Emergence of Clostridium difficile ribotype 027 in Korea.
Emergence of Clostridium difficile ribotype 027 in Korea.
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DOI：
10.3343/kjlm.2011.31.3.191
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发表时间：
2011-07
期刊：
影响因子：
--
通讯作者：
Chong Y
中科院分区：
文献类型：
--
作者：
Kim H;Lee Y;Moon HW;Lim CS;Lee K;Chong Y
自 2003 年以来，艰难梭菌感染 (CDI) 显着上升，并与北美和欧洲的高毒力核糖型 027 爆发有关。本研究的目的是确定韩国艰难梭菌分离株中核糖型 027 的流行情况，表征核糖型 027 分离株，并确定感染这些分离株的患者中 CDI 的临床严重程度。 2002 年至 2009 年间，从两家三级医院和一家商业实验室疑似 CDI 患者的粪便标本中总共回收了 1,251 株艰难梭菌。通过 PCR 检测了毒素 A (tcdA)、毒素 B (tcdB) 和二元毒素（cdtA 和 cdtB）基因。 PCR扩增后通过测序检测tcdC基因的突变。对于分子基因分型，我们进行了 PCR 核糖分型、脉冲场凝胶电泳 (PFGE) 和多位点可变数量串联重复分析 (MLVA)。使用 Etest 试纸（AB BioMérieux，瑞典）测定莫西沙星的最低抑制浓度。我们鉴定出7株核糖型为027的菌株。这些菌株与流行株具有相同的tcdC突变，其中6株对莫西沙星耐药。分离株分为 3 种不同的 PFGE 类型和 7 种不同的 MLVA 类型。 7例均为散发病例。艰难梭菌核糖型 027 并不常见，但在韩国已经出现。应密切监测这种核糖型的传播，以避免 CDI 在韩国爆发。
Clostridium difficile infection (CDI) has markedly risen and is associated with hypervirulent ribotype 027 outbreaks in North America and Europe since 2003. The aims of this study were to determine the prevalence of ribotype 027 among C. difficile isolates in Korea, to characterize the ribotype 027 isolates, and to determine the clinical severity of CDI in patients infected with these isolates. A total of 1,251 isolates of C. difficile recovered from stool specimens of suspected CDI patients at two tertiary-care hospitals and one commercial laboratory between 2002 and 2009. Genes for toxin A (tcdA), toxin B (tcdB), and binary toxin (cdtA and cdtB) were detected by PCR. Mutation in the tcdC gene was detected by sequencing after PCR amplification. For molecular genotyping, we performed PCR-ribotyping, pulsed-field gel electrophoresis (PFGE), and multilocus variable-number tandem-repeat analysis (MLVA). Minimum inhibitory concentrations of moxifloxacin were determined using Etest strips (AB bioMérieux, Sweden). We identified 7 isolates as ribotype 027. These isolates had the same tcdC mutation as the epidemic strain, and 6 of them were resistant to moxifloxacin. The isolates were categorized into 3 different PFGE types and 7 different MLVA types. All the 7 cases had occurred sporadically. C. difficile ribotype 027 is uncommon, but it has emerged in Korea. The spread of this ribotype should be closely monitored in order to avoid an outbreak of CDI in Korea.
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