The first identification of the epidemic Clostridioides difficile PCR ribotype 027 strain in Brazil: a case report of colitis in a patient from a public hospital in Rio de Janeiro

Infections with epidemic polymerase chain reaction ribotype (RT) 027 strains are characterized by higher mortality and morbidity and have caused outbreaks in North America and Europe. To date, RT027 isolates have not conclusively been shown in Brazil, although other clade 2 isolates have been identified. This case report discusses a 60-year-old patient, with medical history of colon adenocarcinoma, who developed a severe Clostridioides difficile infection (CDI) after chemotherapy, but showed a full recovery. The infection was caused by a C. difficile RT027 strain, demonstrating conclusively for the first time that this RT is present in Brazil. This case emphasizes the need for early CDI diagnosis of C. difficile in Brazilian hospitals for prompt treatment and notification.