Ribotypes and New Virulent Strains Across Europe

  • Jeanne Couturier
  • Kerrie Davies
  • Cécile Gateau
  • Frédéric Barbut
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 1050)


Clostridium difficile is a major bacterial cause of post-antibiotic diarrhoea. The epidemiology of C. difficile infections (CDI) has dramatically changed since the early 2000s, with an increasing incidence and severity across Europe. This trend is partly due to the emergence and rapid worldwide spread of the hypervirulent and epidemic PCR ribotype 027. Profiles of patients with CDI have also evolved, with description of community-acquired (CA) infections in patients with no traditional risk factors for CDI. However, recent epidemiological studies indicated that some European countries have successfully controlled the dissemination of the 027 clone whereas other countries recently reported the emergence of other virulent or unusual strains. The aims of this review are to summarize the current European CDI epidemiology and to describe the new virulent C. difficile strains circulating in Europe, as well as other potential emerging strains described elsewhere. Standardized typing methods and surveillance programmes are mandatory for a better understanding and monitoring of CDI in Europe.


C. difficile PCR ribotypes Emerging strains European epidemiology Binary toxin 


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Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  • Jeanne Couturier
    • 1
    • 2
  • Kerrie Davies
    • 3
  • Cécile Gateau
    • 1
  • Frédéric Barbut
    • 1
    • 2
  1. 1.National Reference Laboratory for C. difficile, Hôpital Saint-AntoineParisFrance
  2. 2.Université Paris Descartes, Faculté de PharmacieParisFrance
  3. 3.Healthcare Associated Infections Research GroupLeeds Teaching Hospitals NHS Trust and University of LeedsLeedsUK

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