A case of Clostridium difficile-associated disease due to the highly virulent clone of Clostridium difficile PCR ribotype 027, March 2007 in Germany.

Increasing rates of Clostridium difficile-associated disease (CDAD) have been reported from North America since 2003. This increase is associated with the emergence and spread of a particular strain of C. difficile characterised as PCR ribotype 027 or pulsotype NAP1. This epidemic strain produces toxins A and B and the binary toxin, is resistant to erythromycin and the newer fluoroquinolones, and patients infected with it are more likely to experience severe disease [1]. More recently, the epidemic PCR ribotype 027 strain has spread to Europe. Epidemics of C. difficile-associated disease (CDAD) due to this new, highly virulent strain have been detected in England and Wales, Ireland, the Netherlands, Belgium, Luxembourg and France, and isolates exhibiting PCR ribotype 027 (no data on virulence-associated traits available) have been detected in Austria, Scotland, Switzerland, Poland, Denmark and Finland [2-7].