Scientists in the United Kingdom have isolated a new strain of *Clostridium difficile* (sometimes called c. diff.) that produces a highly toxic form of diarrhea that does not respond to commonly used antibiotics such as Cipro (ciprofloxacin).
The strain, NAP1/027, was first seen in an outbreak in hospitals in Quebec, Canada, but has also been associated with diarrheal disease in hospitals as widely spread as the United States, Britain, and the Netherlands. Researchers also obtained bacteria from the new strain in diarrhea in Quebec that was community, not hospital, acquired.
Clostridium difficile is a risk for patients recovering from colorectal surgery and those receiving chemotherapy. It can also result from changes in the healthy intestinal bacterial flora after the use of antibiotics.
The strain produces as much as 16-23 times the dangerous toxins as older c. diff. infection and can be fatal.. In 2003 and the first half of 2004, over 100 people died from the disease in the University of Sherbrooke Hospital near Montreal.
The research team examined bacteria from 124 patients involved in the Quebec epidemic and found that 67% of the hospital-acquired infections were due to the new strain — NAP1/027. However, there was also a 37% NAP1/027 infection rate among those who became sick in the community.
Michael Warny, M.D. and his team reported their findings in the September 24, 2005 issue of *The Lancet.* They offered this interpretation:
The severity of C difficile-associated disease caused by NAP1/027 could result from hyperproduction of toxins A and B. Dissemination of this strain in North America and Europe could lead to important changes in the epidemiology of C difficile-associated disease.
[Read an article about the NAP1/027 strain on *Medpage Today*](http://www.medpagetoday.com/PublicHealthPolicy/PublicHealth/tb1/1788)
[Read the study abstract in *The Lancet.*](http://www.thelancet.com/journals/lancet/article/PIIS014067360567420X/abstract)