Update of Clostridium difficile infection due to PCR ribotype 027 in Europe, 2008

Since the emergence of a new virulent strain of Clostridium difficile characterised as toxinotype III, North American pulsedfield type 1 (NAP1), restriction-endonuclease analysis group type BI and PCR-ribotype 027 (Type 027), multiple outbreaks have been reported in North America and Europe [1-9]. The increased virulence of C. difficile Type 027 is thought to be associated with a 1 base pair deletion at position 117 of the tcdC gene which leads to an increased or prolonged production of toxins A and B, and possibly the production of a binary toxin [1-3]. However, these virulence factors are not unique for Type 027 and are also present in other PCR ribotypes.