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Previous Volume 354:1199-1203 March 16, 2006 Number 11 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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To the Editor: The two articles by McDonald et al.¹ and Loo et al.² (Dec. 8 issue) document the spread of NAP1 Clostridium difficile isolates of toxinotype III in North America. This emerging strain is thought to be more virulent than earlier strains, perhaps related to its increased capacity to produce toxins.³ However, NAP1 is not solely responsible for the increasing prevalence and severity of C. difficile–associated disease. At our hospital, the rate of C. difficile–associated disease has greatly increased, and we have documented substantial treatment failure and mortality.⁴ Only 18 percent of isolates have been of the . . . [Full Text of this Article]

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