Clostridium Difficile Is A Gram Positive, Anaerobic, Spore Forming Bacillus

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Introduction Clostridium difficile is a gram positive, anaerobic, spore forming bacillus. In 1935 it was first described as member of the intestinal flora in healthy neonates [1] , and then in 1978 it was recognised as a cause of diarrhoea [2]. Today it is widely acknowledged as the leading cause of hospital-acquired diarrhoea. This organism can cause a variety of diseases, from mild diarrhoea to severe pseudomembranous colitis, and collectively these are known as C. difficile infections (CDIs) [3]. It is known that the symptoms seen in patients infected with C. difficile are due to the toxins (toxin A and toxin B) that are produced by the organism [4]. Some strains of C. difficile seem to have an increased virulence which can be associated with increased severity, recurrence and increased mortality. This increased virulence is thought to be a result of increased expression of toxins A, B [5]. There is also another toxin produced by C. difficile known as binary toxin, this is also thought to contribute towards increased virulence [6]. A particular strain of C. difficile that does seem to have increased virulence is the strain known as PCR ribotype O27 or North American pulsed (NAP)-field type 01. In Europe PCR ribotype O27 is the sixth most common ribotype [7], and new ribotypes are being detected that appear to have evolved from the O27 lineage [8], making the need for a method to demonstrate strain relatedness highly important. In a hospital setting knowing the

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