[Comparison between biotype of Vibrio cholerae O1 and genotype using polymerase chain reaction].

To compare between biotype of Vibrio cholerae O1 and genotype using polymerase chain reaction (PCR), 9 classical and 81 El Tor biovar strains were investigated for hemolysis, agglutination of avian erythrocytes, VP test reactivity, sensitivity to both polymyxin B and classical phage IV, and genotype using PCR amplification of hlyA, tcpA, rtxA and rtxC. One classical biovar strain showed atypical reaction upon agglutination of avian erythrocytes. Eighteen El Tor biovar strains showed atypical reactions, with the exception of sensitivity to polymyxin B. By PCR detection of hlyA, rtxA and rtxC amplifications, all classical biovar strains possessed only classical type hlyA, while all El Tor biovar strains possessed El Tor type hlyA, rtxA and rtxC. By PCR analysis of amplicons, all classical biovar strains possessed classical type tcpA. One ctx-negative El Tor biovar strain possessed degenerated classical type tcpA and 4 ctx-negative El Tor biovar strains had no detectable tcpA. These results indicated that genotype of V. cholerae O1 using PCR detection of hlyA, rtxA and rtxC was consistent with biotype of the organism, suggesting that analysis of the genotype of the organism was as effective as by biochemical properties. However, PCR detection of hlyA is most appropriate for the biotyping of V. cholerae O1, as compared to biochemical properties, since El Tor biovar was originally distinguished from classical biovar strains by the hemolytic reaction.

[A nosocomial outbreak of diarrhea caused by toxin A-negative, toxin B-positive Clostridium difficile in a cancer center hospital].

Between February and July 2001, 15 patients were diagnosed as Clostridium difficile-associated diarrhea in a ward of hematological neoplasm and lung cancer in a cancer center hospital. Of these 15 patients, 10 had malignant lymphoma, and 12 and 11 had exposure to antimicrobial agents and cancer chemotherapy, respectively, before the onset of diarrhea. Toxin A-positive, toxin B-positive (A+ B+) C. difficile was recovered from five patients and the remaining 10 patients suffered from diarrhea caused by toxin A-negative, toxin B-positive (A- B+) strains. All of the 10A- B+ isolates represented an identical banding pattern by PCR ribotyping and classified into one type (two subtypes) by pulsed field gel electrophoresis typing, indicating that a nosocomial outbreak of diarrhea caused by A- B+ C. difficile occurred among the patients hospitalized on this ward. Detection of toxin A in stool specimens by a toxin A detection kit was performed on 14 patients. Although two patients who carried A+ B+ strains were positive for toxin A assay, toxin A detection test was negative in 12 patients including 10 patients with A- B+ C. difficile infection. Diagnosis of C. difficile-associated diarrhea by combination of toxin A assay in feces and culture of C. difficile could successfully lead to recognition of an outbreak caused by A- B+ C. difficile in a cancer center hospital.