Skip Navigation



JAC Advance Access published online on May 5, 2007
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkm113
This Article
Right arrow Full Text Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
60/1/83    most recent
dkm113v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Freeman, J.
Right arrow Articles by Wilcox, M. H.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Freeman, J.
Right arrow Articles by Wilcox, M. H.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© The Author 2007. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Effect of metronidazole on growth and toxin production by epidemic Clostridium difficile PCR ribotypes 001 and 027 in a human gut model

Jane Freeman, Simon D. Baines, Katie Saxton and Mark H. Wilcox*

Department of Microbiology, Leeds Teaching Hospital and University of Leeds, Leeds LS1 3EX, UK

Received 20 December 2006; returned 12 March 2007; revised 15 March 2007; accepted 22 March 2007

* Correspondence address. Department of Microbiology, Leeds General Infirmary, The Old Medical School, Leeds LS1 3EX, UK. Tel: +44-113-392-6818; Fax: +44-113-343-5649; E-mail: mark.wilcox{at}leedsth.nhs.uk

Objectives: We compared the behaviour of Clostridium difficile PCR ribotypes 001 and 027 in a human gut model, and compared the responses to metronidazole exposure.

Methods: Using a human gut model primed with pooled human faeces, gut flora bacterial counts, C. difficile total viable counts, spore counts and cytotoxin titres were determined, following exposure to clindamycin, in the absence or presence of metronidazole.

Results: Duration of cytotoxin production by C. difficile ribotype 027 was markedly longer than that of ribotype 001 (23 versus 13 days, respectively), but peak toxin titres were similar. During toxin production, total C. difficile ribotype 027 populations had higher proportions of vegetative cells than did ribotype 001 (median 56.33 versus 23.54%). Similarly, total C. difficile ribotype 027 populations remained predominantly as vegetative cells for longer than did ribotype 001 (20 versus 9 days). The effects of metronidazole on C. difficile were markedly less than expected. Titres of C. difficile ribotype 001 cytotoxin were reduced but recurred following metronidazole administration. C. difficile ribotype 027 cytotoxin titres in the distal section of the gut model were unaffected by metronidazole. These observations correlated with poor metronidazole concentrations.

Conclusions: Duration of cytotoxin production by C. difficile ribotype 027 markedly exceeds that of ribotype 001. Sub-optimal gut concentrations of metronidazole, possibly due to inactivation by components of normal gut flora, are associated with continued toxin production. These findings may help to explain the increased severity of symptoms and higher case-fatality ratio associated with infections due to C. difficile ribotype 027.

Key Words: CDI , C. difficile , antibiotic-associated diarrhoea , virulence


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 Antimicrob. Agents Chemother.Home page
S. D. Baines, J. Freeman, and M. H. Wilcox
Tolevamer Is Not Efficacious in the Neutralization of Cytotoxin in a Human Gut Model of Clostridium difficile Infection
Antimicrob. Agents Chemother., May 1, 2009; 53(5): 2202 - 2204.
[Abstract] [Full Text] [PDF]

Home page
 J Antimicrob ChemotherHome page
S. D. Baines, R. O'Connor, K. Saxton, J. Freeman, and M. H. Wilcox
Activity of vancomycin against epidemic Clostridium difficile strains in a human gut model
J. Antimicrob. Chemother., March 1, 2009; 63(3): 520 - 525.
[Abstract] [Full Text] [PDF]

Home page
 Antimicrob. Agents Chemother.Home page
K. Saxton, S. D. Baines, J. Freeman, R. O'Connor, and M. H. Wilcox
Effects of Exposure of Clostridium difficile PCR Ribotypes 027 and 001 to Fluoroquinolones in a Human Gut Model
Antimicrob. Agents Chemother., February 1, 2009; 53(2): 412 - 420.
[Abstract] [Full Text] [PDF]

Home page
 J Antimicrob ChemotherHome page
S. D. Baines, R. O'Connor, K. Saxton, J. Freeman, and M. H. Wilcox
Comparison of oritavancin versus vancomycin as treatments for clindamycin-induced Clostridium difficile PCR ribotype 027 infection in a human gut model
J. Antimicrob. Chemother., November 1, 2008; 62(5): 1078 - 1085.
[Abstract] [Full Text] [PDF]

Home page
 J. Clin. Microbiol.Home page
T. Akerlund, I. Persson, M. Unemo, T. Noren, B. Svenungsson, M. Wullt, and L. G. Burman
Increased Sporulation Rate of Epidemic Clostridium difficile Type 027/NAP1
J. Clin. Microbiol., April 1, 2008; 46(4): 1530 - 1533.
[Abstract] [Full Text] [PDF]

Home page
 J. Clin. Microbiol.Home page
W. N. Fawley, J. Freeman, C. Smith, C. Harmanus, R. J. van den Berg, E. J. Kuijper, and M. H. Wilcox
Use of Highly Discriminatory Fingerprinting to Analyze Clusters of Clostridium difficile Infection Cases Due to Epidemic Ribotype 027 Strains
J. Clin. Microbiol., March 1, 2008; 46(3): 954 - 960.
[Abstract] [Full Text] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.