First Australian isolation of epidemic Clostridium difficile PCR ribotype 027

Thomas V Riley, Sarah Thean, Graham Hool and Clayton L Golledge
Med J Aust 2009; 190 (12): 706-708.

We report the first isolation in Australia of a hypervirulent epidemic strain of Clostridium difficile, PCR ribotype 027. It was isolated from a 43-year-old woman with a permanent ileostomy, who appears to have been infected while travelling in the United States. The isolate was positive for toxin A, toxin B and binary toxin, and resistant to fluoroquinolone antimicrobials, and had characteristic deletions in the tcdC gene. All diagnostic laboratories and health care facilities in Australia should now be on high alert for this organism.

A 43-year-old woman was admitted to a Perth hospital at the end of October 2008. She had been diagnosed with ulcerative colitis 8 years previously and, in 2002, underwent proctocolectomy and permanent ileostomy. Since then, she had experienced a number of stoma problems requiring surgical repair or local revision. On this occasion, computed tomography (CT) showed a parastomal small-bowel herniation, with a normal appearance on ileoscopy. The herniation was repaired with intraperitoneal mesh.

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  • Thomas V Riley1,2
  • Sarah Thean2
  • Graham Hool3
  • Clayton L Golledge2

  • 1 Microbiology and Immunology, University of Western Australia, Perth, WA.
  • 2 Division of Microbiology and Infectious Diseases, PathWest Laboratory Medicine (WA), Queen Elizabeth II Medical Centre, Perth, WA.
  • 3 Perth, WA.



We are grateful to Professor Vincent Caruso (St John of God Hospital Pathology, Western Australia) for providing the photomicrographs.

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