Outbreaks of severe Clostridium difficile disease have been caused by hypervirulent strains.
Clinical manifestations of hypervirulence:
(1) greater 30-day and one-year mortality rates
(2) greater rate of toxic megacolon and colectomy
(3) greater risk of ICU admission
Correlations:
(1) PCR ribotypes 078 and 017
(2) pulsed-field gel electrophoresis NAP1, NAP7 or NAP8
(2) multi-drug resistance
(3) resistance to certain disinfectants
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Specialty: Infectious Diseases, Gastroenterology
