Published online by Cambridge University Press:  02 January 2015

Endale T. Mekonen ,
Dale N. Gerding ,
Susan P. Sambol ,
Jean M. Pottinger ,
Joseph J. Pulvirenti ,
Dayle Marsh ,
Frank E. Kocka  and
Stuart Johnson
Endale T. Mekonen
Affiliation:
Department of Medicine, Chicago Healthcare System, Division, andNorthwestern University Medical School, Chicago, Illinois
Dale N. Gerding
Affiliation:
Department of Medicine, Chicago Healthcare System, Division, andNorthwestern University Medical School, Chicago, Illinois
Susan P. Sambol
Affiliation:
Department of Medicine, Chicago Healthcare System, Division, andNorthwestern University Medical School, Chicago, Illinois
Jean M. Pottinger
Affiliation:
Department of Medicine, Chicago Healthcare System, Division, andNorthwestern University Medical School, Chicago, Illinois
Joseph J. Pulvirenti
Affiliation:
Division of Infectious Diseases, Cook County HospitalandRush Medical College, Chicago, Illinois
Dayle Marsh
Affiliation:
Division of Microbiology, Cook County HospitalandChicago Medical School, Chicago, Illinois
Frank E. Kocka
Affiliation:
Division of Microbiology, Cook County HospitalandChicago Medical School, Chicago, Illinois
Stuart Johnson*
Affiliation:
Department of Medicine, Chicago Healthcare System, Division, andNorthwestern University Medical School, Chicago, Illinois
*
Medicine Service, VA Chicago Healthcare System, Lakeside Division, 333 East Huron, Chicago, IL 60611
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Abstract

Objective:

To determine the epidemiology and relatedness of Clostridium difficile isolates in two geographically separated hospitals in a large metropolitan area, each with unique patients and personnel.

Design:

Observational descriptive molecular epidemiology of clinical C. difficile isolates.

Setting:

Two tertiary-care hospitals in Chicago.

Methods:

Consecutive C. difficile isolates from the clinical laboratory of a Veterans Affairs hospital during a 13-month period were typed by restriction endonuclease analysis (REA). During an overlapping 3-month period, stool specimens that tested positive for C. difficile toxin from patients at a nearby county hospital were cultured and the recovered isolates typed by the same method.

Results:

Nineteen (68%) of 28 nosocomial isolates at the smaller, Veterans Affairs hospital belonged to REA group K. Within this group of closely related strains, 9 distinct REA types were recognized. Twenty-one (72%) of 29 nosocomial isolates at the larger, county hospital also belonged to group K. However, the predominant REA types within group K differed markedly at each institution.

Conclusions:

These findings demonstrate a high degree of similarity among nosocomial C. difficile strains from different hospitals in the same city and suggest the possibility of an extended outbreak of a prototype group K strain with subsequent genetic drift at the two different institutions.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 23 , Issue 11 , November 2002 , pp. 648 - 652
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2002

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