Abstract

In Austria, Clostridium difficile is the leading cause of community-acquired bacterial diarrheal illness and the most frequently identified cause of hospital-acquired diarrhea [1]. It is the causative agent of pseudomembranous colitis. A new emerging hypervirulent strain of C. difficile - PCR ribotype 027 - causes more severe disease and is associated with a higher case-fatality-ratio than other types [2]. This increased virulence is associated with two deletions in a toxin regulator gene resulting in hyperproduction of toxins A and B. The incidence of C. difficile-associated disease (CDAD) due to type 027 is increasing in the United States, Canada, Asia and Europe [2,3,4,5,6]. In Austria, C. difficile type 027 has so far only been discovered once, in a British tourist with pseudomembranous colitis in 2006 [7]. In April 2008, C. difficile PCR ribotype 027 was found in two cases of C. difficile-associated disease affecting Austrian citizens treated in hospitals in Vienna and Graz, Austria. .