Clostridium difficile ribotype 126 in southern Taiwan: A cluster of three symptomatic cases

Yuan Pin Hung, Hsiao Ju Lin, Bo Yang Tsai, Hsiao Chieh Liu, Hsiu Chuan Liu, Jen Chieh Lee, Yi Hui Wu, Mark H. Wilcox, Warren N. Fawley, Po Ren Hsueh, Pei Jane Tsai, Wen Chien Ko*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

22 Citations (Scopus)


Introduction: Several virulent Clostridium difficile clones, designated as polymerase chain reaction (PCR) ribotypes 017, 027, or 078, are well recognized in western countries. However, the ribotype distribution of clinical C.difficile isolates in Taiwan remains unclear. Method: Between 2010 and 2012, we identified three patients with C.difficile-associated diarrhea (CDAD) at a hospital in southern Taiwan. The C.difficile strains isolated from these patients were further characterized by PCR detection of tcdA, tcdB, tcdC, cdtA, and cdtB, toxinotyping, multilocus sequence typing, ribotyping and repetitive-based PCR. Results: Three C.difficile strains harbored tcdCδ39 and belonged to multilocus sequence typing 11 (ST11), toxinotype V, and ribotype 126 (a ribotype 078-like clone). Notably, one patient developed pseudomembranous colitis and recurrent CDAD. These three isolates were noted between January 2012 and June 2012 and were identical, as evidenced by repetitive sequence-based PCR, suggestive of case clustering. Conclusion: A hypervirulent C.difficile clone, ribotype 126, causing pseudomembranous colitis and recurrent CDAD, is present in southern Taiwan.

Original languageEnglish
Pages (from-to)188-192
Number of pages5
Publication statusPublished - 1 Dec 2014
Externally publishedYes

Bibliographical note

Funding Information:
This work was supported by the grants from National Science Council of Taiwan ( NSC 102-2314-B-675-002 , 102-2320-B-006-027 , 102-2628-B-006-015-MY3 ) and Ministry of Health & Welfare, Taiwan ( MOHW103-TDU-B-211-113002 ).

Publisher Copyright:
© 2014 Elsevier Ltd.


  • Clostridium difficile
  • Ribotype 078-like
  • Ribotype 126
  • Taiwan


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