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    Larcombe, Sarah Hutton, Melanie L. and Lyras, Dena 2016. Involvement of Bacteria Other Than Clostridium difficile in Antibiotic-Associated Diarrhoea. Trends in Microbiology, Vol. 24, Issue. 6, p. 463.

    Salmona, Maud Jolivet, Sarah Duprilot, Marion Akpabie, Anani Clément Fourati, Slim and Decousser, Jean-Winoc 2016. Laboratory-based strategy using a new marketed polymerase chain reaction assay to manage diarrheic episodes among patients from rehabilitation and long-term care facilities. American Journal of Infection Control, Vol. 44, Issue. 6, p. 716.

    Nicolle, Lindsay E. 2014. Infection prevention issues in long-term care. Current Opinion in Infectious Diseases, Vol. 27, Issue. 4, p. 363.


Concurrent outbreaks with co-infection of norovirus and Clostridium difficile in a long-term-care facility

  • A. LUDWIG (a1) (a2), K. SATO (a3), P. SCHIRMER (a2), A. MANIAR (a4) (a5), C. LUCERO-OBUSAN (a2), C. FLEMING (a6), R. RYONO (a2), G. ODA (a2), M. WINTERS (a2) and M. HOLODNIY (a2) (a7)
  • DOI:
  • Published online: 22 February 2013

We describe an outbreak of simultaneous Clostridium difficile and norovirus infections in a long-term-care facility. Thirty patients experienced acute gastroenteritis, and four had co-infection with identical C. difficile 027 and genotype II.4 New Orleans norovirus strains. Co-occurring infection requires improved understanding of risk factors, clinical impact, and testing strategies.

Corresponding author
*Author for correspondence: A. Ludwig, M.D., Veterans Health Administration, Office of Public Health, 3801 Miranda Avenue (132), Palo Alto, CA 94304, USA. (Email:
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1.E Scallan , Foodborne illness acquired in the United States – major pathogens. Emerging Infectious Diseases 2011; 17: 715.

2.BA Lopman , Clinical manifestation of norovirus gastroenteritis in health care settings. Clinical Infectious Diseases 2004; 39: 318324.

3.CP Johnston , Outbreak management and implications of a nosocomial norovirus outbreak. Clinical Infectious Diseases 2007; 45: 534540.

5.DB Blossom , C McDonald . The challenge posed by reemerging Clostridium difficile infection. Clinical Infectious Diseases 2007; 45: 222227.

6.GE Bignardi , K Staples , N Majmudar . A case of norovirus and Clostridium difficile infection: casual or causal relationship? Journal of Hospital Infection 2007; 67: 198200.

9.RA Luna , Rapid stool-based diagnosis of Clostridium difficile infection by real-time PCR in a children's hospital. Journal of Clinical Microbiology 2011; 49: 851857.

10.P Spigaglia , P Mastrantonio . Molecular analysis of the pathogenicity locus and polymorphism in the putative negative regulator of toxin production (TcdC) among Clostridium difficile clinical isolates. Journal of Clinical Microbiology 2002; 40: 34703475.

11.M Wilcox , W Fawley . Viral gastroenteritis increases the reports of Clostridium difficile infection. Journal of Hospital Infection 2007; 66: 395396.

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Epidemiology & Infection
  • ISSN: 0950-2688
  • EISSN: 1469-4409
  • URL: /core/journals/epidemiology-and-infection
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