Association between production of toxins A and B and types of Clostridium difficile.

One hundred and seventy two strains of Clostridium difficile isolated from 62 patients with antibiotic associated diarrhoea or pseudomembranous colitis were analysed for the production of toxins A and B and typed using 35S-methionine labelling followed by sodium dodecyl sulphate polyacrylamide gel electrophoresis (SDS-PAGE). There was a correlation between production of toxins A and B and the type of C difficile. One hundred and forty four of 172 strains were either high or low producers of both toxins. Toxins were not detected in 28 of 172 strains. Types A and Y were consistently non-toxin producers; types B and E were high toxin producers. Type X, the epidemic strain, showed variable toxin production. Symptoms of 49 patients with haematological malignant pathology who were part of a documented outbreak of antibiotic associated diarrhoea, were analysed in relation to toxin production and type of the clinical strains isolated. In general, there was a correlation between symptoms of antibiotic associated diarrhoea, the type of C difficile, and its potential for producing toxins.