1887

Abstract

As part of the follow-up investigations associated with an outbreak of severe illness and death among illegal injecting drug users during 2000, 43 cultures of type A, 40 type A and 6 isolates of were characterised by amplified fragment length polymorphism (AFLP) analysis. Among the 43 isolates, 23 different AFLP profiles were detected. The same AFLP profile was detected in isolates from 18 drug users investigated during 2000 from Scotland, England, the Republic of Ireland and Norway and a wound from a patient in 2000 who was not identified as a drug user. Unique AFLP profiles were obtained from four drug users from England and the Republic of Ireland, 10 historical isolates from culture collections, an isolate from food (1989) and three isolates from wounds (1995, 1991, 1988). The 40 isolates were from 13 drug users, the contents of one syringe and two samples of heroin. Sixteen AFLP types of were distinguished and there was little evidence for commonality among the isolates. The AFLP types of from heroin differed and were unique. Six isolates of were from four drug users and two samples of heroin. Four different AFLP patterns were distinguished. Three AFLP types were isolated from four drug users. isolates from an aspirate and a heroin sample collected from the same drug user were identical, and were also indistinguishable from an isolate from a groin infection in a second drug user. The AFLP type of the isolate from a second and unrelated heroin sample was unique. The AFLP results showed no or very limited evidence for commonality between the different isolates of and . In marked contrast, the isolates from the majority of the drug users during 2000 were homogeneous, suggesting a common source or clonal selection of a type, or both, which either had an adaptive advantage in spore germination, survival or growth following the drug preparation and the injection procedure, or produced a more severe clinical presentation.

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2002-11-01
2024-04-19
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References

