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Clostridium difficile Infection in Patients with Haematological Malignant Disease: Risk Factors, Faecal Toxins and Pathogenic Strains

S. R. Heard, B. Wren, M. J. Barnett, J. M. Thomas and S. Tabaqchali
Epidemiology and Infection
Vol. 100, No. 1 (Feb., 1988), pp. 63-72
Stable URL: http://www.jstor.org/stable/3863272
Page Count: 10
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Since scans are not currently available to screen readers, please contact JSTOR User Support for access. We'll provide a PDF copy for your screen reader.
Clostridium difficile Infection in Patients with Haematological Malignant Disease: Risk Factors, Faecal Toxins and Pathogenic Strains
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Abstract

Two hundred and forty-eight patients from shared oncology and general medical wards were prospectively studied over a 6-month period for carriage of Clostridium difficile during an outbreak of clinical disease with an epidemic strain of the organism. Risk factors for infection were assessed. Acute leukaemia and/or its treatment were identified as significantly increasing the risk of infection. The relationship between the type of C. difficile isolated (as defined by a typing system based on the incorporation of $[{}^{65}{\rm S}]$methionine into bacterial proteins followed by gel electrophoresis), the presence of faecal toxins A and B and clinical symptoms were analysed. Carriage of the epidemic strain, type X, had a significant association with symptoms amongst oncology patients, with two thirds of these patients having detectable faecal toxin A and one third detectable faecal toxin B. During an outbreak of C. difficile-associated disease, typing the organism and assaying for both faecal toxins in symptomatic patients may be of benefit in determining which patients require specific, urgent treatment.

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