  1. Brettle RP. Infection and injection drug use. J Infect 1992; 25:121–131
    [Google Scholar]
  2. Horsburgh CR, Anderson JR, Boyko EJ. Increased incidence of infections in intravenous drug users. Infect Control Hosp Epidemiol 1989; 10:211–215 [CrossRef]
    [Google Scholar]
  3. Peat M, Budd J, Burns SM, Robertson R. Audit of blood borne virus infections in injecting drug users in general practice. Commun Dis Public Health 2000; 3:244–246
    [Google Scholar]
  4. Martin C, Schaller MD, Lepori M, Liaudet L. Cranial nerve palsies and decending paralysis in a drug abuser resulting from wound botulism. Intensive Care Med 1999; 25:765–769 [CrossRef]
    [Google Scholar]
  5. Werner SB, Passaro D, McGee J, Schechter R, Vugia DJ. Wound botulism in California, 1951–1998: recent epidemic in heroin injectors. Clin Infect Dis 2000; 31:1018–1024 [CrossRef]
    [Google Scholar]
  6. Jensenius M, Lovstad RZ, Dhaenens G, Rorvik LM. A heroin user with a wobbly head. Lancet 2000; 356:1160 [CrossRef]
    [Google Scholar]
  7. Talan DA, Moran GJ. Tetanus among injecting drug users: California 1997. Ann Emerg Med 1998; 32:385–386 [CrossRef]
    [Google Scholar]
  8. Ringertz SH, Hoiby EA, Jensenius M. et al. Injectional anthrax in a heroin skin-popper. Lancet 2000; 354:1574–1575
    [Google Scholar]
  9. Bloomfield SF, Arthur M. Mechanisms of inactivation and resistance of spores to chemical biocides. Soc Appl Bacteriol Symp Suppl 1994; 23:91S–104S
    [Google Scholar]
  10. Christie B. Gangrene bug ‘‘killed 35 heroin users’'. BMJ 2000; 320:1690 [CrossRef]
    [Google Scholar]
  11. Anon Serious unexplained illness among drug injectors. Commun Dis Rep CDR Wkly 2000; 24:195
    [Google Scholar]
  12. Anon Clostridium novyi is likely cause of ‘serious unexplained illness’ as cases continue to be reported. Commun Dis Rep CDR Wkly 2000; 24:213–216
    [Google Scholar]
  13. Anon Update: Clostridium novyi and unexplained illness among injecting drug users: Scotland, Ireland and England April–June 2000. MMWR Morb Mortal Wkly Rep 2000; 49:543–544
    [Google Scholar]
  14. Ryan JM, Paul J, Curtis S, Patel NK. Clostridium novyi infection: a fatal association with injecting drug users. Emerg Med J 2001; 18:138–139 [CrossRef]
    [Google Scholar]
  15. McGuigan CC, Penrice GM, Black M. et al. Outbreak of infection with Clostridium novyi and other sporulating bacteria in Scottish injecting drug users. J Med Microbiol 2002; 51:971–977
    [Google Scholar]
  16. Hood J, Horne G, Sweeney G, Baird K. Third case of wound botulism in an injecting drug user. SCIEH Weekly Report 2000; 34:200
    [Google Scholar]
  17. Mulleague L, Bonner SM, Samuel A. et al. Wound botulism in drug addicts in the United Kingdom. Anaesthesia 2001; 56:120–123 [CrossRef]
    [Google Scholar]
  18. Dancer SJ, McNair D, Finn P, Kolstot AB. Bacillus cereus cellulitis from contaminated heroin. J Med Microbiol 2002; 51:278–281
    [Google Scholar]
  19. Athwal BS, Gale AN, Brett MM, Youl BD. Wound botulism in UK. Lancet 2000; 356:2001–2002 [CrossRef]
    [Google Scholar]
  20. Khan M, Chay S, Bonner S, Brett M. Wound botulism in injecting drug users: second case in England. Eurosurveillance Weekly 200022June
    [Google Scholar]
  21. Zabeau M, Vos P. Selective restriction fragment amplification: a general method for DNA fingerprinting. Munich, European Patent Office No: EP 0534–858 1993
    [Google Scholar]
  22. Vos P, Hogers R, Bleeker M. et al. AFLP: a new technique for DNA fingerprinting. Nucleic Acids Res 1995; 23:4407–4414 [CrossRef]
    [Google Scholar]
  23. Janssen P, Coopman R, Huys G. et al. Evaluation of the DNA fingerprinting method AFLP as a new tool in bacterial taxonomy. Microbiology 1996; 142:1881–1893 [CrossRef]
    [Google Scholar]
  24. Gibson JR, Slater E, Xerry J, Tompkins DS, Owen RJ. Use of an amplified-fragment length polymorphism technique to fingerprint and differentiate isolates of Helicobacter pylori . J Clin Microbiol 1998; 36:2580–2585
    [Google Scholar]
  25. Fry NK, Bangsborg JM, Bernander S. et al. Assessment of intercentre reproducibility and epidemiological concordance of Legionella pneumophila serogroup 1 genotyping by amplified fragment length polymorphism analysis. Eur J Clin Microbiol Infect Dis 2000; 19:773–780 [CrossRef]
    [Google Scholar]
  26. McLauchlin J, Ripabelli G, Brett MM, Threlfall EJ. Amplified fragment length polymorphism (AFLP) analysis of Clostridium perfringens for epidemiological typing. Int J Food Microbiol 2000; 56:21–28 [CrossRef]
    [Google Scholar]
  27. Ripabelli G, McLauchlin J, Mithani V, Threlfall EJ. Epidemiological typing of Bacillus cereus by amplified fragment length polymorphism. Lett Appl Microbiol 2000; 30:358–363 [CrossRef]
    [Google Scholar]
  28. Maagaard A, Hermansen N, Heger B. et al. Serious systemic illness among injecting drug users in Europe: new case in Oslo. Euroserveillance Weekly 200014September
    [Google Scholar]
  29. Holdeman LV, Moore WEC, Cato EP. eds Anaerobe laboratory manual, 4th edn. Blacksburg, VA: Virginia Polytechnic Institute and State University; 1977
    [Google Scholar]
  30. Hutson RA, Thompson DE, Collins MD. Genetic interrelationships of saccharolytic Clostridium botulinum types B, E and F and related clostridia as revealed by small-subunit rRNA gene sequences. FEMS Microbiol Lett 1993; 108:103–110 [CrossRef]
    [Google Scholar]
  31. Berry PR, Gilbert RJ. Clostridium perfringens type A food poisoning. In Duerden BI, Draser BS. eds Anaerobes in human disease London, Arnold: 1991362–371
    [Google Scholar]
  32. Stringer MF, Turnbull PCB, Gilbert RJ. Application of serological typing to the investigation of outbreaks of Clostridium perfringens food poisoning, 1970–1978. J Hyg 1980; 84:443–456 [CrossRef]
    [Google Scholar]
  33. Stringer MF, Watson GN, Gilbert RJ. Clostridium perfringens type A: serological typing and methods for the detection of enterotoxin. In Corry JEL, Roberts D, Skinner FA. eds Isolation and identification methods for food poisoning organisms. Society for Applied Bacteriology Technical Series no 17 London: Academic Press; 1982111–135
    [Google Scholar]
  34. Stringer MF, Watson GN, Gilbert RJ. et al. Faecal carriage of Clostridium perfringens . J Hyg 1985; 95:277–288 [CrossRef]
    [Google Scholar]
  35. Fach P, Popoff MR. Detection of enterotoxigenic Clostridium perfringens in food and faecal samples with a duplex PCR and the slide latex agglutination test. Appl Environ Microbiol 1997; 63:4232–4236
    [Google Scholar]
  36. Parry JM, Turnball PCB, Gibson JR. A colour atlas of Bacillus species London: Wolf Medical Publications; 1983
    [Google Scholar]
  37. Taylor AJ, Gilbert RJ. Bacillus cereus food poisoning: a provisional serotyping scheme. J Med Microbiol 1975; 8:543–550 [CrossRef]
    [Google Scholar]
  38. Gilbert RJ, Parry JM. Serotypes of Bacillus cereus from outbreaks of food poisoning and from routine foods. J Hyg 1977; 78:69–74 [CrossRef]
    [Google Scholar]
  39. Hatheway CL, Johnson EA. Clostridium : the spore-bearing anaerobes. In Balows A, Duerden BI. eds Topley and Wilson's microbiology and microbial infections. , 9th edn. vol 2 Systematic bacteriology London, Arnold: 1998731–782
    [Google Scholar]
  40. Koneman EW, Davis MA. Postmortem bacteriology.III. Clinical significance of microorganisms recovered at autopsy. Am J Clin Pathol 1974; 61:28–40
    [Google Scholar]
  41. McGuigan C, Roworth M. Clostridium novyi type A infection: a sporadic fatal case. Scand J Infect Dis 2002; 34:209–211 [CrossRef]
    [Google Scholar]
  42. McLaughlin J, Mithani V, Bolton FJ. et al. An investigation into the microflora of heroin. J Med Microbiol 2002; 51:1001–1008
    [Google Scholar]
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